Pharmacology, part 3: Respiratory Medications - Corticosteroids, Leukotriene Antagonists, Antitussives

by Cathy Parkes April 27, 2020

Full Transcript

Alright. In this video, we are going to go over some more important respiratory medications, including corticosteroids, leukotriene receptor antagonists, as well as antitussives.

So let's first talk about corticosteroids. So we're going to focus on locally-acting steroids as opposed to systemic steroids, which we'll be covering in the endocrine system. So we're talking about either inhalers or intranasal corticosteroids. There's a number of medications that fall within this drug class. They are listed here on card number four and include medications such as beclomethasone, mometasone, budesonide, and fluticasone. So you would use these medications for asthma or rhinitis, which is a fancy name for a runny nose. They work by decreasing inflammation locally. And they do have some side effects. These side effects are much less than if we were taking a systemic steroid, but they can include things like a headache, pharyngitis, which is a fancy name for a sore throat, and a possible fungal infection from candidiasis. So an important, super important teaching you need to do for your patient is after administration, they need to rinse their mouth out to prevent this fungal infection from occurring and then if your patient is going to be using a bronchodilator, such as albuterol, in conjunction with a steroid, they should administer the bronchodilator first to help open up the airways, wait five minutes, and then administer the corticosteroid. So the one tip I have here is for the medication fluticasone. So if you take fluticasone for your nasal congestion, your rhinitis, it will let you be able to play the flute. Because playing the flute while you're congested would probably not work out, and that's why you need the fluticasone.

Alright. Now, let's talk about leukotriene receptor antagonists. The two medications I'd be familiar with that fall under this class include montelukast and zafirlukast. They both end in that -lukast. They are used for asthma, and they are also used for prevention of exercise-induced bronchoconstriction. So their mode of action is to decrease the effect of leukotrienes in the body which are inflammatory chemicals that are released in response to an allergen. So it decreases the effect of these leukotrienes which, in turn, reduces airway inflammation and bronchoconstriction. So the way that I remember this mode of action is that meds that end in -lukast help to decrease the effect of leukotrienes. Okay, which are those inflammatory chemicals. So side effects that are associated with this class of medication include headache. And with zafirlukast, you may also see an increase in liver enzymes. In terms of administration, montelukast should be taken in the evening or 2 hours before exercise. And zafirlukast is recommended to be taken on an empty stomach.

Alright. Now, let's talk about antitussive medications which are medications used to treat your patient's cough. There are a number to be familiar with. And if you're following along with cards, I'm on card number 6. So to remember which medications are antitussive, I remember A, B, C, D. So antitussives, which starts with A, include benzonatate, which starts with a B. Codeine, which starts with a C, and dextromethorphan, which starts with a D. So they're all used to treat cough, but they all work a little differently. So benzonatate works by having an anesthetic effect on the vagal nerve receptors in the airway. Side effects can include sedation, constipation, as well as GI upset. Codeine binds to opioid receptors in the CNS and decreases the patient's cough reflex. But as you know, Codeine is an opioid medication. So it's going to have some fairly serious side effects including sedation, respiratory depression, hypotension, constipation, and GI upset. And then finally, we have dextromethorphan which you guys might know as Delsym. That's the brand name. It works by suppressing the cough reflex in the medulla. So side effects that you may have with Delsym are usually pretty minor. They may include dizziness and possible sedation at high doses.

Alright. In my next video, I will be finishing up the key respiratory medications I feel that you should know. I'll be talking about expectorants, mucolytics, decongestants, as well as antihistamines. Thanks so much for watching!

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