Pulmonary Pharmacology:

Delivery Devices and Medications

Course Number: 980107                                                      12 CEUs

 

Introduction

Pulmonary pharmacology involves the therapeutic use of drugs that affect the lungs and are delivered by a variety of modalities. RCPs need to have a general knowledge of the drugs (agents) most commonly used to treat respiratory problems, an in-depth knowledge of airway pharmacology and the equipment utilized for delivery of the medications.

 

The care of patients with pulmonary diseases involves utilizing a wide spectrum of drugs to provide everything from emergency interventions for acutely and critically ill persons, to administering maintenance support for a relatively stable patient.

 

RCPs are primarily involved in administering drugs that are specifically designed to treat the so-called pathological triad of pulmonary disease: bronchospasm, airway inflammation, and retained secretions. However, since the respiratory system cannot be disassociated from cardiac and vascular systems, respiratory care pharmacology necessarily involves a relatively broad scope of drug classes.

 

The front line arsenal for treating pulmonary diseases consists of bronchodilators, antimuscarinics, corticosteroids, mucokinetics, mucolytics, and decongestants. There are also a variety of other agents available for treating pulmonary ailments, including oxygen, antibiotics, local anesthetics, respiratory stimulants, and muscle relaxants. Because of the inter-connectedness of the body systems, additional groups of drugs that may be administered to patients with respiratory diseases include anti-infectives, CNS drugs, antiarrhythmic agents, anticoagulants, antihypertensives, and diuretics.

 

While this course is intended to present you with a comprehensive review of the wide spectrum of the drugs used in pulmonary medicine, it begins with a detailed review of the various modalities available for their delivery to patients suffering from respiratory diseases. Whenever appropriate, we have presented you with Journal articles relating to various medications. Hopefully this will add to the value of this course and not simply distract you.

 

The course includes detailed discussions of aerosol therapy, nebulizers, and humidifiers. Therapeutic procedures and medication functions are also examined in this valuable continuing education unit. The resources drawn upon and synthesized for the following material can be found in the References section at the end of the course.

 

 

General Principles of Pharmacology

 

Pharmacology involves the study of drugs, and drugs are defined as chemical substances that exert a biologic effect on the recipient. Medical drugs are used for the treatment or prevention of disease, and drugs are considered useful when they can maintain, enhance or alter bodily function when a patient is cannot cope with a particular disease. Pharmacology is concerned with the following:

·        the chemical and physical properties of drugs

·        the physiologic effects and site of action of drugs

·        how drugs exert their effects

·        how the body absorbs, distributes, metabolizes, and excretes the drugs

·        dosages and routes of administration of drugs

·        side effects, toxicity, and contraindications

 

The safe administration of drugs requires awareness of the following factors:

·        mode of action

·        side effects

·        toxicity

·        range of common dosages

·        rate and route of excretion

·        individual differences in responses

·        interaction with other drugs or food

·        contraindications

 

For drugs to exert their expected therapeutic benefits, they need to be made available for absorption in the body’s systems. Availability depends to a large extent on the route of administration of the drug. Drugs can be administered gastrointestinally, parenterally, or topically. Topical administration includes application to the skin and directly to the lungs by inhalation.

 

In order for a drug to be administered via inhalation, it must first either be vaporized or placed in an aerosol suspension. This generally requires the use of special equipment. The following discussion reviews the types of equipment available for administering drugs via inhalation.