Respiratory Pharmacology - European Society of Anaesthesiology

33 Pages·2016·2.57 MB·English

by  Beatriz Manrique

Respiratory Pharmacology
Manuel Otero Lopez
Department of Anaesthetics and Intensive Care
Hôpital Européen Georges Pompidou, Paris, France
Programme
Bronchomotor tone
Drugs and factors influencing airway calibre
Drugs and factors affecting pulmonary vascular
resistance
Pulmonary pharmacology of inhaled anaesthetics
Drugs stimulating respiratory centre (respiratory analeptics)
Surfactant replacement therapy
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BRONCHOMOTOR TONE
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Regulation of bronchomotor tone
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Regulation of bronchomotor tone
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Bronchoconstriction leads to the following:
• increased difficulty in breathing
• inadequate ventilation
• V/Q mismatch
• impaired ability to cough
• hypoxaemia
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Drugs and Factors Influencing
Airway Calibre
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Drugs and Factors Acting on Airway Calibre
Bronchoconstriction
Cholinergic drugs
β -adrenergic antagonists
2
Inflammatory mediators
Allergy and anaphylaxis
Bronchodilatation
β -adrenergic agonists
2
Methylxanthines
Anticholinergics
Prevention of bronchoconstriction
Membrane stabilizers - sodium cromoglycate
Steroids
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3 types of bronchodilator are in clinical use
β -adrenergic agonists
2
Methylxanthines
Anticholinergics
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Effects of -agonists on the airways
Specific
• Increase in intracellular cAMP and cause bronchodilatation
Non-specific but complementary
• Inhibition of mast cell mediator release
• Inhibition of plasma exudation and microvascular leakage
• Prevention of airway oedema
• Increased mucus secretion and mucociliary clearance
• Prevention of tissue damage mediated by O free radicals
2
• Decreased AcCh release in cholinergic nerves by an action on
prejunctional  -receptors
2
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