treatment of asthma asthma 的治疗.pptVIP

Respiratory tract drugs Lu-Tai Tien, Ph.D. School of Medicine Fu-Jen Catholic University 藥物投予方式 吸入 藥物可直接運送至呼吸道上，而其吸入劑又不致造成全身性副作用 較為普遍 口服 靜脈注射 Classification of drugs Drugs used to treat asthma Drugs used to treat allergic rhinitis Drugs used to threat chronic obstruction pulmonary diseases (COPD) Drugs used to treat cough Stimuli / Other Factors allergens not all atopic have asthma dust mites, pollen pollutants SOx food additives bisulfite antioxidants cold air drugs aspirin exercise industrial chemicals and byproducts aluminum smelters cedar dust lung infection predisposing before age of two genetic predisposition more boys than girls in childhood more women than men from 2nd decade onwards. Familial risk of allergies Control of Airway Diameter Parasympathetic ACh is the neurotransmitter at airway smooth muscle it acts at M3 receptors- activation causes formation of IP3 (increasing Ca2+) and diacylglycerol F tension is the result No sympathetic innervation β2 adrenoceptors are present in airway smooth muscle normally epinephrine released from adrenal medulla activates Other nerves - bradykinin, neurokinins Therapies for Asthma Treatments that mitigate an asthma attack Treatments that relax airway smooth muscle Treatments that mitigate chronic inflammation Relaxing airway contraction Inhibition of Bronchoconstriction Phosphodiesterase Inhibitors Muscarinic receptor antagonists β-adrenoceptor agonists Phosphodiesterase Inhibitors Methylxanthine (caffeine is in this group) Theophylline (aminophylline is the ethylenediamine complex) The therapeutic index of Theophylline is slow Causing severe toxicity (the conc. 20 μg/mL in blood) Inhibits the breakdown of cyclic AMP by inhibiting phosphodiesterase cAMP produced by β2-adrenoceptor activation initiates a phosphorylation cascade causing relaxation of airway smooth muscle They are adenosine receptor antagonists Clinical Use of Phosphodiesterase Inhibitors Given orally Sustained release preparations are available Blood