Chronic obstructive pulmonary disease and respiratory by Sanjeev Kumar

1. Chronic obstructive pulmonary disease
(COPD)
Sanjeev Kumar
B.Pharm 6th Semester
SKB College of Pharmacy Kamptee

2. Chronic obstructive pulmonary disease (COPD) is a common lung disease.
Having COPD makes it hard to breathe. There are two main forms of COPD:
Chronic bronchitis, which involves a long-term cough with mucus.
Emphysema, which involves damage to the lungs over time.

3. Causes
 Cigarette smoking
 Air Pollution
 Infections
 Genetic Conditions
Symptoms
 Attacks of morning cough during winter
 Shortness of breath
 Wheezing
 Fatigue
 Chest Pain
 Weight Loss

4. Pathogenesis

5. Treatments
1) Stop Smoking
2) Bronchodilators
Albuterol Salmeterol Ipratropium Tiotropium
Levalbuterol Formoterol
Fenoterol Arformoterol
Terbutaline Indacaterol

6.  These agents are antagonists of muscarinic receptors (i.e., M1, M2 , and M3 subtypes).
 Blockade of these receptors in the smooth muscle of the airways inhibits the activity of acetylcholine,
which reduces cGMP levels to yield bronchodilation.
 Ipratropium and Tiotropium: Ipratropium is considered a short-acting anticholinergic because its
effects last for 4-6 hrs.
 both quaternary compounds and are minimally absorbed into systemic circulation upon inhalation.
 common side effects of these two agents include dry mouth, nausea, and metallic taste.
 Other potential side effects are tachycardia, blurred vision, urinary retention, and constipation.
3) Corticosteroids
Prednisone
Methylprednisolone
Budesonide
These drugs are improve lungs function.
Pills have more side effects than inhaled corticosteroids.

7. 4) Combinations
 Short acting beta agonists + Anticholinergics (Albuterol+Ipratropium,Fenoterol+Ipratropium)
 Long acting beta agonists + Anticholinergics
 Long acting beta agonists + Corticosteroids
5) Methylxanthines
Theophylline
6) Phosphodiesterase-4 Inhibitors
Roflumilast and cilomilast

8. 7) Antibiotics
azithromycin,
clarithromycin
telithromycin
cefuroxime,
cefpodoxime
doxycycline
Others Approaches:-
 Supplemental oxygen to help with low oxygen and energy levels
 Vaccines for flu and Pneumonia to help prevent infections

9. Respiratory Stimulants/Analeptics/Brainstem Stimulants
 These drugs stimulate respiration and or sometimes used to respiratory failure
 They may bring about temporary improvement in in respiration.
 They have low safety margin and may produce convulsions.
Drugs for Treatment
Doxapram
Acts mainly on the brainstem and spinal cord and increase the activity of medullary
respiratory and vasomotor centres
Nikethamide
Picrotoxin (GABA receptor Antagonist)
Pentylenetetrazole

10.  Referneces:-
1) Rang and Dale’s Pharmacology 8th Edition.
2) Essentials of Medical Pharmacolgy 8th edition by K.D Tripathi
3) https:/www.Wikipedia.org