Corticosteroids Beta-agonist bronchodilators

Emphysema is treated by using bronchodilators such as anticholinergic and beta agonists (ipratropium bromide, theophylline) to open the airway by relaxing muscles around the bronchi. Corticosteroids are used to reduce the inflammation that is associated with emphysema. 

Use of Anti-Inflammatory Agents The use of beta-adrenergic agonist bronchodilators alone may not be adequate to control asthma in many patients. Early consideration should be given to adding anti-inflammatory agents, for example, corticosteroids. 

Q12 It is recommended that a trial of a short-acting beta-2-agonist (/S)-agonist) inhaler be made for a few weeks as some COPD patients do benefit from bronchodilation. Although his doctor has prescribed a bronchodilator previously, it may be useful for Bill to try this again. There should also be a trial of a corticosteroid inhaler, as this diminishes the inflammatory component of COPD. If there is no appreciable benefit after four weeks, the steroid should be discontinued. 

The most commonly used bronchodUators are the beta-adrenoceptor agonists. In some patients, a muscarinic blocking drug (eg, ipratropium) has a useful bronchodilating effect. Cromolyn and nedocromil inhibit the degranulation of mast cells and are useful as prophylactic agents in some patients. They are not useful in an acute attack. Systemic corticosteroids are reserved for patients with severe asthma who do not respond adequately to other agents, but inhaled steroids (eg, beclomethasone) are standard prophylactic therapy for aU individuals with moderate or severe recurrent asthma... 

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