fbpx
Wikipedia

Bronchodilator

April 12, 2024

A bronchodilator or broncholytic[1] (although the latter occasionally includes secretory inhibition as well) is a substance that dilates the bronchi and bronchioles, decreasing resistance in the respiratory airway and increasing airflow to the lungs. Bronchodilators may be originating naturally within the body, or they may be medications administered for the treatment of breathing difficulties, usually in the form of inhalers. They are most useful in obstructive lung diseases, of which asthma and chronic obstructive pulmonary disease are the most common conditions. Although this remains somewhat controversial, they might be useful in bronchiolitis and bronchiectasis. They are often prescribed but of unproven significance in restrictive lung diseases.[2]

Bronchodilator
SpecialtyPulmonology
[edit on Wikidata]

Bronchodilators are either short-acting or long-acting. Short-acting medications provide quick or "rescue" relief from acute bronchoconstriction. Long-acting bronchodilators help to control and prevent symptoms. The three types of prescription bronchodilating drugs are beta-2 adrenergic agonists (short- and long-acting), anticholinergics (short- and long-acting), and theophylline (long-acting).

Short-acting β2-adrenergic agonists edit

These are quick-relief or "rescue" medications that provide quick, temporary relief from asthma symptoms or flare-ups. These medications usually take effect within 20 minutes or less, and can last from four to six hours. These inhaled medications are best for treating sudden and severe or new asthma symptoms. Taken 15 to 20 minutes ahead of time, these medications can also prevent asthma symptoms triggered by exercise or exposure to cold air. Some short-acting β-agonists, such as salbutamol, are specific to the lungs; they are called β2-adrenergic agonists and can relieve bronchospasms without unwanted cardiac side effects of nonspecific β-agonists (for example, ephedrine or epinephrine). Patients who regularly or frequently need to take a short-acting β2-adrenergic agonist should consult their doctor, as such usage indicates uncontrolled asthma, and their routine medications may need adjustment.[citation needed]

Long-acting β2-adrenergic agonists edit

Main article: Long-acting beta-adrenoceptor agonist

These are long-term medications taken routinely in order to control and prevent bronchoconstriction. They are not intended for fast relief. These medications may take longer to begin working, but relieve airway constriction for up to 12 hours. Commonly taken twice a day with an anti-inflammatory medication, they maintain open airways and prevent asthma symptoms, particularly at night.[citation needed]

Salmeterol and formoterol are examples of these.

Anticholinergics edit

Main article: Anticholinergics

Some examples of anticholinergics are tiotropium (Spiriva) and ipratropium bromide.[citation needed]

Tiotropium is a long-acting, 24-hour, anticholinergic bronchodilator used in the management of chronic obstructive pulmonary disease (COPD).

Only available as an inhalant, ipratropium bromide is used in the treatment of asthma and COPD. As a short-acting anticholinergic, it improves lung function and reduces the risk of exacerbation in people with symptomatic asthma.[3] However, it will not stop an asthma attack already in progress. Because it has no effect on asthma symptoms when used alone, it is most often paired with a short-acting β2-adrenergic agonist. While it is considered a relief or rescue medication, it can take a full hour to begin working. For this reason, it plays a secondary role in acute asthma treatment. Dry throat is the most common side effect. If the medication gets in contact with the eyes, it may cause blurred vision for a brief time.

The use of anticholinergics in combination with short-acting β2-adrenergic agonists has been shown to reduce hospital admissions in children and adults with acute asthma exacerbations.[4][5]

Other edit

Available in oral and injectable form, theophylline is a long-acting bronchodilator that prevents asthma episodes. It belongs to the chemical class methylxanthines (along with caffeine). It is prescribed in severe cases of asthma or those that are difficult to control. It must be taken 1–4 times daily, and doses cannot be missed. Blood tests are required to monitor therapy and to indicate when dosage adjustment is necessary. Side effects can include nausea, vomiting, diarrhea, stomach or headache, rapid or irregular heart beat, muscle cramps, nervous or jittery feelings, and hyperactivity. These symptoms may signal the need for an adjustment in medication. It may promote acid reflux, also known as GERD, by relaxing the lower esophageal sphincter muscle. Some medications, such as seizure and ulcer medications and antibiotics containing erythromycin, can interfere with the way theophylline works. Coffee, tea, colas, cigarette-smoking, and viral illnesses can all affect the action of theophylline and change its effectiveness. A physician should monitor dosage levels to meet each patient's profile and needs.

