17 topics with brief breakdowns: definitions, key facts, and class questions.
This section is dedicated to drugs that control pulmonary ventilation, bronchial drainage, and airway tone. Here, we analyze how to stimulate the respiratory center using analeptics, when the prescription of antitussive agents is justified, and what the fundamental difference is between classical expectorants and mucolytics (acetylcysteine, ambroxol, bromhexine).
Special emphasis is placed on the heavy artillery of pulmonology: the pharmacotherapy of bronchial asthma and COPD. You will study basic and symptomatic therapy drugs: inhaled glucocorticosteroids, anticholinergics (antimuscarinics), methylxanthines, as well as targeted agents such as antileukotriene drugs, the PDE-4 inhibitor roflumilast, and anti-IgE antibodies (omalizumab). Mast cell membrane stabilizers and pulmonary surfactant preparations, which save lives in neonatology, deserve special attention.
In pharmacology, the mechanisms of relieving bronchospasm, the sites of action of inhaled steroids, and fatal errors—such as why centrally acting antitussives must under no circumstances be combined with mucolytics—are questioned most strictly.
How long does it take for the effect of Carbogen inhalation to appear?
The effect caused by carbon dioxide develops on average 5–6 minutes after inhalation.
Why must codeine not be prescribed for a productive cough?
In productive (wet) cough, it is necessary to clear sputum. Suppressing the reflex with codeine will lead to the stagnation of infected secretions in the bronchi, depriving cough of its protective drainage function.
How do mucolytic agents differ from secretomotor agents?
Mucolytics disrupt the structure of sputum and reduce its viscosity through chemical depolymerization. Secretomotor agents increase the volume of the liquid component of the secretion and activate the movement of the ciliated epithelium.
Why does acetylcysteine save lives in paracetamol poisoning?
It acts as a donor for glutathione synthesis. Glutathione is essential for the endogenous detoxification of paracetamol metabolites, preventing severe liver damage (hepatotoxicity).
What is the fundamental difference in the chemical structure of ambroxol and acetylcysteine?
Acetylcysteine is a derivative of the amino acid cysteine and contains a sulfhydryl SH-group. Ambroxol, on the other hand, is a benzylamine derivative containing bromine atoms and a cyclohexyl ring in its structure.
Is bromhexine an active substance in its own right?
No, the substance acts as a prodrug. It exhibits its main pharmacological properties after conversion into its active metabolite, ambroxol.
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