Asthma anticholinergic drugs

Oxitropium is an anticholinergic drug that is used in the treatment of asthma. 

The leaves of Pilocarpus species, including Pilocarpus jaborandi (jaborandi) and Pilocarpus racemosus (acei-tillo), contain pilocarpine or isopilocarpine as major alkaloids as well as a variety of minor alkaloids. Pilocarpine (see separate monograph) is an agonist at acetylcholine receptors, which enhances salivary flow, sweating, and gastrointestinal motility. It can interfere with asthma therapy and the effect of anticholinergic drugs. 

Keywords Anticholinergics asthma p-agonist corticosteroids drug response genetic association leukotriene polymorphisms. 

Although atropine and related compounds possess bronchodilator activity, their use is associated with the typical spectrum of anticholinergic side effects (see Chapter 13), and they are no longer used in the treatment of asthma. To improve the clinical utility of anticholinergics, quaternary amine derivatives of atropine were developed. By virtue of their positive charge, these drugs are absorbed poorly across mucosal surfaces and thus produce fewer side effects than atropine, especially when given by inhalation. 

The practitioner should be alert to the possible inoculation into the eye of any drug or substance with anticholinergic properties, including plants, cosmetics, perfumes, or medicines. Unilateral fixed and dilated pupils have been reported after the use of antiperspi-rants, transdermal scopolamine (Transderm Scop) for the prophylaxis of motion sickness, and from direct droplet contamination associated with the use of anticholinergic aerosols for treatment of acute asthma and other airflow obstructions. 

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