Respiratory System Drugs

Drugs For Cough

1. Pharyngeal demulcents Lozenges, cough drops, linctuses containing syrup, glycerine, liquorice.

2. Expectorants (Mucokinetics)

(a) Bronchial secretion enhancers: Sodium or Potassium citrate, Potassium iodide, Guaiphenesin (Glyceryl guaiacolate), balsum of

Tolu, Vasaka, Ammonium chloride.

(b) Mucolytics: Bromhexine, Ambroxol, Acetylcysteine, Carbocisteine

3. Antitussives (Cough centre suppressants)

(a) Opioids: Codeine, Ethylmorphine, Pholcodeine.

(b) Nonopioids: Noscapine, Dextromethorphan, Chlophedianol.

(d) Peripherally acting: Prenoxdiazine.

4. Adjuvant antitussives

Bronchodilators: Salbutamol, Terbutalin.

DRUGS FOR BRONCHIAL ASTHMA

1. Prevention of AG:AB reaction—avoidance of antigen, hyposensitization—possible in extrinsic asthma and if antigen can be identified.

2. Neutralization of IgE (reaginic antibody)— Omalizumab.

3. Suppression of inflammation and bronchial hyperreactivity—corticosteroids.

4. Prevention of release of mediators—mast cell stabilizers.

5. Antagonism of released mediators—leukotriene antagonists, antihistamines, PAF antagonists.

6. Blockade of constrictor neurotransmitter— anticholinergics.

7. Mimicking dilator neurotransmitter—sympathomimetics.

8. Directly acting bronchodilators—methylxanthines.

CLASSIFICATION

I. Bronchodilators

A. β2 Sympathomimetics: Salbutamol, Terbutaline, Bambuterol, Salmeterol, Formoterol, Ephedrine.

B. Methylxanthines: Theophylline (anhydrous), Aminophylline, Choline theophyllinate, Hydroxyethyl theophylline, Theophylline ethanolate of piperazine, Doxophylline.

C. Anticholinergics: Ipratropium bromide, Tiotropium bromide.

II. Leukotriene antagonists

Montelukast, Zafirlukast.

III. Mast cell stabilizers

Sodium cromoglycate, Ketotifen.

IV. Corticosteroids

A. Systemic: Hydrocortisone, Prednisolone and others.

B. Inhalational: Beclomethasone dipropionate, Budesonide, Fluticasone propionate, Flunisolide, Ciclesonide.

V. Anti-IgE antibody

Omalizumab