Antiasthmatic are the drugs or medicines that treat or prevent asthma attacks.
3. Mast cell stabilizers
Define as is a medication that relaxes and opens the airways,
or bronchi, in the lungs.
Mechanism of action: They causes widening of the airway by
relaxing bronchial smooth muscles by stimulate beta receptors
1 Salbutamol 2-4 mg orally
2 Terbutaline 5mg orally.
3 Formoterol 80 mcg B.D. orally
4 Albuterol 200-400 mcg inhaled every 6 hrly.
• Relieving the distress of asthma.
• Bronchospasm or broncho- constriction.
• Patient with uncontrolled arrythmias.
• Prolonged use of albuterol may cause hypokalemia
• Nervousness, Anxiety,Tremor, Headache, Palpitations, Tachycardia &Arrhythmias
• (beta) blocker antagonize effects of adrenergic agonists.
• Prolonged use of theophylline cause additive effects.
• Nurse should monitor the patient’s blood pressure, pulse,
respiratory rate, and breathing sounds.
• Teach the patients that how to use inhalers.
• Instruct the patient to avoid respiratory irritants, such as smoke,
dust, and strong smell.
•Mechanism of action: These drugs are weak
CNS stimulants that are powerful smooth
muscle relaxants thus they relax the smooth
muscle of bronchi. They also havediuretic
• To treat and prevent bronchospasm.
• To treat asthma, bronchitis, emphysema
• Hypersensitivity to any xanthine.
• Infection or irritation of rectum or lower portion.
• Give cautiously in neonates, in elderly patients, heart disorders hepatic disorders.
• Drug Interaction:
• (beta) Blocker may antagonize the effects ofmethylxanthines.
• Erythromycin may increase the half life of methylxanthines, and increasing the risk of
• Rifampicin, phenobarbital phenytoin, cigarette smoking and charcoal – broiled food may shorten the half-
life of drugs and reducing their effectiveness.
• Respiratory arrest.
• Peptic ulcer.
• Epigastric pain.
• Nurse should assess for signs and symptoms of toxicity.
• Nurse also should know that therapeutic sr. level of
theophylline ranges from 10 to 20 mcg/ml.
• Advise patients to decrease consumption of xanthine –
containing food and beverages.
• Todetect toxicity, nurse should monitor sr drugs levels.
Mast cell Stabilizers –
•Mast cell stabilizers works to prevent allergy cells
called mast cell from breaking open and releasing
chemicals that help to cause inflammation.
•They are not effective once the allergic reaction has
occurred and mediators are released from mast cells.
So they are useless during asthmatic attack.
•They are used in the prophylaxis of asthma.
• They inhibit mast cell activity, thus prevent the
release of allergic mediators like histamine,
serotonin, prostaglandins, cytokines.
• These chemical are essential for an inflammation
and allergic reactions
• They block mast
cell degranulation, stabilizing the cell and thereby
preventing the release of histamine and related
S. No. Drug Doses
20mg 4times a day
3 Ketotifen 1-2mg OD or BD
Indication / uses
• Prevent asthma symptoms from occurring or prophylaxis to asthmatic attack.
• Todecrease inflammation or bronchospasm.
• Todecrease allergic reactions.
• Precautiously with renal dysfunction, hepatic dysfunction.
• Lactation, Cardiac arrhythmias
• Throat irritations, Nasal irritations, Wt. Gain, Headache, Drowsiness, Dry mouth,
• Nurse should monitor drugs adverse reactions.
• Instruct patients that this drug is not effective in an acute attack.
• Nurse should instruct the patient how to use metered – dose inhaler or
• If more than one inhalation is ordered, advise patient to wait 1-2 minutes
before taking second puff.
• If the parents is also receiving an inhaled bronchodilator, advise the
patient to use bronchodilators first to open the airways and then wait
approximately 5min before using cromolyn sodium to maximize its
•These drugs have anti-
inflammatory as well as anti-
allergic actions thus they are
effective in bronchial asthma.
•They prevent the release of or
counteract the bronchial mediators
(Kinins, serotonin, Histamine) that
cause tissue inflammation
responsible for edema and airway
S. No Drugs Doses
1 Prednisolone 5-60mg per day in divided dose.
100μgm (microgram) 6hrly by aerosol
3 Budesonide 400 μgm (microgram) daily in divided dose.
4 Fluticasone 100-250μgm (microgram) BID by aerosol
200μgm (microgram) 6hrly by aerosol.
