BRONCHODILATORS

ASTHMA

Asthma is a chronic disease that affects your airways. Your airways are tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways become sore and swollen. That makes them very sensitive, and they may react strongly to things that you are allergic to or find irritating. When your airways react, they get narrower and your lungs get less air.

Symptoms of asthma include:

-Wheezing

-Coughing, especially early in the morning or at night

-Chest tightness

-Shortness of breath

Not all people who have asthma have these symptoms. Having these symptoms doesn't always mean that you have asthma. Your doctor will diagnose asthma based on lung function tests, your medical history, and a physical exam. You may also have allergy tests.

When your asthma symptoms become worse than usual, it's called an asthma attack. Severe asthma attacks may require emergency care, and they can be fatal.

COPD
COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. The main cause of COPD is long-term exposure to substances that irritate and damage the lungs. This is usually cigarette smoke. Air pollution, chemical fumes, or dust can also cause it.

At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include:
-A cough that produces a lot of mucus
-Shortness of breath, especially with physical activity
-Wheezing
-Chest tightness

Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. There is no cure. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant. Quitting smoking is the most important step you can take to treat COPD.

CROUP
Croup is breathing difficulty and a "barking" cough. Croup is due to swelling around the vocal cords. It is common in infants and children.

PHARMACOLOGY
BRONCHODILATORS

1. Adrenoceptor agonists:

-Selective beta agonists: Bambuterol Hydrochloride (Bambec), Fenoterol Hydrobromide, Formoterol Fumarate (Atimos, Foradil, Oxis), Salbutamol (Ventolin, Ventmax, Airomir, Asmasal, Salbulin), Salmeterol (Serevent) and Terbutaline Sulphate (Bricanyl). 

-Other adrenoceptor agonists: Ephedrine Hydrochloride and Orciprenaline Sulphate (Alupent).

2. Antimuscarinic bronchodilators:

-Ipratropium Bromide (Atrovent, Respontin).

-Tiotropium (Spiriva).

3. Theophylline:

-Theophylline (Nuelin, Slo-Phyllin).

-Aminophylline (Phyllocontin Continus).

4. Compound bronchodilator preparations:

-Combivent (ipratropium bromide + salbutamol).

-Duovent (fenotrol hydrobromide + ipratropium bromide).

5. Peak flow meters, inhaler devices and nebulisers:

-Peak flow meters: standard range (MicroPeak, Mini-Wright, Personal Best, Piko-1, Pocketpeak and Vitalograph) and low range (Mini-Wright and Pocketpeak).

-Drug delivery devices: inhaler devices (pressurised metered dose inhalers, breath-actuated inhalers and dry powder inhalers) and spacer devices (Able Spacer, AeroChamber, Babyhaler, Haleraid, Nebuchamber, Nebuhaler, Optichamber, Volumatic, Pocket Chamber and PARI Vortex Spacer).

-Nebulisers: e.g: Medix Lifecare Nebuliser:

Source:
-http://www.nlm.nih.gov/medlineplus/
-BNF 57 March 2009