Bronchodilator
Encyclopedia
A bronchodilator is a substance that dilates the bronchi
and bronchiole
s, decreasing resistance in the respiratory airway
and increasing airflow to the lung
s. Bronchodilators may be endogenous (originating naturally within the body), or they may be medication
s administered for the treatment of breathing difficulties. They are most useful in obstructive lung disease
s, 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 disease
s.
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 β2-agonists (short- and long-acting), anticholinergics (short-acting), and theophylline
(long-acting).
) are specific to the lungs; they are called β2-agonists and can relieve bronchospasms without unwanted cardiac (β1) side effects of nonspecific β-agonists (for example, ephedrine or epinephrine). Patients who regularly or frequently need to take short-acting β-agonists should consult their doctor, as such usage indicates uncontrolled asthma, and their routine medications may need adjustment.
Salbutamol is an example of a Short-acting β2-agonists
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.
(Spiriva) and ipratropium bromide
.
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. It 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 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.
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 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
, methamphetamine
, and cocaine
, have bronchodilating effects and were used often for asthma
due to the lack of effective β2-agonists for use as bronchdilators, but are now rarely, if ever, used medically for their bronchodilation effect.
Other substances with reported bronchodilator effects:
Bronchus
A bronchus is a passage of airway in the respiratory tract that conducts air into the lungs. The bronchus branches into smaller tubes, which in turn become bronchioles....
and bronchiole
Bronchiole
The bronchioles or bronchioli are the first airway branches that no longer contain cartilage or glands in their submucosa. They are branches of the bronchi.The bronchioles terminate by entering the circular sacs called alveoli.- Structure :...
s, decreasing resistance in the respiratory airway
Respiratory system
The respiratory system is the anatomical system of an organism that introduces respiratory gases to the interior and performs gas exchange. In humans and other mammals, the anatomical features of the respiratory system include airways, lungs, and the respiratory muscles...
and increasing airflow to the lung
Lung
The lung is the essential respiration organ in many air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located near the backbone on either side of the heart...
s. Bronchodilators may be endogenous (originating naturally within the body), or they may be medication
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
s administered for the treatment of breathing difficulties. They are most useful in obstructive lung disease
Obstructive lung disease
Obstructive lung disease is a category of respiratory disease characterized by airway obstruction. It is generally characterized by inflamed and easily collapsible airways, obstruction to airflow, and frequent office visits and hospitalizations. Types of obstructive lung disease include; Asthma,...
s, of which asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
and chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...
are the most common conditions. Although this remains somewhat controversial, they might be useful in bronchiolitis
Bronchiolitis
Bronchiolitis is inflammation of the bronchioles, the smallest air passages of the lungs. It usually occurs in children less than two years of age and presents with coughing, wheezing, and shortness of breath. This inflammation is usually caused by viruses...
. They are often prescribed but of unproven significance in restrictive lung disease
Restrictive lung disease
Restrictive lung diseases are a category of extrapulmonary, pleural, or parenchymal respiratory diseases that restrict lung expansion, resulting in a decreased lung volume, an increased work of breathing, and inadequate ventilation and/or oxygenation...
s.
Bronchodilators are either short-acting or long-acting. Short-acting medications provide quick or "rescue" relief from acute bronchoconstriction
Bronchoconstriction
Bronchoconstriction is the constriction of the airways in the lungs due to the tightening of surrounding smooth muscle, with consequent coughing, wheezing, and shortness of breath. Bronchoconstriction can also be due to an accumulation of thick mucus....
. Long-acting bronchodilators help to control and prevent symptoms. The three types of prescription bronchodilating drugs are β2-agonists (short- and long-acting), anticholinergics (short-acting), and theophylline
Theophylline
Theophylline, also known as dimethylxanthine, is a methylxanthine drug used in therapy for respiratory diseases such as COPD and asthma under a variety of brand names. Because of its numerous side-effects, the drug is now rarely administered for clinical use. As a member of the xanthine family, it...
(long-acting).
Short-acting β2-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 β-agonists (for example salbutamolSalbutamol
Salbutamol or albuterol is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease. It is marketed as Ventolin among other brand names....
) are specific to the lungs; they are called β2-agonists and can relieve bronchospasms without unwanted cardiac (β1) side effects of nonspecific β-agonists (for example, ephedrine or epinephrine). Patients who regularly or frequently need to take short-acting β-agonists should consult their doctor, as such usage indicates uncontrolled asthma, and their routine medications may need adjustment.
Salbutamol is an example of a Short-acting β2-agonists
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. 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
Salmeterol
Salmeterol is a long-acting beta2-adrenergic receptor agonist drug that is currently prescribed for the treatment of asthma and chronic obstructive pulmonary disease. It is currently available as a dry powder inhaler that releases a powdered form of the drug...
and Formoterol
Formoterol
Formoterol or eformoterol is a long-acting β2-agonist used in the management of asthma and/or chronic obstructive pulmonary disease...
are examples of these.
