Drug used to treat Asthma 1- Atropine: M-anticholinergic drug; Cause bronchodilation Can be used for asthmatic attack 2- Salbutamol:

highly selective 2-agonist; Causes bronchodilation by stimulation of 2-receptor Can be used for asthmatic attack 3- Theophylline: inhibits phosphodiesterase & ADH, block adenosine receptor, inhibits release of histamine from mast cells Can be used for asthmatic attack 4- Sodium Chomoglycate: inhibit degradation of mast cells & inhibit release of histamine Can be used for asthmatic attack (only prevent) For treatment of Asthmatic attack used: 1- M-anticholinergic drugs (Atropine) 2- 2-adrenergic drugs (Isoprenalin, Orciprenalin, Salbutamol) 3- Theophylline, Aminophylline (Bronchodilators) 4- Glucocorticoids (Hydrocortisone, Beclomethasone) For treatment of Asthma (only to prevent asthmatic attack) 1- Sodium Chomoglycate cells 2- Ketotifen 3- Zafirlukast selective, reversible inhibitors of leukotrien 1 receptor Leukolyties Bromhexine Both drugs can use in chronic bronchitis & bronchoectasis Bronhexine: 1- Potent mucolytic & mucokinetic 2- Induces bronchial secretion 3- Depolymerises mucopolysaccharides directly (as well as by liberating lysosomal enzymes) Side effects: rhinorrhoea, lacrymation Acetyl Cysteine: 1- Open disulfide bonds in mucoproteins present in sputum Acetyl Cysteine They block histamine release by inhibit degranulation of mast

Aiman Tymer 2012

2- Administrated directly into respiratory tract by aerosol Side effects: irritating to mucosa, often induces bronchoconstriction Mucokinetics 1- Direct acting: Potassium iodide Potassium iodide: 1- Secreted by bronchial glands & in this process irritates them 2- volume of secretion 3- Also gastric irritant, acts reflexly as well Use: Acute & chronic bronchitis Adverse effects: acne, flare, foetal infantile goiter & hypothyroidism (not use in pregnant) hypothyroidism, goiter Specacuana (Syrup Specacuananae): Gastric irritant reflexly enhance bronchial secretion & sweating Use: often in combination with antitussives Adverse effects: nausea Antitussive 1- Cough center suppressants: Opioids: Codeine, Ethylmorphine Non-opioids: Oxeladin 2- Cough peripheri suppressants: Liberin Codeine: 1- Its an opium-alkaloid, qualitatively similar to but less potent the morphine 2- Its more selective for cough center 3- It suppresses cough about 6 hours 4- Its antitussive action is blocked by opioid antagonist: Naloxone Adverse effects: constipation, respiratory depression, drowsiness, dependence Ethylmorphine: similar to codeine Oxeladin: 1- Synthetic centrally acting antitussive agent 2- In contrast opioids it has not respiratory depression & dependence (& others side effect of opioids) Liberin: prolonged use 2- Reflexly acting: Specacuana

Aiman Tymer 2012

1- Taken orally 2- It acts on sensory nerve ending in the lungs to reduce afferent tussal impulses 3- It has also been shown to depress cough center [!!It has mixed action!!] 4- It is considered to been specially useful in cough of chronic bronchitis, emphysema, asthma & tuberculosis 5- Does not depress respiration 6- Has no constipation action Histamine Has 2 type of receptors: H1 & H2 1- Stimulating of H2 receptor causes: a- dilation of smaller blood vessels (arterioles, capillaries & venules) b- heart rate & cardiac output c- fall in blood pressure (especially due to large doses) d- capillary permeability due to separation of endothelial cells exudation of plasma e- bronchoconstriction 2- Stimulating of H2 receptor causes gastric acid secretion H1 antagonist (anti histamine) 1- Highly sedative: Promothaxine Promothaxine: 1- It has H1 receptor & causes CNS depression 2- It has anti allergic action (many manifestation of immediate hypersentivity & suppression) 3- It prevents anaphylactic fall in BP & bronchoconstriction 4- It control vomiting of pregnancy & other causes 5- It reduces tremor, rigidity & diarrhoea of parkinsonism because has anti muscarinic action 6- Can use in preventing motion sickness Adverse effects: sedation, lack of concentration, light headiness, headache, fatigue, dry mouth, urinary retention, blurring vision, epigastria distress Loratadine: 1- It has long acting selective H1 antagonist 2- Its non toxic (without adverse effects specifically for Promothazine) 2- Non-sedative: Loratadine

Aiman Tymer 2012