JAWAHARLAL NEHRU TECHNOLOGICAL UNIVERSITY HYDERABAD B.Pharmacy III Year PHARMACOLOGY-III Previous Question Paper (August/September-2021 - R17)

Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive airflow limitation. The primary signs and symptoms include chronic cough, excessive sputum production, dyspnea (shortness of breath) on exertion, wheezing, and chest tightness. In advanced stages, patients may exhibit cyanosis, peripheral edema, and weight loss.

Management focuses on symptom relief and reducing exacerbations using the following drug classes:

1. Bronchodilators: These are the cornerstone of therapy. Short-acting beta-2 agonists (SABA) like salbutamol provide rapid relief, while long-acting beta-2 agonists (LABA) like salmeterol and formoterol provide sustained bronchodilation. Anticholinergics such as ipratropium (SAMA) or tiotropium (LAMA) block muscarinic receptors to reduce bronchoconstriction.
2. Corticosteroids: Inhaled corticosteroids (ICS) like fluticasone or budesonide are used in combination with LABAs for patients with frequent exacerbations to reduce airway inflammation.
3. Phosphodiesterase-4 Inhibitors: Roflumilast is used in severe cases associated with chronic bronchitis to reduce inflammation.
4. Methylxanthines: Theophylline is used as an add-on therapy, though its use is limited by a narrow therapeutic index.

Expectorants and antitussives serve opposing roles in the management of respiratory conditions involving cough.

While expectorants promote the expulsion of mucus to clear the airway, antitussives are intended to inhibit the cough reflex when the cough is non-productive and causes patient distress or exhaustion. Using antitussives in a productive cough is generally contraindicated as it may lead to mucus accumulation and secondary infection.