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Bronchodilator & Steroid

Bronchodilator & Steroid

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Published by Faiz Taqiu
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Published by: Faiz Taqiu on Apr 11, 2013
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WHAT ARE BRONCHODILATORS?
Bronchodilators are medications that relax the bronchial muscles. Relaxing these muscles makes the airways larger, allowingair to pass through the lungs easier. This helps people with COPD breathe better. Many different kinds of bronchodilators areavailable. They can be grouped according to how long they work (called short- and long-acting drugs) or the way in which theywiden or dilate the airways (beta-agonists, anticholinergics or theophyllines). While all bronchodilators widen the airways, theywork in different ways to do so. It is therefore possible to combine bronchodilators in order to achieve maximal benefit. Manypeople with COPD experience constant breathing difficulty. Bronchodilators therefore need to be taken regularly to keepbreathing under control, this is called maintenance medication. Conversely, reliever medications are used for temporarybreathless.
 
What kinds of bronchodilators are there?
The three main groups of bronchodilators are beta-agonists, anticholinergics and theophyllines. Bronchodilators are importantin treating the symptoms of COPD, such as breathlessness, cough and sputum production. People with COPD are generallyprescribed at least one bronchodilator, however, sometimes two or three medications are needed to control symptoms.Bronchodilators can also be used to "relieve" worsening symptoms. Reliever drugs are usually short acting and, therefore, arenot the best way to control day-to-day symptoms. In order to give you regular control or to maintain your breathing, these short-acting bronchodilators would have to be taken frequently, day and night, 24 hours a day. This is not very practical for mostpeople.It is unusual to find two people with COPD on the same program of medication. Some need bronchodilators from only onegroup, while some need bronchodilators from all three groups. For example, a person may need a beta-agonist as well as ananticholinergic and a theophylline drug. The number of different bronchodilators people with COPD need depends on how welltheir symptoms are controlled.
MECHANISM OF BRONCHODILATOR DRUGS
 
Inhaled allergens stimulate sensory nerve endings called irritant receptors lying below the airwayepithelium.
 
Stimulation of these irritant receptors causes parasympathetic nerves to release acetylcholine (ACh).
 
When acetylcholine binds to M3 muscarinic receptors on airway smooth muscle, a series of events isinitiated which results in an increase in intracellular calcium (Ca2+) and smooth muscle contraction(bronchoconstriction or bronchospasm)
 
 
Some inflammatory mediators such as histamine (not shown in illustration) can also increaseintracellular calcium and cause bronchospasm.
 
 
There are drugs that can be used to counteract this bronchoconstriction
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Beta-2 agonist drugs bind to beta-2 receptors on airway smooth muscle and cause an increase in theconcentration of cAMP in the muscle cell which results in smooth muscle relaxation. When airway smoothmuscle relaxes, the diameter of the air passages is enlarged.
 
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Aminophylline blocks the action of phosphodiesterases and prevents the breakdown of cAMP to 5'-AMP. Thisalso has the effect of relaxing smooth muscle and allowing the airways to dilate.
 
The bronchoconstricting effects of acetylcholine can be blocked by muscarinic antagonists such as ipratropium bromide.Muscarinic antagonists bind to muscarinic receptors and prevent acetylcholine from binding (see illustration).Bronchodilation can also be achieved by alpha-2 agonist drugs that bind to alpha-2 receptors on parasympathetic nervesand prevent acetylcholine from being released. The following schematic illustrates the mechanism of action of the varioustypes of bronchodilator drugs.
 
 
What Are Steroids?
Drugs commonly referred to as "steroids" are classified as anabolic (or anabolic-androgenic) and corticosteroids.Corticosteroids, such as cortisone, are drugs that doctors typically prescribe to help control inflammation in the body.They're often used to help control conditions like asthma and lupus.They're not the same as the anabolic steroids that receive so much media attention for their use by some athletes and bodybuilders.Anabolic steroids are synthetic hormones that can boost the body's ability to produce muscle and prevent musclebreakdown. Some athletes take steroids in the hopes that they will improve their ability to run faster, hit farther, liftheavier weights, jump higher, or have more endurance. In the United States, it is against the law to use anabolic steroidswithout a prescription.Androstenedione, or "andro," is a kind of anabolic steroid taken by athletes who want to build muscle. But researchsuggests that andro taken in large doses every day can significantly increase levels of testosterone, which can lead to anumber of health problems.
How Do Anabolic Steroids Work?
Anabolic steroids are drugs that resemble the chemical structure of the body's natural sex hormone testosterone, which ismade naturally by the body. Testosterone directs the body to produce or enhance male characteristics such as increasedmuscle mass, facial hair growth, and deepening of the voice, and is an important part of male development during puberty.When anabolic steroids increase the levels of testosterone in the blood, they stimulate muscle tissue in the body to growlarger and stronger. However, the effects of too much testosterone circulating in the body can be harmful over time.
Dangers of Anabolic Steroids
Steroids are dangerous for two reasons: they are illegal, and they can damage a person's health, especially if used in largedoses over time. Also, the health problems caused by steroids may not appear until years after the steroids are taken.Although they might help build muscle, steroids can produce very serious side effects. Using steroids for a long time cannegatively affect the reproductive system. In males, steroids can lead to impotence, a reduction in the amount of spermproduced in the testicles, and even reduced testicle size.

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