Additionally, some psychostimulant drugs that have an amphetamine like mode of action, such as amphetamine,[6] methamphetamine, and cocaine,[7] have bronchodilating effects and were used often for asthma due to the lack of effective β2-adrenergic agonists for use as bronchodilator, but are now rarely, if ever, used medically for their bronchodilatory effects.

Gaseous carbon dioxide also relaxes airway musculature: hypocapnia caused by deliberate hyperventilation increases respiratory resistance while hypercapnia induced by carbon dioxide inhalation reduces it;[8] however, this bronchodilating effect of carbon dioxide inhalation only lasts 4 to 5 minutes.[9] Nonetheless, this observation has inspired the development of S-1226, carbon dioxide-enriched air formulated with nebulized perflubron.[10]

Common bronchodilators edit

The bronchodilators are divided into short- and long-acting groups. Short-acting bronchodilators are used for relief of bronchoconstriction, while long-acting bronchodilators are predominantly used for prevention.

Short-acting bronchodilators include:

Long-acting bronchodilators include

Experimental bronchodilator edit

From among 6000 compounds that relax the smooth muscle cells of the lungs' airways and open up the airways in asthmatic lung tissues, researchers have identified a drug called TSG12. TSG12 is a specific transgelin-2 (TG2)-agonist that relaxes airway smooth muscle cells and reduces asthmatic pulmonary resistance. The authors claim that "TSG12 is both non-toxic and more effective in reducing pulmonary resistance than current bronchodilators and could be a promising therapeutic approach for treating asthma without losing effectiveness over time."[11][12]

References edit

  1. ^ Venes, Donald (2017-01-25). Taber's Cyclopedic Medical Dictionary. F.A. Davis. ISBN 9780803659407.
  2. ^ Sathe NA, Krishnaswami S, Andrews J, Ficzere C, McPheeters ML (July 2015). "Pharmacologic Agents That Promote Airway Clearance in Hospitalized Subjects: A Systematic Review" (PDF). Respiratory Care. 60 (7): 1061–70. doi:10.4187/respcare.04086. PMID 25944943. S2CID 7017557.
  3. ^ Price D, Fromer L, Kaplan A, van der Molen T, Román-Rodríguez M (July 2014). "Is there a rationale and role for long-acting anticholinergic bronchodilators in asthma?". npj Primary Care Respiratory Medicine. 24 (1): 14023. doi:10.1038/npjpcrm.2014.23. PMC 4373380. PMID 25030457.
  4. ^ Rodrigo GJ, Castro-Rodriguez JA (September 2005). "Anticholinergics in the treatment of children and adults with acute asthma: a systematic review with meta-analysis". Thorax. 60 (9): 740–6. doi:10.1136/thx.2005.040444. PMC 1747524. PMID 16055613.
  5. ^ Griffiths B, Ducharme FM (December 2013). "Combined inhaled anticholinergics and short-acting beta2-agonists for initial treatment of acute asthma in children". Paediatric Respiratory Reviews. 14 (4): 234–5. doi:10.1016/j.prrv.2013.08.002. PMID 24070913.
  6. ^ is listed as having medical uses as bronchodilator. Medic8
  7. ^ Streatfeild D (17 June 2003). Cocaine: An Unauthorized Biography. Macmillan. p. 110. ISBN 978-0-312-42226-4. Retrieved 14 February 2011.
  8. ^ van den Elshout, F. J.; van Herwaarden, C. L.; Folgering, H. T. (January 1991). "Effects of hypercapnia and hypocapnia on respiratory resistance in normal and asthmatic subjects". Thorax. 46 (1): 28–32. doi:10.1136/thx.46.1.28. ISSN 0040-6376. PMC 1020910. PMID 1908137.
  9. ^ Fisher, H. K.; Hansen, T. A. (November 1976). "Site of action of inhaled 6 per cent carbon dioxide in the lungs of asthmatic subjects before and after exercise". The American Review of Respiratory Disease. 114 (5): 861–870. doi:10.1164/arrd.1976.114.5.861 (inactive 31 January 2024). ISSN 0003-0805. PMID 984580.{{cite journal}}: CS1 maint: DOI inactive as of January 2024 (link)
  10. ^ Green, Francis H. Y.; Leigh, Richard; Fadayomi, Morenike; Lalli, Gurkeet; Chiu, Andrea; Shrestha, Grishma; ElShahat, Sharif G.; Nelson, David Evan; El Mays, Tamer Y.; Pieron, Cora A.; Dennis, John H. (2016-07-28). "A phase I, placebo-controlled, randomized, double-blind, single ascending dose-ranging study to evaluate the safety and tolerability of a novel biophysical bronchodilator (S-1226) administered by nebulization in healthy volunteers". Trials. 17: 361. doi:10.1186/s13063-016-1489-8. ISSN 1745-6215. PMC 4964056. PMID 27464582.
  11. ^ New drug therapy could lead to more effective treatment for millions with asthma
  12. ^ Yin, Lei-Miao; Xu, Yu-Dong; Peng, Ling-Ling; Duan, Ting-Ting; Liu, Jia-Yuan; Xu, Zhijian; Wang, Wen-Qian; Guan, Nan; Han, Xiao-Jie; Li, Hai-Yan; Pang, Yu; Wang, Yu; Chen, Zhaoqiang; Zhu, Weiliang; Deng, Linhong; Wu, Ying-Li; Ge, Guang-Bo; Huang, Shuang; Ulloa, Luis; Yang, Yong-Qing (2018). "Transgelin-2 as a therapeutic target for asthmatic pulmonary resistance". Science Translational Medicine. 10 (427). doi:10.1126/scitranslmed.aam8604. PMC 6310021. PMID 29437149.

