ࡱ> bdc:( / 00DArialngs||/0z[ 0D[SOalngs||/0z[ 0 DTahomags||/0z[ 00DWingdings||/0z[ 0 A .  @n?" dd@  @@`` LJ      0AA@83ʚ;ʚ;g4[d[dz[ 0ppp@ <4dddd@ 0|X/ 80___PPT10 ppm'Drugs Affecting the Respiratory System '  OVERVIEW  Drugs can be delivered to the lungs by inhalation, oral, or parenteral routes. Inhalation is often preferred because the drug is delivered directly to the target tissue--the airways--and is effective in doses that do not cause significant systemic side effects. $< DRUGS USED TO TREAT ASTHMA ( Asthma is a chronic disease that affects 4 to 5% of the U.S. population, or approximately 10 million patients. The disease is characterized by episodes of acute bronchoconstriction causing shortness of breath, cough, chest tightness, wheezing and rapid respirations. $WRole of inflammation in asthma DAirflow obstruction in asthma is due to bronchoconstriction resulting from contraction of bronchial smooth muscle, inflammation of the bronchial wall, and increased mucous secretion. may be related to recent exposure to allergens, inhaled irritants leading to bronchial hyperactivity and inflammation of the airway mucosa. EZE$( Adrenergic agonists Inhaled adrenergic agonists with beta-2 activity are the drugs of choice for mild asthma, that is, in patients showing only occasional, intermittent symptoms beta-2 Agonists are potent bronchodilators that relax airway smooth muscle directly. Short acting drugsMost clinically useful beta-agonists have a rapid (15 to 30 minutes) onset of action and provide relief for 4 to 6 hours. They are used for symptomatic treatment of bronchospasm and as "rescue agents" to combat acute bronchoconstriction. 6 ( Long acting drugsSalmeterol xinatoate is a chemical analog of albuterol, but differs by having a long lipophilic side chain that increases the affinity of the drug for the beta-adrenoceptor. d    A  Corticosteroids Inhaled glucocorticoids are the drugs of first choice in patients with moderate to severe asthma who require inhalation of beta-adrenergic agonists more than once daily $ Actions on lungSteroids have no direct effect on the airway smooth muscle. Instead, inhaled glucocorticoids decrease the number and activity of cells involved in airway inflammation-macrophages, eosinophils, and T-lymphocytes. 6MX   Pharmacokinetics Inhaled drugs: has markedly reduced the need for systemic corticosteroid treatment. However, a few precautions are required for successful inhalation therapy. A large fraction (typically 80 to 90%) of inhaled glucocorticoids is deposited in the mouth and pharynx, or is swallowed  $8  PharmacokineticsSystemic steroids: Patients with severe exacerbation of asthma (status asthmaticus) may require intravenous admin- istration of methylprednisolone or oral prednisone t4     !            &DRUGS USED TO TREAT ALLERGIC RHINITIS ''(&Rhinitis is an inflammation of the mucous membranes of the nose, and is characterized by sneezing, nasal itching, watery rhinorrhea and congestion. $y  &Antihistamines (H1 receptor blockers) ''(&QAntihistamines are the most frequently used agents in the treatment of sneezing and watery rhinorrhea associated with allergic rhinitis. H1-Histamine receptor blockers, such as diphenhydramine, chlorpheniramine, Ioratadine, terfenadine and astemizole are useful in treating the symptoms of allergic rhinitis caused by histamine release. ~[ L   W alpha-Adrenergic agonists alpha-Adrenergic agonists ("nasal decongestants") such as phenylephrine, constrict dilated arterioles in the nasal mucosa and reduce airway resistance. $: QCorticosteroids Corticosteroids are effective when administered as nasal sprays. Topical steroids may be more effective than systemic antihistamines in relieving the nasal symptoms of both allergic and nonallergic rhinitis. 