Bronchodilator
Bronchodilator | |
---|---|
Specialty | Pulmonology |
A bronchodilator or broncholytic
Bronchodilators are either short-acting or long-acting. Short-acting medications provide quick or "rescue" relief from acute
Short-acting β2-adrenergic agonists
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
Long-acting β2-adrenergic agonists
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
Some examples of anticholinergics are
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
Available in oral and injectable form,
Additionally, some
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
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:
- Salbutamol/albuterol (Proventil or Ventolin)
- Levosalbutamol/levalbuterol (Xopenex)
- Pirbuterol (Maxair)
- Epinephrine(Primatene Mist)
- Racemic Epinephrine(Asthmanefrin, Primatene Mist Replacement)
- Ephedrine (Bronkaid)
- Terbutaline
Long-acting bronchodilators include
- Salmeterol (Serevent or Seretide)
- Clenbuterol (Spiropent)
- Formoterol
- Bambuterol
- Indacaterol
Experimental bronchodilator
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
- ISBN 9780803659407.
- S2CID 7017557.
- PMID 25030457.
- PMID 16055613.
- PMID 24070913.
- ^ Amphetamine is listed as having medical uses as bronchodilator. Medic8
- ISBN 978-0-312-42226-4. Retrieved 14 February 2011.
- PMID 1908137.
- PMID 984580.)
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: CS1 maint: DOI inactive as of January 2024 (link - PMID 27464582.
- ^ New drug therapy could lead to more effective treatment for millions with asthma
- PMID 29437149.