Bronchodilator

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A bronchodilator is a substance that dilates the bronchi and bronchioles, decreasing airway
resistance and thereby facilitating airflow. Bronchodilators may be endogenous (originating
naturally within the body), or they may be medications administered for the treatment of
breathing difficulties. 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. They are often prescribed but of
unproven significance in restrictive lung diseases.

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 2-agonists (short-
and long-acting), anticholinergics (short-acting), and theophylline (long-acting).

Contents
[hide]

1 Short-acting 2-agonists
2 Long-acting 2-agonists
3 Anticholinergics
4 Other
5 Common bronchodilators

6 References

[edit] Short-acting 2-agonists

These are quick-relief or "rescue" medications that provide quick fast, 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
-agonists (for example albuterol) are specific to the lungs; they are called 2-agonists and can
relieve bronchospasms without unwanted cardiac (1) side effects of nonspecific -agonists (for
example, ephedrine or epinephrine). Patients who regularly or frequently need to take short-
acting -agonists should consult their doctor, as such usage indicates uncontrolled asthma, and
their routine medications may need adjustment.
[edit] Long-acting 2-agonists
These are long-term medications taken routinely in order to control and prevent
bronchoconstriction. They are not intended for fast relief. These medications 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.

Salmeterol and Formoterol are examples of these.

[edit] Anticholinergics
Only available as an inhalant, ipratropium bromide relieves acute or new asthma symptoms.
Because it has no effect on asthma symptoms when used alone, it is most often paired with a
short-acting 2-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 minor role in 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.

[edit] Other
Available in oral and injectable form, theophylline is a long-acting bronchodilator that prevents
asthma episodes. It belongs to the chemical class methyl xanthines (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 theopylline 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[1], methamphetamine[2], and cocaine[3], have bronchodilating effects and were used
often for asthma due to the lack of effective 2-agonists for use as bronchdilators, but are now
rarely, if ever, used medically for their bronchodilation effect.[citation needed]

[edit] Common bronchodilators

Commercial Pharmaceuticals
 Albuterol: Short-acting 2-agonists. Brand names: Salbutamol (Canada), Proventil or
Ventolin (U.S.)
Accu-Hale
Pirbuterol (Maxair)
Epinephrine (Primatene)
Ephedrine (Bronkaid)
Salmeterol (Serevent)
Levosalbutamol (Can.) or levalbuterol (U.S.): Short-acting 2-agonist. Brand names:
Xopenex
Clenbuterol (Spiropent)
Formoterol

Other substances with reported bronchodilator effects

Amphetamine
Methamphetamine
Cocaine
Theophylline
Theobromine[4] (Theobroma Cacao)
THC[5]

[edit] References
Drug information: http://www.nlm.nih.gov/medlineplus/druginformation.html

1. ^ http://www.medic8.com/medicines/Amphetamine.html Amphetamine is listed as having

medical uses as bronchodilator
2. ^ http://www.erowid.org/chemicals/meth/meth_faq.shtml Under section "Effects",
methamphetamine is established as having bronchodilating effects
3. ^ http://books.google.com/books?
id=9ceLzaeHsZAC&pg=PA110&lpg=PA110&dq=cocaine+bronchodilation&source=bl&ots=VJ
ObwHdv0p&sig=mVLOdILfc9tp_TWQeNHnvYaqHWo&hl=en&ei=7EQUSoqxBqCY8wTPh7
GABA&sa=X&oi=book_result&ct=result&resnum=10 Page 110 of "Cocaine" by Dominic
Streatfeild
4. ^ http://www.ncbi.nlm.nih.gov/pubmed/4056254 The bronchodilator effect and pharmacokinetics
of theobromine in young patients with asthma
5. ^ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1429361/pdf/brjclinpharm00292-0050.pdf The
Bronchodilator Effect of THC