Medications Used for the Respiratory System

  • Shelley PeacockEmail author


Commonly acquired respiratory conditions may be acute or chronic and range from acute rhinitis to chronic obstructive pulmonary disease (COPD). In this chapter the pathophysiology of the selected conditions are explained and the subsequent pharmacological approach to treatment identified and applied to nursing care and practice.

The core concepts of inflammation and receptor-mediated muscle relaxation are explained in order to explain the effect of aspects of pharmacological treatment. Medications such as antihistamines, corticosteroids, nedocromil and leukotriene antagonists are examined in relation to the allergenic-inflammatory response of the respiratory tract. Classic-receptor mediated bronchodilation-constriction theory will also be explored in relation to sympathetic agonists and parasympathetic antagonists.

Pharmacological aspects such as pharmacokinetic interactions together with specific nursing responsibilities associated with the medications concerned are addressed.


Antihistamines Corticosteroids Beta agonists Muscarinic antagonists Leukotriene receptor antagonists Phosphodiesterase inhibitors 


  1. Ahovuo-Saloranta A, Rautakorpi U-M, Borisenko OV et al (2014) Antibiotics for acute maxillary sinusitis in adults. Cochrane Database Syst Rev (2):CD000243. Accessed 13/5/19
  2. Barr JG, Al-Reefy H, Fox AT, Hopkins C (2014) Allergic rhinitis in children. Br Med J 349:1–8CrossRefGoogle Scholar
  3. British Lung Foundation (2018) Asthma statistics. BLF. Accessed 21/5/2019
  4. British National Formulary (2019) British Medical Association and Royal Pharmaceutical Society. Accessed 30/4/2019
  5. Cronin MJ, Khan S, Saeed S (2013) The role of antibiotics in the treatment of acute rhinosinusitis in children: a systematic review. Arch Dis Child 98(4):299–303CrossRefGoogle Scholar
  6. Derendorf H (2007) Pharmacokinetic and pharmacodynamic properties of inhaled ciclesonide. J Clin Pharmacol 47(6):782–789CrossRefGoogle Scholar
  7. Electronic Medicines Compendium (eMC) (2019). Accessed 21/5/2019
  8. Falagas ME, Giannopoulou KP, Vardakas KZ, Dimopoulos G, Karageorgopoulos DE (2008) Comparison of antibiotics with placebo for treatment of acute sinusitis: a meta-analysis of randomised controlled trials. Lancet Infect Dis 8(9):543–552CrossRefGoogle Scholar
  9. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, Cohen N, Cervin A, Douglas R, Gevaert P, Georgalas C, Goossens H, Harvey R, Hellings P, Hopkins C, Jones N, Joos G, Kalogjera L, Kern B, Kowalski M, Price D, Riechelmann H, Schlosser R, Senior B, Thomas M, Toskala E, Voegels R, Wang de Y, Wormald PJ (2012) EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 50(1):1–12CrossRefGoogle Scholar
  10. Galli SJ, Tsai M (2012) IgE and mast cells in allergic disease. Nat Med 18(5):693–704CrossRefGoogle Scholar
  11. Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2019) Guideline update global strategy for the diagnosis, management, and prevention of COPD. Focus on pharmacologic treatment for COPD. Accessed 12/5/2019
  12. Greiner AN, Hellings PW, Rotiroti G, Scadding GK (2012) Allergic rhinitis. Lancet 378(9809):2112–2122CrossRefGoogle Scholar
  13. Halpin DM, Decramer M, Celli B (2012) Exacerbation frequency and course of COPD. Int J Chron Obstruct Pulmon Dis 7:653–661CrossRefGoogle Scholar
  14. Harper (2018) How to use nose drops. Accessed 27/4/2018
  15. Joint Formulary Committee (2017) British National Formulary (online). BMJ Group and Pharmaceutical Press, London. Accessed 21/5/2019Google Scholar
  16. Lipworth B, Newton J, Ram B (2017) An algorithm recommendation for the pharmacological management of allergic rhinitis in the UK: a consensus statement from an expert panel. NPJ Prim Care Respir Med 27(3):1–8Google Scholar
  17. National Clinical Guideline Centre (2010) Chronic obstructive pulmonary disease management of chronic obstructive pulmonary disease in adults in primary and secondary care. NICE clinical guidelines, no. 101. National Clinical Guideline Centre, LondonGoogle Scholar
  18. National Collaborating Centre for Mental Health (2011) Generalised anxiety disorder in adults. The NICE guideline on management in primary, secondary and community care (full NICE guideline). National Institute for Health and Clinical Excellence, London. Google Scholar
  19. National Institute for Health and Care Excellence (2018a) Clinical knowledge summaries, rhinitis. Accessed 23/10/18
  20. National Institute for Health and Care Excellence (2018b) Clinical knowledge summaries, NICE sinusitis.!topicsummary. Accessed 23/4/19.
  21. National Institute for Health and Care Excellence (2018c) Clinical knowledge summaries, asthma.!scenario:1. Accessed 21/4/2019
  22. National Institute for Health and Care Excellence (2018d) Clinical knowledge summaries, COPD. Accessed 21/4/2019
  23. National Institute for Health and Care Excellence (NICE) (2017) Sinusitis (acute): antimicrobial prescribing. National Institute for Health and Care Excellence, London. Accessed 11/5/2019Google Scholar
  24. Peters AT, Spector S, Hsu JHDL, Baroody FM, Chandra RK, Grammer LC, Kennedy DW, Cohen NA, Kaliner MA, Wald ER, Karagianis A (2014) Diagnosis and management of rhinosinusitis: a practice parameter update. Ann Allergy Asthma Immunol 113(4):347–385CrossRefGoogle Scholar
  25. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD (2015) Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 152(2 Suppl):S1–S39PubMedGoogle Scholar
  26. Scadding GK, Kariyawasam HH, Scadding G, Mirakian R, Buckley RJ, Dixon T, Durham SR, Farooque S, Jones N, Leech S, Nasser SM, Powell R, Roberts G, Rotiroti G, Simpson A, Smith H, Clark AT (2017) BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (revised edition 2017; first edition 2007). Clin Exp Allergy 47(7):856–889CrossRefGoogle Scholar
  27. Singh M, Singh M, Jaiswal N, Chauhan A (2017) Heated, humidified air for the common cold. Cochrane Database Syst Rev 2017(8):CD001728PubMedCentralGoogle Scholar
  28. Zhou SF, Xue CC, Yu XQ, Li C, Wang G (2007) Clinically important drug interactions potentially involving mechanism-based inhibition cytochrome P540 3A4 and the role of therapeutic drug monitoring. Drug Monitor 29(6):687–710CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.School of Health and Care ProfessionsUniversity of PortsmouthPortsmouthUK

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