External links edit

  • Drug information

April 12, 2024
bronchodilator, bronchodilator, broncholytic, although, latter, occasionally, includes, secretory, inhibition, well, substance, that, dilates, bronchi, bronchioles, decreasing, resistance, respiratory, airway, increasing, airflow, lungs, originating, naturally. A bronchodilator or broncholytic 1 although the latter occasionally includes secretory inhibition as well is a substance that dilates the bronchi and bronchioles decreasing resistance in the respiratory airway and increasing airflow to the lungs Bronchodilators may be originating naturally within the body or they may be medications administered for the treatment of breathing difficulties usually in the form of inhalers They are most useful in obstructive lung diseases of which asthma and chronic obstructive pulmonary disease are the most common conditions Although this remains somewhat controversial they might be useful in bronchiolitis and bronchiectasis They are often prescribed but of unproven significance in restrictive lung diseases 2 BronchodilatorSpecialtyPulmonology edit on Wikidata Bronchodilators are either short acting or long acting Short acting medications provide quick or rescue relief from acute bronchoconstriction Long acting bronchodilators help to control and prevent symptoms The three types of prescription bronchodilating drugs are beta 2 adrenergic agonists short and long acting anticholinergics short and long acting and theophylline long acting Contents 1 Short acting b2 adrenergic agonists 2 Long acting b2 adrenergic agonists 3 Anticholinergics 4 Other 5 Common bronchodilators 6 Experimental bronchodilator 7 References 8 External linksShort acting b2 adrenergic agonists editThese are quick relief or rescue medications that provide quick temporary relief from asthma symptoms or flare ups These medications usually take effect within 20 minutes or less and can last from four to six hours These inhaled medications are best for treating sudden and severe or new asthma symptoms Taken 15 to 20 minutes ahead of time these medications can also prevent asthma symptoms triggered by exercise or exposure to cold air Some short acting b agonists such as salbutamol are specific to the lungs they are called b2 adrenergic agonists and can relieve bronchospasms without unwanted cardiac side effects of nonspecific b agonists for example ephedrine or epinephrine Patients who regularly or frequently need to take a short acting b2 adrenergic agonist should consult their doctor as such usage indicates uncontrolled asthma and their routine medications may need adjustment citation needed Long acting b2 adrenergic agonists editMain article Long acting beta adrenoceptor agonist These are long term medications taken routinely in order to control and prevent bronchoconstriction They are not intended for fast relief These medications may take longer to begin working but relieve airway constriction for up to 12 hours Commonly taken twice a day with an anti inflammatory medication they maintain open airways and prevent asthma symptoms particularly at night citation needed Salmeterol and formoterol are examples of these Anticholinergics editMain article Anticholinergics Some examples of anticholinergics are tiotropium Spiriva and ipratropium bromide citation needed Tiotropium is a long acting 24 hour anticholinergic bronchodilator used in the management of chronic obstructive pulmonary disease COPD Only available as an inhalant ipratropium bromide is used in the treatment of asthma and