Respiratory Pharmacology - European Society of Anaesthesiology PDF
Preview Respiratory Pharmacology - European Society of Anaesthesiology
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 www.esahq.org BRONCHOMOTOR TONE www.esahq.org Regulation of bronchomotor tone www.esahq.org Regulation of bronchomotor tone www.esahq.org Bronchoconstriction leads to the following: • increased difficulty in breathing • inadequate ventilation • V/Q mismatch • impaired ability to cough • hypoxaemia www.esahq.org Drugs and Factors Influencing Airway Calibre www.esahq.org 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 www.esahq.org 3 types of bronchodilator are in clinical use β -adrenergic agonists 2 Methylxanthines Anticholinergics www.esahq.org 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 www.esahq.org
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