6 ` ` 33PP` 13` 3333` Q_{` 333fpKNāvI` j@v۩ῑ΂H>?" dd@,?n<d@ `7 `2@`7``2 n?" dd@   @@``PR    @ ` ` p>>  z  H (  H H <P" H"0C  H Td" H"0C  H <d"U_ H"0C  H Td">& H"0C  H N"P H"0C  H <"p H"0C  H C x?d?"bUv H"0C   H <P #" `   LUSQdkYkHrh7h_     H 0 "   8USQdkYkHre,g7h_ ,{N~ ,{ N~ ,{V~ ,{N~    H 6 "]}  b*0  H 6@) "] }   d*0  H 6D2 "]T}  d*0B H s *޽h ? 333380___PPT10.(г%  Blends   0 ( 0L (  LT + L "+bb P@ L# "Dwoh L s *"PP L Bd" P@bb P 0  L# "Nyh L s *"P   L Bd"P 0 z  L <" a*h  L s *"  L  f?d?"+)  L BlA ?#" ` p  LUSQdkYkHrh7h_    L 0D " `    NUSQdkYkHroRh7h_  L 6G "`p   f* 0 L 6XS "`p   h*"0 L 6] "`  h*"0B L s *޽h ? 333380___PPT10.(г%*  *(  x  c $&q L p q r  S &q L `   q H  0޽h ? 3380___PPT10.GUZ0  0 0(   x  c $) H    x  c $& H   H  0޽h ? 3380___PPT10.`l_0  @0(  x  c $sq H   q x  c $tq H  q H  0޽h ? 3380___PPT10.0'0  P0(  x  c $ |q H   q x  c $|q H  q H  0޽h ? 3380___PPT10.`0  `0(  x  c $q H   q x  c $q H  q H  0޽h ? 3380___PPT10.p0  p0(  x  c $q H   q x  c $q H  q H  0޽h ? 3380___PPT10.=F0   0(   x  c $q H   q x  c $q H  q H  0޽h ? 3380___PPT10.m0  $0(  $x $ c $0q H   q x $ c $q H  q H $ 0޽h ? 3380___PPT10.ٯ0  (0(  (x ( c $?@ABrMNOPQ/012345678\HIJKL !"#$%&'()aCDEFGq>?@AB [/0123456789:;<=` !"#$%&'()*+,-.p[ g'-- @ !s E--'--- @ !d"---- @ !d%-- -- @ !d+--"""-- @ !d0--$$$-- @ !d6--&&&-- @ !d=--(((-- @ !dB--***-- @ !dH--,,,-- @ !dM--...-- @ !dT--000-- @ !d\--222-- @ !d`--444-- @ !dh--666-- @ !dn--888-- @ !ds--:::-- @ !dz--<<<-- @ !d-->>>-- @ !d--@@@-- @ !d--BBB-- @ !d--DDD-- @ !d--FFF-- @ !d--HHH-- @ !d--JJJ-- @ !d--LLL-- @ !d--NNN-- @ !d--PPP-- @ !d--RRR-- @ !d--TTT-- @ !d--VVV-- @ !d--XXX-- @ !d--ZZZ-- @ !d--\\\-- @ !d--^^^-- @ !d--```-- @ !d--bbb-- @ !d--ddd-- @ !d--fff-- @ !d--hhh-- @ !d--jjj-- @ !d --lll-- @ !d--nnn-- @ !d--ppp-- @ !d--rrr-- @ !d!--ttt-- @ !d(--vvv-- @ !d---xxx-- @ !d3--zzz-- @ !d:--|||-- @ !d>--~~~-- @ !dE---- @ !dI---- @ !dP---- @ !dT---- @ !d\---- @ !d`---- @ !dg---- @ !dl---- @ !dr---- @ !dw---- @ !d}---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d$---- @ !d,---- @ !d3---- @ !d;---- @ !dB---- @ !dJ---- @ ! dQ---- @ !d\---- @ !dd---- @ ! dk---- @ !dv---- @ ! d~---- @ ! d---- @ ! d---- @ !d---- @ !d---- @ ! d---- @ ! d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d---- @ !d0---- @ !dF---- @ !!d`---- @ !)d---- @ !.d---'@Tahoma-. 33%2 vDrugs Affecting the )""%!""# ."System-@Tahoma-. 33$2 EvRespiratory System & " !# 3.-՜.+,0P     Ļʾojd0X!A ArialTahoma WingdingsBlends(Drugs Affecting the Respiratory System OVERVIEW DRUGS USED TO TREAT ASTHMA Role of inflammation in asthma Adrenergic agonists Short acting drugsLong acting drugsCorticosteroids Actions on lungPharmacokinetics Pharmacokinetics'DRUGS USED TO TREAT ALLERGIC RHINITIS 'Antihistamines (H1 receptor blockers) alpha-Adrenergic agonists Corticosteroids  õʾĸģ õƬ_ Xweiwei  !"#$%&'()*+,./0123456789:;<=>?@ABCDEFGHIJKLMNPQRSTUVXYZ[\]^aRoot EntrydO)Current UserWSummaryInformation(-CPowerPoint Document(0XDocumentSummaryInformation8ORoot EntrydO)E}De@Current User8SummaryInformation(-CPowerPoint Document(0X  !"#$%&'()*+,./0123456789:;<=>?@ABCDEFGHIJKLMNPQRSTUVa _ X΢û_o(u7b