ALLERGY\MEDICAL HELP: BRONCHODILATORS AND ANTI-CHOLINERGICS
Bronchodilators are used in the control of asthma by making the bronchial muscles relax. There are two types of drugs used as bronchodilators – beta-adrenoceptor agonists, and xanthine drugs.
Beta-adrenoceptor agonists can be given in aerosol, powder or tablets. They relax the muscles around the lung airways and are primarily used to relieve, not prevent, bronchospasm; they are sometimes taken before steroid inhalers to free the airways so that the steroids penetrate throughout the lungs. The effectiveness of an inhaled dose lasts for up to six hours. Slow-release tablets or syrup can be useful overnight. They may cause side effects, but usually only briefly if used in excessive doses; these include tremors, palpitations, and headaches. The beneficial effects of the drugs cease once use is stopped.
At present, it appears wiser to prevent asthma using avoidance, desensitisation and, if necessary, inhaled steroids so that relief medication of this kind is not required too frequently, as there is some evidence that prolonged regular use may increase the twitchiness of the airways. Some doctors prefer prevention of asthma to prescribing these drugs indefinitely.
The most commonly used types are as follows:
• Salbutamol: Ventolin, Ventodisks, Volmax, Cobutolin, Salbulin,
Salbuvent, Asmaven, Aerolin-Auto
• Terbutaline: Bricanyl, Monovent
• Pirbuterol: Exirel
• Reproterol: Bronchodil
• Rimiterol:- Pulmadil
For people sensitive to excipients – other ingredients used in preparing the drug – the powder form of an inhaler is usually well tolerated.
One of the most important elements in the effectiveness of these drugs lies in operating the inhaler properly so that the right amount of drug reaches the affected parts. Many inhalers now have metered doses – in forms of turbohaler, diskhaler, or rotohaler.
It is particularly important for children to learn to operate an inhaler properly on their own. Many GPs now run asthma clinics and can advise. The National Asthma Campaign (address in CHARITIES) also offers advice and local support groups.
If a child has problems using an inhaler, bronchodilator drugs can be given as slow-release tablets or in syrups. If the child is highly sensitive to many things, however, a powder inhaler is probably the best alternative.
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