Chronic bronchitis bronchodilators

The two major types of bronchodilators are the sym-padiomimetics and die xantiiine derivatives. The anticholinergic drug ipratropium bromide (Atrovent) is used for bronchospasm associated witii COPD, chronic bronchitis, and emphysema. Ipratropium is included in die Summary Drug Table Bronchodilators. Chapter 25... 

Bronchospasm (solution and aerosol) Used alone or in combination with other bronchodilators (especially beta-adrenergics) as a bronchodilator for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. 

Chronic obstructive pulmonary disease is a respiratory condition characterized by irreversible airway obstruction caused by chronic bronchitis or emphysema. The major symptoms of COPD include chronic cough, increased sputum production, and dyspnea. The vast majority of patients with COPD are those who are current or former heavy smokers. Other risk factors for the development of COPD include occupational exposure (dusts, chemicals) and rare genetic disorders (a -antitrypsin deficiency). The medical management of COPD includes pharmacotherapy (bronchodilators, corticosteroids, and antibiotics) in combination with interventions to reduce risk factors for disease progression (e.g., smoking cessation). Some patients require long-term administration of supplemental oxygen. 

Antimuscarinics are potent bronchodilators and are used in the treatment of chronic bronchitis and asthma. 

Theophylline is used as a bronchodilator in the treatment of asthma and reversible bronchospasm associated with chronic bronchitis and emphysema. Unlabeled use includes treatment of sleep apnea in neonates. 

Chronic bronchitis is treated with bronchodilator medication that dilates the bronchi. Antibiotics are not used to treat chronic bronchitis except if a subsequent lung infection develops. 

The treatment of acute exacerbations of chronic bronchitis includes attempts to mobilize and enhance sputum expectoration (chest physiotherapy, humidification of inspired air), oxygen if needed, aerosolized bronchodilators (al-... 

For patients who consistently demonstrate clinical limitation in airflow, a therapeutic challenge of bronchodilators (such as albuterol aerosol) should be considered. Pulmonary function tests can be performed before and after 82-agonist aerosol administration to determine more objectively a patient s propensity to benefit from supplemental aerosol therapy. However, this laboratory assessment, often performed at times of better health, may not accurately predict a patient s potential benefit from P2 aerosols during an acute exacerbation of chronic bronchitis. 

Antimuscarinic drugs are used to relieve, or at least partially reverse, bronchoconstriction that is refractory to P2 adrenoreceptor stimulants. These drugs work by blocking acetylcholine receptors (the so-called muscarinic receptors) in the bronchioles. This effectively prevents bronchoconstriction in response to parasympathetic stimulation. They may be used in combination with other bronchodilators. Antimuscarinics are of particular use in chronic bronchitis where the airways seem resistant to P2 receptor stimulation and because they also reduce mucus secretion. They are most frequently used as aerosol inhalers and in nebulizers. 

Explain why antimuscarinic bronchodilators are likely to be more effective in chronic bronchitis rather than asthma. 

Aminophylline - bronchodilator asthma, chronic bronchitis Amiodarone - anti-arrhythmic Amisulpiride - antipsychotic Amitriptyline - antidepressant... 

Ipratropium - anti-muscarinic bronchodilator asthma, chronic bronchitis... 

Theophylline - bronchodilator asthma, chronic bronchitis Thipental - intravenous general anaesthetic Tiabendazole - anthelmintic Tioconazole - antifungal... 

Theophylline, a bronchodilator, is indicated for the symptomatic relief of bronchospasm in patients not currently receiving theophylline who require rapid relief of acute symptoms and for prophylaxis of bronchial asthma, bronchospasm of chronic bronchitis, and emphysema (see also Figure 94). 

TIOTROPIUM BROMIDE (Spiriva powder for inhalation 18mcg (as base)) Tiotropium bromide is an anticholinergic that inhibits smooth muscle receptors, leading to bronchodilation. It is indicated for long-term, maintenance treatment of broncho-spasm associated with COPD, including chronic bronchitis and emphysema. 

As noted in Section II, a bronchodilator effect of inhaled NO was demonstrated in guinea pigs (Dupuy et al., 1992) and later in anesthetized rabbits (Hogman et al., 1993b). However, the bronchodilator effect in humans with stable asthma or chronic bronchitis was less dramatic, or absent, in several patients inhaling 80 ppm NO for 10 min (Hogman etal., 1993c). Similar weak bronchodilatory effects of inhaled NO were reported by Kacm-arek et al. (1993). 

Roflumilast has received approval from the European Medicines Agency (EMA) for use as maintenance treatment in severe COPD associated with chronic bronchitis with frequent exacerbations, as an add-on to bronchodilator therapy. 

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