COPD As a short acting anticholinergic it improves lung function and reduces the risk of exacerbation in people with symptomatic asthma 3 However it will not stop an asthma attack already in progress Because it has no effect on asthma symptoms when used alone it is most often paired with a short acting b2 adrenergic agonist While it is considered a relief or rescue medication it can take a full hour to begin working For this reason it plays a secondary role in acute asthma treatment Dry throat is the most common side effect If the medication gets in contact with the eyes it may cause blurred vision for a brief time The use of anticholinergics in combination with short acting b2 adrenergic agonists has been shown to reduce hospital admissions in children and adults with acute asthma exacerbations 4 5 Other editAvailable in oral and injectable form theophylline is a long acting bronchodilator that prevents asthma episodes It belongs to the chemical class methylxanthines along with caffeine It is prescribed in severe cases of asthma or those that are difficult to control It must be taken 1 4 times daily and doses cannot be missed Blood tests are required to monitor therapy and to indicate when dosage adjustment is necessary Side effects can include nausea vomiting diarrhea stomach or headache rapid or irregular heart beat muscle cramps nervous or jittery feelings and hyperactivity These symptoms may signal the need for an adjustment in medication It may promote acid reflux also known as GERD by relaxing the lower esophageal sphincter muscle Some medications such as seizure and ulcer medications and antibiotics containing erythromycin can interfere with the way theophylline works Coffee tea colas cigarette smoking and viral illnesses can all affect the action of theophylline and change its effectiveness A physician should monitor dosage levels to meet each patient s profile and needs Additionally some psychostimulant drugs that have an amphetamine like mode of action such as amphetamine 6 methamphetamine and cocaine 7 have bronchodilating effects and were used often for asthma due to the lack of effective b2 adrenergic agonists for use as bronchodilator but are now rarely if ever used medically for their bronchodilatory effects Gaseous carbon dioxide also relaxes airway musculature hypocapnia caused by deliberate hyperventilation increases respiratory resistance while hypercapnia induced by carbon dioxide inhalation reduces it 8 however this bronchodilating effect of carbon dioxide inhalation only lasts 4 to 5 minutes 9 Nonetheless this observation has inspired the development of S 1226 carbon dioxide enriched air formulated with nebulized perflubron 10 Common bronchodilators editThe bronchodilators are divided into short and long acting groups Short acting bronchodilators are used for relief of bronchoconstriction while long acting bronchodilators are predominantly used for prevention Short acting bronchodilators include Salbutamol albuterol Proventil or Ventolin Levosalbutamol levalbuterol Xopenex Pirbuterol Maxair Epinephrine Primatene Mist Racemic Epinephrine Asthmanefrin Primatene Mist Replacement Ephedrine Bronkaid TerbutalineLong acting bronchodilators include Salmeterol Serevent or Seretide Clenbuterol Spiropent Formoterol Bambuterol IndacaterolExperimental bronchodilator editFrom among 6000 compounds that relax the smooth muscle cells of the lungs airways and open up the airways in asthmatic lung tissues researchers have identified a drug called TSG12 TSG12 is a specific transgelin 2 