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Asthma & COPD Relievers (Inhaled Beta-2 Receptor Agonists (Drugs:
…
Asthma & COPD Relievers
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Inhaled Anti-Muscarinics
Drugs:
Short-acting antimuscarinics (SAMAs) - Ipratropium
Long-acting antimuscarinics (LAMAs) - Tiotropium, Glycopyrronium
Mechanism of action:
- Blocks M1, M2 & M3 receptors
- Most importantly blocks M3 in bronchial smooth muscle
- This prevents ACh from the SNS signalling for bronchoconstriction
- Also decreases mucous production
Clinical effects:
- Bronchodilation & mucous inhibition
Adverse effects:
Local - dry mouth, cough, hoarseness
Systemic (rare) - Tachycardia, arrhythmias, urinary retention, constipation
SAMAs vs LAMAs:
- SAMAs last for about 4 hours, LAMAs last for 24 hours
- SAMAs can be used instead of SABAs in COPD but only useful to replace SABAs in severe attacks
- LAMAs are used for COPD when symptoms are inadequately controlled
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Magnesium
Mechanism of action:
- Can cause bronchodilation by inhibiting calcium influx, histamine release or ACh release
- Also increases Beta-2 agonist action
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Adverse effects:
- Hypotension, CNS & respiratory depression, arrhymthmias
Clinical use:
- Administered IV if little response to salbutamol