محاضرة ٤

• Drugs used to treat chronic obstructive pulmonary disease (COPD)

  • Inhaled bronchodilators
  • Anticholinergic agents (ipratropium and tiotropium)
  • β2-adrenergic agonists (albuterol, salmeterol)
  • Corticosteroids
• Corticosteroids


  They are the foundation of therapy for COPD. They increase airflow, alleviate symptoms, and decrease exacerbation of disease.
• Drugs used to treat allergic rhinitis

  • Oral antihistamines with decongestants
  • Antihistamines (H1-receptor blockers)
  • α-Adrenergic agonists
  • Corticosteroids
  • Cromolyn
  • Leukotriene antagonists
• Antihistamines (H1-receptor blockers)


  Diphenhydramine (alermine), chlorpheniramine, loratadine and fexofenadine (no sedation), are useful in treating the symptoms of allergic rhinitis caused by histamine release.
• α-Adrenergic agonists


  Short-acting (nasal decongestant) like phenylephrine, which constricts the dilated arterioles in the nasal mucosa and reduces the airway resistance. Longer-acting: oxymetazoline is also available.
• The α-agonist nasal formulations should be used no longer than 3 days due to the risk of rebound nasal congestion.
• Administration of oral α-adrenergic agonist formulations results in longer duration of action, but also increased systemic effects.
• Corticosteroids


  • beclomethasone, budesonide, fluticasone sprays
• Cromolyn


  It should be taken at least 1 to 2 weeks prior to allergen exposure to get a good therapeutic effect. Nasal formulation of cromolyn is available.
• Leukotriene antagonists


  They (Montelukast) indicated for treatment of seasonal and perennial allergic rhinitis.
• Drugs used to treat cough

  • Codeine
  • Dextromethorphan
• Codeine


  It is the standard treatment for cough suppression. Codeine decreases the sensitivity of cough centers in the CNS to peripheral stimuli and decreases mucosal secretion. Cough suppression occur at doses lower than those required for analgesia.
• Dextromethorphan

  It is a synthetic derivative of morphine that suppresses the central cough center. It has no analgesic effects in antitussive doses. It has a low addictive effect, but may cause dysphoria at high doses. Dextromethorphan has fewer side effects than codeine.
• Expectorant and mucolytic drugs

  • They alter the viscosity of the sputum
  • They change the volume of the respiratory fluid
  • They facilitate expectoration
• Acetylcysteine


  It reduces the viscosity of sputum by depolymerizing mucopolysaccharides.
• Potassium iodide, glyceryl guaiacolate (Exidil, Tussilet), and ammonium chloride (Samilin)

  They stimulate the respiratory tract secretion by a reflex through of irritation of stomach.
• Terpin

  It is a volatile oil used as vehicle for cough mixtures.