•Use cautiously in patients who are
immunosuppressed and in those taking
prednisone or other corticosteroids.
•Use very cautiously in patients with viral
•Bronchospasm after inhalation of
• Nurse should instruct the patient to rinse his mouth, after using inhaled
• Nurse should teach the patient to:
Use bronchodilators several minutes before glucocorticoid inhaler.
Rinse mouth after using inhaled steroids.
Use and care for inhaler properly.
•Antihistamines are the drugs
used in the treatment od
allergic disorders and some
•These drugs block the effect of histamine and its
receptors. They also provide some sort of sedation.
There are four types of antihistamines drugs.
1. Highly sedatives.
2. Moderate sedatives.
3. Mild sedatives.
4. Non sedatives.
•Allergic reactions (Hay fever, Vasomotor rhinitis
•Because of their anticholinergic actions they are
used as antiemetics and useful in motion
•As hypnotics, Mild sedative/anxiolytics.
•Special precautions in acute asthma and pregnancy,
Due to anticholinergic effect
• Drowsiness in common.
• Dryness of mouth.
• Blurring of vision.
• Urinary retention.
• Severe toxicity may causes death to cardiac and respiratory failure.
•Antihistamines are best given in the evening
since all antihistamines cause drowsiness.
•Advise to patient not to drive vehicle or do not
•Advise to patient to avoid sedative such as
alcohol or sedative hypnotics.
• These drugs reduced the viscosity of sputum that leads to
easily expel the sputum.
S No. Drugs Doses
1 Acetylcysteine 2.5 ml of 10-20% solution given
by inhalation or nebulization
2 Bromhexine 8-16 mg TDS.
• Totreat abnormal viscid, or
thick and hard mucus.
• As an antidote for
Hypersensitivity to these
Cautiously in elderly,
pregnant or breastfeeding
• Severe rhinorrhea
• Activated charcoal
• Incompatible with
amphotericin B, Hydrogen
•To assess the airway and maintain it patent.
•Provide suction if needed.
•Assess the pattern breath sounds, cough, and
•Advise patient to maintain a fluid intake of 2-
•Warn the patient about the rotten egg smell of
•A Decongestant drugs used
to relieve nasal congestion
in upper respiratory tracts.
Mechanism of action
•Decongestants are sympathomimetic drugs
that act by stimulating the α (alpha) –
adrenergic receptors. The decongestant
effect due to vasoconstriction of the blood
vessel in the nose sinuses etc. the
vasoconstriction effect reduces swelling or
inflammation and mucous formation in the
nasal passage and make it easier to breath.
•For temporary relief of nasal congestion due
to common cold.
•Upper respiratory tract allergens.
•To promote nasal and sinus drainage.
•Hypersensitivity to these drugs.
•MAO (Monoamine oxidase) inhibiters drugs therapy.
•Use cautiously in older age patient they are more likely to
experience adverse reaction.
•Nasal contestant should not be used for more than three
days, and oral decongestant should not used more than
7days because prolonged use will result in rebound
•If given with other
sympathomimetic amines may
increase central nervous system
•If given with MAO inhibiters may
cause severe hypertension.
• Nurse should assess adverse effect of drugs.
• Monitor pulse rate, BP, and ECG.
• Advise patient not to share the container with other
people and not allow the tip of
the container to touch the nasal passage to avoid
Drugs for cough
•The drug which used in cough are:
•They are used to suppress dry cough
mostly because their aim to control
rather than eliminate cough. These
are also called cough center
•These are the drugs that act in
the CNS to increase threshold of
1 Codeine (Opioids) 15-60mg up to every 4 hrs
2 Noscapine (Non opioids) PO 15-30 mg itramin maleate
3 Dextromethorphan (Non
10-30mg PO 4-8hrs max.
4 mg PO 4-6 hrly
25 mg PO 4hrly not to exceed
150 mg / day.
•Assess the side effects or adverse
reaction during the therapy.
•Special precaution should be keep in
mind before drug administration.
•Advise to patient not to driving after
taken opioids drugs such as codeine
•These drugs help in removal of
secretions of respiratory tract and
mucolytic agents produce liquification of
mucous making expectoration easier.
•They increase bronchial secretions or
reduce its viscosity, sodium and
potassium citrate increase bronchial
secretion by salt action also these drugs
stimulate gastric mucosa or directly
acting on mucous membrane of lungs to
increase the secretion of mucous.
•Chronic productive cough.
•Thick mucous production.
•Combinations with antitussives drugs for