Anticholinergics
Some examples of anticholinergics are tiotropiumTiotropium
Tiotropium bromide is a long-acting, 24 hour, anticholinergic bronchodilator used in the management of chronic obstructive pulmonary disease . Tiotropium bromide capsules for inhalation are co-promoted by Boehringer-Ingelheim and Pfizer under the trade name Spiriva...
(Spiriva) and ipratropium bromide
Ipratropium
Ipratropium bromide is an anticholinergic drug used for the treatment of chronic obstructive pulmonary disease and acute asthma. It blocks the muscarinic acetylcholine receptors in the smooth muscles of the bronchi in the lungs, opening the bronchi...
.
Tiotropium is a long-acting, 24 hour, anticholinergic bronchodilator used in the management of chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...
(COPD).
Only available as an inhalant, ipratropium bromide is used in the treatment of asthma and COPD. It 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 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.
Other
Available in oral and injectable form, theophyllineTheophylline
Theophylline, also known as dimethylxanthine, is a methylxanthine drug used in therapy for respiratory diseases such as COPD and asthma under a variety of brand names. Because of its numerous side-effects, the drug is now rarely administered for clinical use. As a member of the xanthine family, it...
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
Gastroesophageal reflux disease
Gastroesophageal reflux disease , gastro-oesophageal reflux disease , gastric reflux disease, or acid reflux disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus...
, also known as GERD, by relaxing the lower esophageal sphincter muscle. Some medications, such as seizure and ulcer medications and antibiotics containing erythromycin
Erythromycin
Erythromycin is a macrolide antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including mycoplasma and...
, 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
Amphetamine
Amphetamine or amfetamine is a psychostimulant drug of the phenethylamine class which produces increased wakefulness and focus in association with decreased fatigue and appetite.Brand names of medications that contain, or metabolize into, amphetamine include Adderall, Dexedrine, Dextrostat,...
, methamphetamine
Methamphetamine
Methamphetamine is a psychostimulant of the phenethylamine and amphetamine class of psychoactive drugs...
, and cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...
, have bronchodilating effects and were used often for asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
due to the lack of effective β2-agonists for use as bronchdilators, but are now rarely, if ever, used medically for their bronchodilation effect.
Common bronchodilators
Commercial Pharmaceuticals:- SalbutamolSalbutamolSalbutamol or albuterol is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease. It is marketed as Ventolin among other brand names....
: Short-acting β2-agonists. Brand names: Proventil or Ventolin (U.S.) - Accu-Hale
- PirbuterolPirbuterolPirbuterol is a beta-2 adrenergic bronchodilator used in the treatment of asthma, available as a breath-activated metered-dose inhaler .-Clinical use:...
(MaxairMaxairMaxairlnes was an airline based in Sweden.It operated a two Fairchild Metrolinerand two Jetstream 32.Was ceased operations in 1995.-Code data:*IATA Code: 8M*ICAO Code: MXL*Callsign: MAXAIR...
) - EpinephrineEpinephrineEpinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines...
(Primatene) - EphedrineEphedrineEphedrine is a sympathomimetic amine commonly used as a stimulant, appetite suppressant, concentration aid, decongestant, and to treat hypotension associated with anaesthesia....
(Bronkaid) - SalmeterolSalmeterolSalmeterol is a long-acting beta2-adrenergic receptor agonist drug that is currently prescribed for the treatment of asthma and chronic obstructive pulmonary disease. It is currently available as a dry powder inhaler that releases a powdered form of the drug...
(Serevent) - Levosalbutamol (Can.) or levalbuterol (U.S.): Short-acting β2-agonist. Brand names: Xopenex
- ClenbuterolClenbuterolClenbuterol is a sympathomimetic amine used by sufferers of breathing disorders as a decongestant and bronchodilator. People with chronic breathing disorders such as asthma use this as a bronchodilator to make breathing easier...
(Spiropent) - FormoterolFormoterolFormoterol or eformoterol is a long-acting β2-agonist used in the management of asthma and/or chronic obstructive pulmonary disease...
Other substances with reported bronchodilator effects:
- Amphetamine
- Methamphetamine
- Cocaine
- Theophylline
- Caffeine
- TheobromineTheobromineTheobromine , also known as xantheose, is a bitter alkaloid of the cacao plant, with the chemical formula C7H8N4O2. It is found in chocolate, as well as in a number of other foods, including the leaves of the tea plant, and the kola nut...
(Theobroma Cacao) - THCTHCTHC commonly refers to tetrahydrocannabinol, the main active chemical compound in Cannabis.THC may also refer to:* Tan Holdings Corporation...
- MDPV