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What’s up frt community aasaiya cotton comes to me today and she says hey i watched this video and she loves the breakdown if you haven’t seen it it’s the adrenergic versus the anticholinergic breakdown of those drugs so we give adrenergic drugs and we give anticholinergic drugs now a science question is why would we give both of these together because the video
Does not go in to talk about doing them it talks about how butyl as an agile nergic and talks about a petroleum bromide and tiotropium bromide as anticholinergics or parasympathetics but it does not talk about when we combine them and there’s some confusion here at sia on your part in the idea that why would you give two drugs one that promotes bronchodilation
And one that doesn’t one that reduces mucus production and one that doesn’t seems like they counterbalance each other well let me break it down for your case’ll this this video is solely dedicated to the breaking down of dual nib and how it works to help our patients okay so the video is overdoing it and we know that doing ab is albuterol and actually no i just
Put the brand name up here because it’s easier than spelling out a petropia and bromide but we know that this is our petropia and bromide you should know that this is our own bromide now when you give these two drugs together you have to understand you’re giving two drugs albuterol and atrovent okay so let’s break these two drugs down we know that our butyl is a
Simple mimetic i should have used more of my board right that’s impasto mimetic which means it mimics the sympathetic nervous system now atrovent is a para some patho lytic the lytic means that it blocks the parasympathetic nervous system now let’s just break these two terms down for a second okay when we talk about the sympathetic nervous so you have these effects
When the sympathetic nervous system is i’m going to use a terminal lit up okay when it lights up this is the effects that it has on a pulmonary system it increases bronchodilation and it decreases mucus production okay that’s the sympathetic nervous system now the parasympathetic nervous system increases bronchoconstriction and increases mucus production now this
Looks like something we like right we want drugs that increase bronchodilation decrease inflammation decrease mucus production so this is good bronchoconstriction and increased mucus production is bad we don’t like that as respiratory therapists now this is how the body works to just protect itself so when allergens or irritants are inhaled the parasympathetic
Nervous system via the vagus nerve says says these vaguely mediated response says airways get small and coach yourself so that this area irritant or this allergen doesn’t cause problems within our airways that’s just the way the body is made to work when the sympathetic nervous system is lit up the fight or flight system the body says open up the airways decrease
Mucus production so that we can get lots of oxygen out into the lungs into the body and out to the tissues so that’s the breakdown of these two systems now think about our beuter on atrovent albuterol is a simple mimetic which means it creates this response good right increase bronchodilation decrease mucus production when you think about atrovent or petroleum
Bromide step further and talk about tiotropium bromide you’re talking about a paris empath olynyk the lytic is key here because that term means to block it means to to not allow the parasympathetic action to take place so when you give atrovent then you are blocking these things which sounds good right you don’t want bronchoconstriction we don’t want increased
Mucus production so let’s block them and that’s what atrovent does when you put these two drugs together i’ll be darn atrovent you get doing it and doing them has this effect to where the albuterol is seeking out beta 2 receptors to initiate this response that atrovent is seeking out cholinergic receptors so we call these are if you break it down even further
You get into the muscarinic receptors and the nicotinic receptors okay so when you seek out muscarinic receptors these are cholinergic receptors that lead to bronchoconstriction and increased mucus production okay but if atrovent binds to these receptors and blocks them from being able to be attached to by acetylcholine then you get a blocking of this happening
And this is how doing that has its effect this is the end this is the end game our butyl promotes bronchodilation and decrease mucus production actor vent aperture from bromide spiriva tiotropium bromide they block effects of the parasympathetic nervous system so you don’t have one that’s causing bronchodilation and one that’s not doing anything or the opposite
You have one that’s causing bronchodilation and the second drug is blocking bronchoconstriction from happening you have one that is decreasing receptors that will lead to a decrease in two receptors decreased mucus production and you have atrovent the other drug that is attaching to receptors that will block the production of increased secretions and that’s how
Doing that works okay so aasaiya thank you for asking this question there’s your answer if you have any other further questions please send me another comment below i’ll clarify it even further pharmacology i love it i know you do too not really students hate pharmacology and it’s okay but you have to have this base knowledge of why we would give somebody doing
Them first of all you got to understand that atrovent and our parasympathetics are maintenance drugs for copd and to be used in conjunction with albuterol for acute status asthmaticus that does not respond to our bureau by itself or beta-2 agonist by themselves i view our level of your neurons openings so there’s a very small population of patients that should
Be receiving doing them i say small population is actually one of the fastest growing populations but outside of your copd years and your acute asthmatics you shouldn’t have somebody on the floor receiving doing them that doesn’t have some type of underlying pulmonary history pulmonary complication that requires maintenance therapy to block bronchoconstriction and
Increased mucus production simple as that guys so hey i hope this helps everybody leave me a comment hit the subscribe button let me know what you think about it love to hear from you hope everybody is enjoying the last week of their break talk to you soon
Transcribed from video
Respiratory Therapy – How Does Duoneb Work? By Respiratory Coach
