Main Categories of Respiratory Pharmacology – Part 2

Here at SimpleNursing.com, we will be going over the respiratory drugs and the two main categories that you need to remember.

We have categorized these respiratory medications to make it easier for you to recall and identify which drugs have to be used for a particular respiratory condition, namely:

• Bronchodilator Team
• Anti-inflammatory Team

How do these categories act and alleviate respiratory ailments? What are the goals of your respiratory drugs? One main condition that can happen to a person’s respiratory system is increased constriction which causes inadequate oxygen exchange within the distal portions of the lung alveoli.

But before thoroughly discussing the drug categories, let’s do a bit of anatomy and physiology of the lungs.

Quick Anatomy and Physiology

Think of your lungs as an inverted tree with a stump and some branches. At the end of those branches are even smaller branches that bear apples. To apply this thought, the lungs, as your tree, have a tree stump and that stump is broken off into two bronchioles. At the distal portions of the lungs, are the alveoli (apples) – this is the area where oxygen and carbon dioxide exchange occurs.

What Can Go Wrong

What are the things that can go wrong with your lungs?

1. Bronchiole constriction – the airways are being obstructed from allergens to different types of triggers like smoking. Without sufficient oxygen going into the distal portions of the lungs, the body won’t be getting any oxygen either.
2. Cholinergic effects – increased mucus secretions. If there’s increased and thick mucus secretions along the branches of your lungs, there won’t be enough oxygen exchange. The client will be sluggish and will be coughing and hacking a lot of mucus which leads to infection. The lungs will drown in all the mucus and oxygen exchange will be impaired, which, technically, what happens in pneumonia.
3. Emphysema – causes alveoli expansion and hardening it. This causes the inability of oxygen exchange and carbon dioxide build-up inside the lungs, causing increased pressure.
4. Bronchitis – persistent infection caused by increased mucus production, leading to inadequate oxygen exchange. The lungs are unable to expectorate or cough up all the secretion from the lungs.
5. Asthma – bronchiole constriction.

Respiratory Drug Categories

After knowing the different types of common lung problems, we’ll go into the primary drugs that help in relieving mucus production and constriction. As previously mentioned, two categories or teams work together in making the client’s lungs function properly. What are these teams?

1. Bronchodilator Team
2. Anti-Inflammatory Team

Bronchodilator Team

With your broncho team, three main drug types fall under this category, and they have the acronym BAM. BAM stands for:

• Beta-2 agonists – relaxes smooth muscles
• Anticholinergic – dilate the bronchiole tubes
• Methylxanthines – acts as a sympathomimetic by increasing circulation inside the lungs to expand the airways, much like the effects of caffeine

In the majority of nursing exams, you’ll encounter a question that goes: What is albuterol – anti-inflammatory or bronchodilator? The answer is beta-2 agonist which is a bronchodilator.

So, what are the drugs under BAM?

• B – Albuterol, Solu-Medrol (long-term beta-2 agonist), Pirbuterol (Maxair – fast-acting)
• A – Ipratropium (Atrovent); or anything that ends in “-pium”
• M – Theophylline (Theo Dur)

Anti-Inflammatory Team

With your anti-inflammatory team, three main drug types fall under this category, and they have the acronym MAL. MAL stands for:

• Mast cell stabilizers – control or prevent specific allergic disorders
• Anti-inflammatory steroids – decrease swelling by decreasing prostaglandins
• Leukotrienes – bronchoconstriction

Again, in a nursing test, you’ll encounter a question that goes: What is Singulair? The answer is leukotriene which is an anti-inflammatory. A quick way to remember this is to remember that, “Luke likes to sing,” which translates to leukotriene is Singulair.

So, what are the drugs under MAL?

• M – Cromolyn
• A – Prednisone, beclomethasone
• L – Singulair

Tip: You can remember cromolyn as a mast cell stabilizer by thinking about a car which has a “mass of chrome.”

Take Away

As a summary, the acronym for the bronchodilator category is BAM; while the acronym for the anti-inflammatory category is MAL.

Hopefully, this helped you differentiate bronchodilators from anti-inflammatory agents. For a more comprehensive summary, don’t forget to download the notecard on this subject at SimpleNursing.com. This notecard separates the drugs and helps you better understand every indication and how they can relieve the constriction and inflammation at the major highways of the respiratory tract.

Furthermore, if you want all the concept maps that you’ll ever need for nursing regarding respiratory lectures, drop by SimpleNursing.com to get a copy of our Pathophysiology Bible which maps out 70 different diagnoses and concept maps – from bronchitis to restrictive airway disease to asthma, COPD, and even emphysema. All of this, plus a more concise breakdown of intensive, useful lectures of over 135 pages.

Also, check out our nursing school resources and pharmacology study guides. See you there!