Bronchodilators: new drugs and controversies.
After complete abstinence, regular use of short-acting beta 2-agonists results in an increase in early and late asthmatic (allergen) response, exercise-induced bronchoconstriction, and nonspecific airways responsiveness (methacholine). Regular use of long-acting beta 2-agonists also results in increased nonspecific airways responsiveness (methacholine) with or without concomitant inhaled corticosteroids and attenuates the response to escalating doses of inhaled short-acting beta 2-agonists such as might be used in an acute exacerbation. In spite of these findings, symptom control and bronchodilation are improved more with the addition of salmeterol than with a doubling of inhaled corticosteroid dose. Selective cyclic nucleotide phosphodiesterase inhibitors show promise in expanding the bronchodilator and anti-inflammatory effects of theophylline.
Kleerup
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Division of Pulmonary and Critical Care Medicine, University of California, Los Angeles School of Medicine 90095-1690, USA.
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D000420:Albuterol / Q000031:analogs & derivatives / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D001250:Asthma, Exercise-Induced / Q000188:drug therapy; D016084:Bronchoconstriction / Q000187:drug effects; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016903:Drug Monitoring; D006801:Humans; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D018343:Receptors, Adrenergic, beta-2 / Q000378:metabolism / Q000502:physiology; D000068299:Salmeterol Xinafoate; D013806:Theophylline / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D010726:Phosphodiesterase Inhibitors; D018343:Receptors, Adrenergic, beta-2; D000068299:Salmeterol Xinafoate; D013806:Theophylline; D000420:Albuterol