Mosby's Pharmacy

Technician
Sixth edition
Therapeutic Agents for the Respiratory System
Learning Objectives—Lesson 21.1
Therapeutic Agents for the Respiratory System

1. Describe the major components of the

respiratory system.
2. List the primary symptoms of conditions
associated with the dysfunction of the
respiratory system. In addition, (a) recognize
prescription and over-the-counter drugs used to
treat conditions of the lower and upper
respiratory systems; (b) write the generic and
trade names for the drugs discussed in this
chapter; and (c) list appropriate auxiliary labels
when filling prescriptions for drugs discussed in
this chapter.
 Respiratory System

What is the Respiratory System?

The Respiratory System is the network of organs
and tissues that help you breathe. It includes your
airways, lungs and blood vessels. The muscles
that power your lungs are also part of the
respiratory system. These parts work together to
move oxygen throughout the body and clean out
waste gases like carbon dioxide.
 Structure and Function
of the Respiratory System
 Respiratory system resembles large inverted
tree
 Large trunk: Trachea
 Two main branches: Bronchi
 Smaller branches: Bronchioles
 Leaves: Alveolar sacs (gas exchange)
 Function: To oxygenate the blood and remove
carbon dioxide
Upper Respiratory System
 Composed of nose, pharynx, larynx, and nasal cavities
 Mucosal lining
 Produces 125 mL of mucus each day
 Protects respiratory tree
 Mucus purifies air by trapping irritants
 Nasal septum separates nose into two cavities
 Cavities lined with mucosal lining and cilia
 Mucous membrane warms and moistens air
 Cilia catch dust particles
 Nose provides sense of smell, drainage for tears
Lower Respiratory System
(Slide 1 of 2)

 Composition: Trachea, bronchial tree, lungs

 Trachea lined with mucosal lining (traps airborne
particles) and cilia
 Trachea branches to left and right bronchi → smaller
bronchi → smaller bronchioles → alveoli
 Pleural cavity lines chest cavity and covers lungs
 Trachea: Windpipe; branches into lungs
 Right bronchus is bigger than left (heart displacement)
 Diaphragm separates chest cavity from abdominal cavity
 Lower Respiratory System
(Slide 2 of 2)

 Lungs divided into lobes: Three on right and two on left

 Right lung has greater capacity
 Left lung is longer, has less capacity
 Mediastinum: Location of heart; separates right and left
lung
 Main function of lungs is breathing, pulmonary ventilation
 Bronchi lead to smaller airways called bronchioles and
finally to alveoli sacs where oxygen and carbon dioxide are
exchanged
Respiration
Respiration is the chemical process by which organic compounds release
energy. The compounds change into different ones by exergonic reactions.
There are two types of respiration:
• • aerobic, which requires oxygen and releases lots of energy
• • anaerobic, which does not require oxygen but releases much less energy
per mole of starting material
 Act of respiration has two distinct phases:
 Inspiration: Movement of air into lungs
 Expiration: Movement of air out of lungs
 Inspiration: Diaphragm flattens, intercostal muscles expand, thoracic
cavity increases in size
 Expiration is passive response
Gas Exchange
(Slide 1 of 2)

 Composition of air: 21% oxygen, 79% nitrogen, 0.5%

carbon dioxide
 Average adult consumes about 250 mL of oxygen;
produces about 200 mL of carbon dioxide
 Travel of air: Bronchioles → alveolar sacs → oxygen
moves across membrane → blood cell → blood cell
drops off carbon dioxide before picking up oxygen →
moves to large veins → left atrium → left ventricle
→ arteries → tissues and organs
Gas Exchange
(Slide 2 of 2)

 Medulla
 Contains respiratory center
 Located in brainstem
 pH balance: Exchange of O2 and CO2 keeps it balanced
in the blood
 CO2 makes bicarbonate to keep pH balance; becomes
alkaline
 CO2 can also increase hydrogen in blood; becomes acidic
 Blood pH: 7.4 to sustain life
Breathing
 Involuntary mechanism
 Breathing rates vary according to size of person
 Smaller size means faster breathing
 Children can breathe twice as fast as adults
 Exhalation: 500 mL of air
 Lung capacity is 5 L
 Elasticity of lungs allows for a variety of
capacities depending on need for oxygen
Disorders/Conditions of the
Upper Respiratory System
 Causes: Genetics, contagious infections, habits
(smoking), environmental factors
 Symptoms: Abnormal breathing and coughing
 Treatments: Antitussives, analgesics, and
antipyretics
 Antibiotics; corticosteroids for severe
conditions
Common Cold
(Slide 1 of 2)

