Chapter 24: Pulmonary Pharmacology

INTRODUCTION

This chapter will be most useful after having a basic understanding of the material in Chapter 36, Pulmonary Pharmacology in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, the 12th Edition contains:

• A description of the pathogenesis of asthma, including Figure 36-1: Cellular mechanisms of asthma

• A description of the pathogenesis of chronic obstructive pulmonary disease (COPD), including Figure 36-2: Cellular mechanisms in chronic obstructive pulmonary disease

• A description of the various routes of drug delivery to the lungs, including Figure 36-3: Schematic representation of the deposition of inhaled drugs

• The molecular structures of some of the drugs used to treat asthma, COPD, and other pulmonary diseases

LEARNING OBJECTIVES

• Understand the mechanisms of action of bronchodilator drugs used to relax airway smooth muscle and drugs used to prevent bronchoconstriction.

• Understand the anti-inflammatory mechanism of action of corticosteroids, and the role of inhaled and oral corticosteroids in the pharmacotherapy of asthma.

• Understand the mechanism of action of mucolytic agents.

• Understand the mechanisms of action of antitussive drugs.

• Understand the mechanisms of action of drugs used to treat pulmonary artery hypertension (PAH).

• Know the untoward effects of the various bronchodilator drugs, corticosteroids, antitussive drugs, and drugs used to treat PAH.

• Know which patients should be treated and when treatment should be initiated in patients with asthma, COPD, and PAH.

• Know which drugs are most effective in treating patients with asthma, COPD, and PAH.

• Know which drugs can be used in combination to treat asthma, COPD, and PAH.