BRONKODILATORDepartment of Pharmacology
Department of Pharmacology
INTRODUCTION
A bronchodilator is a substance that dilates the bronchi and bronchioles , increasing airflow
Bronchodilators may be endogenous (originating naturally within the body), or they may be medications administered for the treatment of breathing difficulties
Faculty of Medicine University of Riau
Department of Pharmacology
HISTORY
The history of bronchodilators goes back 4000 years to a Chinese doctor named Ma Huang, who devised a bronchodilator using Ephedra
The first modern-day bronchodilators, developed about 70 years ago, included ephedrine and adrenaline
Prior to that, whisky, caffeine, tobacco, and chloroform were used to treat paroxysms of the bronchial tubes.
Faculty of Medicine University of Riau
Department of Pharmacology
Bronchial asthma is the most common application of these drugs
They are also intended to help improve the breathing capacity of patients with COPD (Chronic Obstructive Pulmonary Diseases), eg: emphysema , pneumonia and bronchitis
Faculty of Medicine University of Riau
Department of Pharmacology
ACTION
Act on β2 receptors in bronchial smooth muscle and bronchial mucous membranes
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
Faculty of Medicine University of Riau
Department of Pharmacology
This medication should be used only when clearly needed during pregnancy
This drug may be excreted into breast milk
Anticholinergics are not recommended for people with glaucoma or urinary disorders
Faculty of Medicine University of Riau
Department of Pharmacology
Department of Pharmacology
These are quick-relief or "rescue" medications that provide fast, temporary relief from asthma symptoms or flare-ups
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
Faculty of Medicine University of Riau
Department of Pharmacology
Long-acting β2-agonists
These are long-term medications taken routinely in order to control and prevent bronchoconstriction
They are not intended for fast relief
Take longer to begin working, but relieve airway constriction for up to 12 hours
Inhaled - Commonly taken twice a day with an anti-inflammatory medication, they maintain open airways and prevent asthma symptoms, particularly at night.
Oral - Long-acting albuterol is available in pill or syrup form.
Effective for 12 hours, albuterol is particularly helpful for nighttime asthma symptoms. Because this medication requires high dosing, there tend to be increased side-effects
Side-effects include increased heart rate; hyperactivity; feeling nervous, shaky, or over-excited; and, very rarely, upset stomach or difficulty sleeping
Faculty of Medicine University of Riau
Department of Pharmacology
Anticholinergics
Relax the muscles and reduce muscle contractions (spasms), by interfering with nerve signals to muscles
Only available as an inhalant, ipratropium bromide relieves acute or new asthma symptoms
It is most often paired with a short-acting β2-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
Faculty of Medicine University of Riau
Department of Pharmacology
Thought to relax muscles by directly affecting the muscle fibres
Available in oral and injectable form
A long-acting bronchodilator that prevents asthma episodes
It belongs to the chemical class methyl xanthines (along with caffeine)
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
Faculty of Medicine University of Riau
Department of Pharmacology
Theophylline
Side-effects can include nausea, vomiting, diarrhea, stomach or headache, rapid or irregular heart beat, muscle cramps, nervous or jittery feelings, and hyperactivity. It may promote acid reflux , by relaxing the lower esophageal sphincter muscle
Interaction: 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
Faculty of Medicine University of Riau
Department of Pharmacology
Relax muscles and reduce inflammation
Usually effective in a few days and often reduce frequency of attacks