Paper I
2014 March (2010 Scheme) · 40 marks · 120 min

Question

Bronchodilators

Q53 marksShort Notes

Answer

Bronchodilators relax bronchial smooth muscle, relieving bronchospasm in asthma and COPD.

Classification

  • β2 agonists:
    • Short-acting (SABA): Salbutamol, Terbutaline
    • Long-acting (LABA): Salmeterol, Formoterol
  • Anticholinergics: Ipratropium bromide, Tiotropium
  • Methylxanthines: Theophylline, Aminophylline
  • Leukotriene antagonists (bronchodilator/anti-inflammatory adjuncts): Montelukast

Mechanism

  • β2 agonists: stimulate β2 receptors → increase cAMP → bronchial smooth muscle relaxation
  • Anticholinergics: block M3 muscarinic receptors → reduce vagally-mediated bronchoconstriction
  • Methylxanthines: phosphodiesterase inhibition (↑cAMP) and adenosine receptor antagonism

Uses

  • Bronchial asthma (acute relief and maintenance)
  • COPD

Adverse effects

  • β2 agonists: tremor, tachycardia, hypokalaemia
  • Anticholinergics: dry mouth
  • Theophylline: narrow therapeutic index — nausea, arrhythmias, seizures at toxic levels

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