Learning objectives
Upon completion of this chapter, you should be able to:
1.
Describe the underlying pathophysiology involved in obstructive pulmonary disease and correlate this
information with the presenting signs and symptoms.
2.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse
reactions and important drug–drug interactions associated with drugs used to treat lower respiratory tract
disorders.
3.
Discuss the use of drugs used to treat obstructive pulmonary disorders across the lifespan.
4.
Compare and contrast the prototype drugs used to treat obstructive pulmonary disorders with other agents
in their class and with other classes of drugs used to treat obstructive pulmonary disorders.
5.
Outline the care considerations, including important teaching points, for people receiving drugs used to treat
obstructive pulmonary disorders.
Test your current knowledge of drugs acting on the lower respiratory tract with a PrepU Practice Quiz!
Glossary of key terms
bronchodilator:
medication used to facilitate respirations by dilating the airways; helpful in symptomatic relief or prevention of
bronchial asthma and bronchospasm associated with chronic obstructive pulmonary disease
Cheyne–Stokes respiration:
abnormal pattern of breathing characterised by apnoeic periods followed by periods of tachypnoea;
may reflect delayed blood flow through the brain
leukotriene receptor antagonists:
drugs that selectively and competitively block or antagonise receptors for the production of
leukotrienes D
4
and E
4
, components of slow-reacting substance of anaphylaxis (SRSA)
mast cell stabiliser:
drug that works at the cellular level to inhibit the release of histamine (released from mast cells in response to
inflammation or irritation) and inflammatory mediators
sympathomimetics:
drugs that mimic the effects of the sympathetic nervous system
xanthines:
naturally occurring substances, including caffeine and theophylline, that have a direct effect on the smooth muscle of the
respiratory tract, both in the bronchi and in the blood vessels
Drugs acting on the
lower respiratory tract
55
BRONCHODILATORS/
ANTIASTHMATICS
Xanthines
aminophylline
caffeine
theophylline
Sympathomimetics
adrenaline
eformoterol
ephedrine
indacaterol
salbutamol
salmeterol
terbutaline
Anticholinergics
ipratropium
tiotropium
DRUGS AFFECTING
INFLAMMATION
Inhaled steroids
beclomethasone
budesonide
ciclesonide
fluticasone
Simulation-based learning
On completion of the chapter, consider the scenario of Jennifer Hoffman (Part 1) who arrives in the emergency room
with respiratory distress. Continue to Part 2. Consider the medication management of Jennifer’s condition throughout
her episode of care, as it relates to your learning in this chapter.
Then, work through the scenarios of Vincent Brody (Parts 1 and 2) and consider how the concepts learnt in this
chapter relating to airway medication management apply to his case. What learning can be applied?
