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Cheatography

*B-Agonists Drugs *Anticholinergic Drugs *Xanthine (Methylxanthine) Drugs

B-Agonists

sympat­hom­imetic bronch­odi­lator
for acute attacks
reduce airway constr­iction and restore normal airflow
Stimulate β2-adr­energic receptors throughout the lungs

3 types

Nonsel­ective (a, B1, B2)
epinep­hrine; acute
 
longer acting
Nonsel­ective B-adre­nergic (B1, B2)
isopro­terenol
Selective (B2)
salbutamol

Mechanism of Action

activation of B2 receptors activates cAMP
bronch­odi­lation and airflow

Indica­tions

bronch­ospasms (asthma, bronch­itis, other pulmonary disease)
hypote­nsion and shock
uterine relaxation (prevent premature labour)
hyperk­alemia (K+ into the cell)

contra­ind­ica­tions

known drug allergy
uncont­rolled cardiac dysrhy­thmias
risk of stroke (vasoc­ons­tri­ctive action)

Adverse Effects

Nonsel­ective (a, B1, B2) Epinep­hrine
insomnia, restle­ssness, anorexia (long term), headache, hyperg­lycemia, tremor, cardiac stim.
Nonsel­ective B-adre­nergic (B1, B2) isopro­terenol
cardiac stim., tremor, anginal pain, headache, hypote­nsion
Selective (B2) albute­rol­/sa­lbu­tamol
hypote­nsi­on/­hyp­ert­ension, tremor, headache

Intera­ctions

risk for hypert­ension
risk for cardiac toxicity
require an adjustment to antihy­per­gly­cemic drugs
 

Antich­oli­nergic Drugs

-pium
ipratr­opium (Atrovent)
tiotropium (Spriva)

Mechanism of Action

ACh causes bronchial constr­iction and narrowing of airways
bind to ACh receptors
ACh to receptors
slow and prolonged
bronch­oco­nst­riction

Adverse Effects

dry mouth or throat
nasal congestion
heart palpit­ations
GI distress
headache
coughing
anxiety
 

Xanthine Deriva­tives (Methy­lxa­nthine)

natural xanthines: alkaloids, caffeine, theobr­omine, and theoph­ylline
theoph­ylline only used a bronch­odi­lator
synthe­thic: aminop­hylline (phyll­oco­ntin) & oxtrip­hylline

Mechanism of Action

cAMP by phosph­odi­est­erase (enzyme that breaks down cAMP)
SM relaxa­tion, bronch­odi­lation, airflow

Drug Effects

contra­cti­lity, HR CO & blood flow to kidney
stimulate cardio and CNS system

Indica­tions

asthma, chronic bronch­itis, & emphysema (COPD)
mild to moderate cases of acute asthma
adjunct drug for COPD

Contra­ind­ica­tions

known drug allergy
uncont­rolled cardiac dysrhy­thmias
seizure disorders
hypert­hyr­oidism
peptic ulcers

Adverse Effects

nausea, vomiting, anorexia
GI reflux during sleep
tachyc­ardia, extra systole, palpit­ations, ventri­cular dysrhy­thmias
transient urination

Intera­ctions

not used often due to many drug intera­ctions
Several drugs increase serum levels of xanthine deriva­tives
used with sympat­hom­imetics can increase and CNS stimul­ation
St. John's wort and cigarette smoking enhance rate of metabolism
charcoal broiling & keto diet xanthine effect
 

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