Bronchodilator drugs

Starting with two chiral centres, there should, therefore, be four stereoisomers, and this is nicely exemplified by the natural alkaloid (-)-ephedrine, which is employed as a bronchodilator drug and decongestant. Ephedrine is (li ,25)-2-methylamino-l-phenylpropan-l-ol, so has the structure and stereochemistry shown. 

Estimates of the important outcome of bone fracture have shown a small increased risk with inhaled glucocorticoids, but this may well be a feature of the disease rather than the therapy, because comparisons with treatment with bronchodilator drugs show no difference between risk factors in patients taking glucocorticoids or bronchodilators. 

Q4 What type of respiratory disease may produce the test results observed in this patient Would a bronchodilator drug be useful for Bob ... 

Spacer devices are useful to deliver drugs into the respiratory tract of young children with asthma. They reduce the deposition of bronchodilator drugs in the pharynx and require little coordination by the patient to deliver the required dose. 

A number of patients who have persistent airflow obstruction exhibit considerable variation in airways resistance and hence in their benefit from bronchodilators drugs for asthma. It is important to recognise the coexistence of asthma with chronic obstructive pulmonary disease in some patients, and to assess their responses to bronchodilators or glucocorticoids over a period of time (as formal tests of respiratory function may not reliably predict clinical response in this setting). 

In the mid-1950s the first pressurized metered dose inhaler (MDI) was developed for the administration of bronchodilator drugs locally to the lung. It was a major advance for the treatment of asthma since it made aerosol medications readily available in an inexpensive small multidose device. 

Albuterol (e.g., Ventolin, Proventil) P2 adrenergic receptor agonist - causes bronchodilation. Drug of choice for treatment of acute asthma symptoms and to prevent exertion-induced asthma. Though promoted as a fte- selective agonists, side effects parallel nonspecific agonists (vasodilation, tachycardia, CNS stimulation, metabolic alterations. Table 2.1). Inhalation preparations have fewer side effects. 

The following two chapters deal with the historical and contemporary aspects of both adrenergic and theophylline-related bronchodilator drugs. Several new structural types are considered that may indicate future trends in these areas. The problems with theophylline therapy are well documented and the need for improved agents of this class is emphasized. 

The last chapter of the book explores in depth an important new area — prostanoid bronchodilator drugs. An extensive review of the chemistry and structure-activity relationships of the prostaglandin bronchodilators is presented for the first time and prospects for a useful clinical agent are discussed. 

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