Asthma belladonna

Unlabeled Uses Glaucoma, severe renal or hepatic disease, bronchial asthma, respiratory depression, convulsive disorders, acute alcoholism, hypersensitivity to belladonna or opium or its components... 

Ext. Belladonna (extract of belladonna) The active agent Is atropine. In neuralgia. It was preferred over opium. Used In cases of whooping cough, scarlet fever, spasmodic asthma, and other Instances calling for an antlspasmodic. 

The most common source of belladonna in the U.S. is in legitimate medicines (asthma preparations, particularly Asthmador, contain belladonna) so this accounts for some of the problems. Also, you will notice traces of belladonna alkaloids in such drugs as Contac capsules and other cold remedies, though in these the adverse effects are minimal, and virtually unnoticeable. Overdose potential on purer forms, including wild jimson weed and Asthmador, is very great. 

Bronchodilation is another property of belladonna alkaloids of potential usefulness. Due to relaxation of the smooth musculature of bronchial passageways, this effect has found applications in asthma and other pulmonary obstructive conditions. At one time the smoking of cigarettes made of stramonium leaves was popular. More recently, atropine, quater-nized with isopropyl bromide (Ipratropium, Fig. 8-13) has been introduced as an aerosol for inhalation. This renewed interest in antimuscarinics resulted in part from clarifications of the role of the parasympathetic system in bronchial obstructions. The availability of a potent agent such as atropine in a poorly absorbed form (i.e., quatemized) would minimize systemic effects following inhalation. Ipratropium bromide does not cross the BBB. It is longer acting and more bronchoselective than atropine methylbromide and exhibits no CNS effects. 

Suamonium 4499 The dried leaves of the jlmson weed, used in medicine similarly to belladonna, especially in asthma. It contains the alkaloids atropine, hyoscyamine and scopolomtne. 

Systemic administration of belladonna alkaloids or their derivatives for bronchial asthma or COPD carries the disadvantage of reducing bronchial secretions and inspissation of the residual secretions. This viscid material is difficult to remove from the respiratory tree, and its presence can dangerously obstruct airflow and predispose to infection. By contrast, ipratropium and tiotropium, administered by inhalation, do not produce adverse effects on mucocfliary clearance, and can be used safely in the treatment of airway disease see Chapter 27). 

A. Prototypes and Pharmacokinetics Atropine and other naturally occurring belladonna alkaloids were used for many years in the treatment of asthma with only modest benefits. A quaternary antimuscarinic agent designed for aerosol use, ipratropium, has achieved much greater success. This drug is dehvered to the airways by pressurized tierosol. When absorbed, ipratropium is rapidly metabolized and has little systemic action. 

The inhalation of nebulized aerosols was advertised as beneficial for many ailments. The Sales-Girons device was advised for pharyngitis, laryngitis, bronchitis, pain, catarrh, asthma, tuberculosis, and sleeplessness (12). The liquids and substances inhaled varied widely and included mineral water containing sulfur, iodine, and chlorine sedatives antiseptics and belladonna. In 1882, Yeo (3) prescribed the use of a mixture of creosote, carbolic acid, eucalyptus, or turpentine with equal parts of spirit and chloroform in his oronasal inhaler. The Yeo inhaler, which is poorly described, is probably more of a vaporizer than an early nebulizer. Earlier, in 1878, Lee (3) performed antiseptic experiments using a jet of steam containing a mixture of phenol and water. Iodoform, iodine, thymol, and terebene were also used (3). 

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