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Drugs Acting on the Respiratory System

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Respiratory Disease and its Management

Part of the book series: Competency-Based Critical Care ((CBCC))

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Abstract

This chapter describes a number of pharmacological agents used to treat respiratory disease in the critically ill. It includes respira-tory stimulants, bronchodilators, corticosteroids, magnesium, pulmonary vasodilators and muco-lytic agents. Where possible, evidence to support practice is included, although in some cases (e.g. mucolytic therapy) little evidence is available. Clinical applications are also described where relevant.

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References

  1. Greenstone M, Lasserson TJ. Doxapram for ventila-tory failure due to exacerbations of chronic obstruc-tive pulmonary disease. Cochrane Database of Systematic Reviews. 2002;Issue 2,Art. No.: CD000223. DOI: 0.1002/14651858.CD000223.

    Google Scholar 

  2. Angus RM, Ahmed AEA, Fenwick LJ, Peacock AJ. Comparison of the acute affects on gas exchange of nasal ventilation and doxapram in exacerbations of chronic obstructive pulmonary disease. Thorax. 1996;51(10):1048–1050.

    Article  PubMed  CAS  Google Scholar 

  3. Newman WJ, Banham SJ, Barr J, et al. A Randomised trial comparing non-invasive ventilation with the respiratory stimulant, doxapram, in the treatment of acute hypercapnic respiratory failure complicating exacerbations of chronic obstructive pulmonary disease. Unpublished data 2001.

    Google Scholar 

  4. DRUGDEX® System [database on CD-ROM]. Version 5.1. Greenwood Village, Colo: Thomson Reuters (Healthcare) Inc.

    Google Scholar 

  5. Summary of Product Characteristics Dopram® Injec-tion. Anpharm Ltd. March 2001.

    Google Scholar 

  6. Kaufman L, Taberner PV. Pharmacology in the Prac-tice of Anaesthesia. London: Edward Arnold; 1996.

    Google Scholar 

  7. British Thoracic Society, SIGN. British Guideline on the Management of Asthma. Thorax. 2008;63 (Suppl IV)

    Google Scholar 

  8. Chronic Obstructive Pulmonary Disease: National Institute of Clinical Excellence. Thorax. 2004;59 (Suppl):1–232

    Google Scholar 

  9. Travers A, Jones A P, Kelly K, Barker SJ, Camargo CA Jr., Rowe BH. Intravenous beta2-agonists for acute asthma in the emergency department. Cochrane Database of Systematic Reviews. 2001;Issue 2,Art. No.: CD002988. DOI: 10.1002/14651858.CD002988.

    Google Scholar 

  10. Innes NJ, Stocking, JA, Daynes TJ, Harrison BDW. Randomised pragmatic comparison of UK and US treatment of acute asthma presenting to hospital. Thorax. 2002;57(12):1040–1044.

    Article  PubMed  CAS  Google Scholar 

  11. Moayyedi P, Congleton J, Page RL, Pearson SB, Muers MF. Comparison of nebulised salbutamol and ipratropium bromide with salbutamol alone in the treatment of chronic obstructive pulmonary disease. Thorax. 1995;50:834–837.

    Article  PubMed  CAS  Google Scholar 

  12. Lanes SF, Garrett JE, Wentworth CE III, Fitzgerald MJ, Karpel JP. The effect of adding ipratropium bromide to salbutamol in the treatment of acute severe asthma: a pooled analysis of three trials. Chest. 1998;114: 365–372.

    Article  PubMed  CAS  Google Scholar 

  13. Parameswaran K, Belda J, Rowe BH. Addition of intravenous aminophylline to beta2-agonists in adults with acute asthma. Cochrane Database of Systematic Reviews. 2000;Issue 4,Art. No.: CD002742. DOI: 10.1002/14651858.CD002742.

    Google Scholar 

  14. Manser R, Reid D, Abramson M. Corticosteroids for acute severe asthma in hospitalised patients. Cochrane Database of Systematic Reviews. 2000; Issue 3,Art. No.: CD001740. DOI: 10.1002/14651858. CD001740.

    Google Scholar 

  15. Wood-Baker RR, Gibson PG, Hannay M, Walters EH, Walters JAE. Systemic corticosteroids for acute exac-erbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2004; Issue 4,Art. No.: CD001288. DOI: 10.1002/14651858. CD001288.pub2.

    Google Scholar 

  16. Maltais F, Ostinelli J, Bourbeau J, et al. Comparison of nebulized budesonide and oral prednisolone with placebo in the treatment of acute exacerba-tions of chronic obstructive pulmonary disease: a randomized controlled trial. Am J Respir Crit Care Med. 2002;165: 698–703.

    PubMed  Google Scholar 

  17. Niewoehner DE, Erbland ML, Deupree RH, et al. Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease. NEJM. 1999;340: 1941–1947.

    Article  PubMed  CAS  Google Scholar 

  18. Rang HP, Dale MM, Ritter JM, Moore P. In Pharma-cology. 5th ed. Edinburgh: Churchill Livingstone; 2003.

    Google Scholar 

  19. British National Formulary 55th Edition. London: BMJ; March 2008.

    Google Scholar 

  20. Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr. Magnesium sulfate for treating exacerbations of acute asthma in the emergency department. Cochrane Database of Systematic Reviews. 1999; Issue 4,Art. No.: CD001490. DOI: 10.1002/14651858.CD001490.