 Common cold is characterized by an infection

of the nasal passages and upper respiratory
system
 Normally caused by a rhinovirus
 There are 140 cold viruses, all untreatable
 Treatments: Antitussives, antihistamines,
expectorants, and decongestants
Common Cold
(Slide 2 of 2)

 Symptoms: Coughing, congestion, and sometimes

wheezing
 Common treatments: Decongestants and antihistamines
 Other symptoms: Rhinitis, coryza, pharyngitis, and
rhinorrhea
 Drug treatments: Decongestants, antihistamines,
antitussives, expectorants, and decongestants
 Liquids, lozenges, nasal sprays, oral tablets, and
capsules

Allergies
Allergens include pollens, animal dander, foods,
medications, chemicals, and environmental pollutants
 Symptoms and reactions include rash, hives, itching, and
nasal congestion
 Severe reactions include stomach pain, vomiting,
wheezing, shortness of breath, low blood pressure,
swelling of the throat, and anaphylactic shock
 Abnormal response of the immune system; can be life
threatening
 Removal of the allergen is best treatment
Rhinitis
Allergic Rhinitis is where your nose gets irritated by
something you're allergic to, such as pollen, causing sneezing
and other symptoms.
 Irritation/inflammation of mucous membrane of nasal
passages
 Causes: Cold, influenza, allergens, air pollution, and strong
odors
 Can be acute (colds/flu) or chronic (seasonal exposure to
allergens)
 Drink fluids to decrease postnasal drip
 Treatment: OTC saline irrigation, air purifiers, and
humidifiers
Influenza
 Viral respiratory illness
 Types A, B, and C
 Annual flu vaccine lessens risk
 Treatment: Rest, fluids, and antivirals
 Asthma
Asthma is a chronic lung disease affecting people of all ages. It
is caused by inflammation and muscle tightening around the
airways, which makes it harder to breathe.
 Dyspnea: Difficult breathing
 Cracking and wheezing sounds
 Can be triggered by allergens
 Produces mucus, which can cause bronchiole constriction
 Drug treatment in two categories: Those used for
maintenance and those used when an attack occurs
 Corticosteroids: Lessen constriction of bronchiole tubes;
available as inhalants or orals
More Asthma Treatments
 Long-acting beta agonists: Activate receptors, muscles
relax
 Leukotriene receptor antagonists: Reduce the
inflammatory actions of leukotrienes that induce
bronchial smooth muscle contraction, airway edema, and
mucus formation
 Short-acting beta agonists: Used as rescue inhalers, used
in nebulizers
 Anticholinergics: Block effects of acetylcholine
Chronic Obstructive Pulmonary Disease
COPD, refers to a group of diseases that cause airflow blockage
and breathing-related problems. It includes emphysema and
chronic bronchitis.
 Three types
 Chronic bronchitis
 Emphysema

 Asthma

 Emphysema causes destruction of alveolar walls

 Loss of elasticity caused by smoking, exposure to
environmental hazards
 Treatments: Quitting smoking, lung transplant
 Drug treatments: Similar to those used for asthma
Pneumonia
Pneumonia is an infection that affects one or both lungs.
 Acute inflammation of lung airways; blocked by thick
mucus
 Sources: Bacterial, viral, fungal, protozoal, and parasitic
 Streptococcus pneumoniae causes rapid onset
 Treatment: Rest, proper hydration, and avoidance of
irritants
 Drug treatment: Antibiotics, antifungals (if fungal infection
occurs), and respiratory medications
 Tuberculosis
Tuberculosis (TB) is a disease caused by germs that are spread
from person to person through the air. TB usually affects the
lungs, but it can also affect other parts of the body, such as the
brain, the kidneys, or the spine. A person with TB can die if they
do not get treatment.
 Treatment consists of several medications in a regimen
 Affects organs, such as kidneys, brain, and spine
 Highly contagious
 Diagnosed with a chest x-ray and PPD skin test
 Sputum test to determine if cured
Lung Cancer

Lung cancer is a type of cancer that starts in the lungs.

Cancer starts when cells in the body begin to grow out of
control.
 Malignancies of airways
 Classifications: Small cell or non-small cell
 Important in diagnosis
 Treatment: Quitting smoking, radiation, and surgical
resection
 Drug treatment: Chemotherapy
Questions?