TG2 agonist that relaxes airway smooth muscle cells and reduces asthmatic pulmonary resistance The authors claim that TSG12 is both non toxic and more effective in reducing pulmonary resistance than current bronchodilators and could be a promising therapeutic approach for treating asthma without losing effectiveness over time 11 12 References edit Venes Donald 2017 01 25 Taber s Cyclopedic Medical Dictionary F A Davis ISBN 9780803659407 Sathe NA Krishnaswami S Andrews J Ficzere C McPheeters ML July 2015 Pharmacologic Agents That Promote Airway Clearance in Hospitalized Subjects A Systematic Review PDF Respiratory Care 60 7 1061 70 doi 10 4187 respcare 04086 PMID 25944943 S2CID 7017557 Price D Fromer L Kaplan A van der Molen T Roman Rodriguez M July 2014 Is there a rationale and role for long acting anticholinergic bronchodilators in asthma npj Primary Care Respiratory Medicine 24 1 14023 doi 10 1038 npjpcrm 2014 23 PMC 4373380 PMID 25030457 Rodrigo GJ Castro Rodriguez JA September 2005 Anticholinergics in the treatment of children and adults with acute asthma a systematic review with meta analysis Thorax 60 9 740 6 doi 10 1136 thx 2005 040444 PMC 1747524 PMID 16055613 Griffiths B Ducharme FM December 2013 Combined inhaled anticholinergics and short acting beta2 agonists for initial treatment of acute asthma in children Paediatric Respiratory Reviews 14 4 234 5 doi 10 1016 j prrv 2013 08 002 PMID 24070913 Amphetamine is listed as having medical uses as bronchodilator Medic8 Streatfeild D 17 June 2003 Cocaine An Unauthorized Biography Macmillan p 110 ISBN 978 0 312 42226 4 Retrieved 14 February 2011 van den Elshout F J van Herwaarden C L Folgering H T January 1991 Effects of hypercapnia and hypocapnia on respiratory resistance in normal and asthmatic subjects Thorax 46 1 28 32 doi 10 1136 thx 46 1 28 ISSN 0040 6376 PMC 1020910 PMID 1908137 Fisher H K Hansen T A November 1976 Site of action of inhaled 6 per cent carbon dioxide in the lungs of asthmatic subjects before and after exercise The American Review of Respiratory Disease 114 5 861 870 doi 10 1164 arrd 1976 114 5 861 inactive 31 January 2024 ISSN 0003 0805 PMID 984580 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint DOI inactive as of January 2024 link Green Francis H Y Leigh Richard Fadayomi Morenike Lalli Gurkeet Chiu Andrea Shrestha Grishma ElShahat Sharif G Nelson David Evan El Mays Tamer Y Pieron Cora A Dennis John H 2016 07 28 A phase I placebo controlled randomized double blind single ascending dose ranging study to evaluate the safety and tolerability of a novel biophysical bronchodilator S 1226 administered by nebulization in healthy volunteers Trials 17 361 doi 10 1186 s13063 016 1489 8 ISSN 1745 6215 PMC 4964056 PMID 27464582 New drug therapy could lead to more effective treatment for millions with asthma Yin Lei Miao Xu Yu Dong Peng Ling Ling Duan Ting Ting Liu Jia Yuan Xu Zhijian Wang Wen Qian Guan Nan Han Xiao Jie Li Hai Yan Pang Yu Wang Yu Chen Zhaoqiang Zhu Weiliang Deng Linhong Wu Ying Li Ge Guang Bo Huang Shuang Ulloa Luis Yang Yong Qing 2018 Transgelin 2 as a therapeutic target for asthmatic pulmonary resistance Science Translational Medicine 10 427 doi 10 1126 scitranslmed aam8604 PMC 6310021 PMID 29437149 External links editDrug information Retrieved from https en wikipedia org w index php title Bronchodilator amp oldid 1210072033, wikipedia, wiki, book, books, library,

article

, read, download, free, free download, mp3, video, mp4, 3gp, jpg, jpeg, gif, png, picture, music, song, movie, book, game, games.