Chapter 52: Adult Respiratory Medications

Bronchodilators including beta-2 adrenergic agonists and methylxanthines work by relaxing bronchial smooth muscle, though methylxanthine therapy requires careful monitoring of serum levels to avoid toxicity manifested through cardiovascular and neurological symptoms. Anticholinergic agents block muscarinic receptors to prevent bronchoconstriction and necessitate allergy screening prior to administration. The chapter details anti-inflammatory strategies utilizing glucocorticoids for acute airway edema, leukotriene modifiers for chronic asthma prophylaxis, mast cell stabilizers that prevent allergic mediator release, and monoclonal antibodies targeting immune pathways with potential for anaphylactic reactions. Additional respiratory agents including antihistamines, decongestants, expectorants, mucolytics, and antitussives each serve distinct roles in symptom management with specific contraindications and duration limits. Tuberculosis treatment receives significant attention, requiring multidrug regimens over extended periods to prevent drug resistance, with each first-line agent presenting unique adverse effects ranging from peripheral neuropathy and optic nerve damage to ototoxicity and nephrotoxicity. The chapter concludes with vaccine and antiviral therapies for influenza and emerging viral respiratory infections, highlighting the importance of timely intervention and ongoing clinical guideline updates. Throughout, the emphasis remains on understanding mechanism of action, recognizing adverse effects, monitoring therapeutic levels where applicable, and educating clients about proper medication technique and lifestyle modifications that support respiratory medication efficacy.