    Google Scholar 

  21. Blitz M, Blitz S, Beasely R, et al. Inhaled magnesium sulfate in the treatment of acute asthma. Cochrane Database of Systematic Reviews. 2003;Issue 3,Art. No.: CD003898. DOI: 10.1002/14651858.CD003898.pub4.

    Google Scholar 

  22. Skobcloff EM. An ion for the lungs. Acad Emerg Med. 1996;3:1082–1085.

    Article  Google Scholar 

  23. Behrends M, Beiderlinden M, Peters J. Combination of sildenafil and bosentan for nitric oxide with-drawal. Eur J Anaesth. 2005;22:154–163.

    Article  Google Scholar 

  24. Cuthbertson BH, Dellinger P, Dyar OJ, et al. UK guidelines for the use of inhaled nitric oxide therapy in the adult ICUs. Int. Care Med. 1997;23:1212–1218.

    Article  CAS  Google Scholar 

  25. Schwebel C, Beuret P, Pedrix J P, et al. (1997) Early nitric oxide inhalation in acute lung injury: results of a double blind randomised study. Int Care Med. 1997;23(1):5.

    Google Scholar 

  26. Lundin S, Mang H, Smithis M, Stenquist O, Frostel C. For the European Study Group of Inhaled Nitric Oxide. Inhalation of inhaled nitric oxide in acute lung injury: preliminary results of a European mul-ticentered study. Int Care Med. 1997;23(1):6.

    Google Scholar 

  27. Rich GF, Murphy GD, Roos CM, Johns RA. Inhaled nitric oxide; selective pulmonary vasodilatation in cardiac surgery patients. Anesthesiology. 1993;78: 1028–1035.

    Article  PubMed  CAS  Google Scholar 

  28. Girard C, Lehot JJ, Pannatier J-C, Filley S, Ffrench P, Estanove S. Inhaled nitric oxide after mitral valve replacement in patients with chronic pulmonary artery hypertension. Anesthesiology. 1992;78:1028–1035.

    Google Scholar 

  29. Snow DJ, Gray SJ, Ghosh S, et al. Inhaled nitric oxide in patients with normal and increased pulmonary vascular resistance after cardiac surgery. Br J Anesth. 1994;72:185–189.

    Article  CAS  Google Scholar 

  30. De Wet CJ, Affleck DG, Jacobsohn E, Avidan MS, Tymkew H, Hill LL. Inhaled prostacyclin is safe effective and affordable in patients with pulmonary hypertension, right heart dysfunction, and refrac-tory hypoxemia after cardiothoracic surgery. J Thor Cardio Surg. 2004;127:1058–1067.

    Article  CAS  Google Scholar 

  31. Olshwescki H, Ghofrani HA, Schmehl T, et al. Inhaled illoprost for pulmonary hypertension. N Eng J Med. 2002;347(5):322–329.

    Article  Google Scholar 

  32. Ghofrani HA, Wiedemann R, Rose F, et al. Combina-tion therapy with oral sildenafil and inhaled iloprost for severe pulmonary hypertension. Ann Intern Med. 2002;136(7):515–522.

    PubMed  CAS  Google Scholar 

  33. Channick RN, Simonaeu G, Sitbon O, et al. (2001) Effects of the dual endothelin receptor antagonist bosentan in patients with pulm HT: a randomised placebo controlled study. Lancet. 2001;358:1119–1123

    Article  PubMed  CAS  Google Scholar 

  34. Michelakis E, Tymchal W, Lien D, Webster L, Hashimoto K, Archer S. Oral sildenafil is an effective and specific pulmonary vasodilator in patients with pul-monary arterial hypertension. Comparison with inhaled nitric oxide. Circulation. 2002;105:2378–2403.

    Article  Google Scholar 

  35. Henke CA, Hertz M, Gustafon P. Combined bron-choscopy and mucolytic therapy for patients with severe refractory status asthmaticus on mechanical ventilation. A case report and review of the litera-ture. Crit Care Med. 1994;22:1880–1883.

    Article  PubMed  CAS  Google Scholar 

  36. Millman M, Millman FM, Goldstein IM, Mercan-detti AJ. Use of Acetylcysteine in bronchial asthma— another look. Ann Allergy. 1985;54:294–296.

    PubMed  CAS  Google Scholar 

  37. Lawson D, Saggers BA. NAC and antibiotics in cystic fibrosis. BMJ. 1965;317.

    Google Scholar 

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© 2009 Springer-Verlag London Limited

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Whelan, G., McKenzie, C. (2009). Drugs Acting on the Respiratory System. In: McLuckie, A. (eds) Respiratory Disease and its Management. Competency-Based Critical Care. Springer, London. https://doi.org/10.1007/978-1-84882-095-1_15

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  • DOI: https://doi.org/10.1007/978-1-84882-095-1_15

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-094-4

  • Online ISBN: 978-1-84882-095-1

  • eBook Packages: MedicineMedicine (R0)

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