Bronchodilators, as their name indicates, are chemical substances whose main function is the dilation of the bronchi and bronchioles , allowing a better passage of air and oxygen through them to the lungs. They are medicines used to treat respiratory diseases that cause respiratory distress.

They serve to improve the flow of air through the respiratory system, they are used mostly in diseases such as asthma that have a chronic significance or allergies that have been present in the patient over the years, although they can also originate within the body and considered endogenous, they are known mostly for their pharmaceutical function.

What is the function of bronchodilators?

The main function of bronchodilators is to participate as a bronchial relaxant, which causes the bronchi to spread out and the air to flow more easily through them.

In addition, they act specifically by reducing the resistance of the respiratory tract to air, that is, these substances make the respiratory tract not oppose the air and its flow.

What are the most commonly used bronchodilators?

There are different types of bronchodilators, the most used currently, due to their characteristics, effect, and duration are:

Ipratropium Bromide

It is currently the most widely used bronchodilator drug, it serves as a treatment for obstructive respiratory diseases that can be reversible, its effect is a little shorter than that of other medications, however, it is very effective in alleviating symptoms that cannot or cannot be treated. tolerate other types of treatment.

Ipratropium bromide exerts action between 4 to 6 hours and therefore is considered short-lived, although specifically it is not.

Tiotropium bromide

It is an anticholinergic bronchodilator, according to its classification that will be seen later, it has a much longer effect (up to 24 hours), it is easy to administer, it only requires to be inhaled once a day.

Tiotropium bromide is used in patients with long-standing severe asthma, and is used in conjunction with other medications. Those who suffer symptoms that are constant, and report very frequent crises despite complying with the letter of the treatment sent by the specialist, are contestants for this bronchodilator.

Inhaled bronchodilators

Inhaled bronchodilators are those that are administered airway through small inhalations of the active substance of the drug either directly or by small nebulizations.

There are also oral bronchodilators, however, these do not have the same effect or speed as inhaled ones, since the latter reach the bronchial muscles quickly and directly, and exert their effect. On the contrary, the former must reach the stomach, and through the blood go to the respiratory system to fulfill their objective.

That is, the effect of inhaled bronchodilators can be seen much faster than those administered by other routes.

Classification of bronchodilators

In our body there are different types of beta adrenergic receptors, the beta-1 that are found in the heart, the beta-2 that are present in different cells, but more abundant in the cells that are part of the smooth muscle, which is the muscle. that constitutes the bronchi, and finally the beta-3 that appear in the adipose tissue.

The classification of bronchodilators was carried out according to the receptor where they bind and thus send the necessary signals to exercise their function in the body.

According to this there are:

  • Beta-2 agonists.
  • Anti-cholinergics.
  • Theophylline
  • Others.

Beta-2 agonists

They are divided into:

  • Short acting.
  • Long-acting.

Short-acting beta-2 agonists

  • Being of short duration, they should be administered in shorter periods of time, usually 2 or 6 hours.
  • They are excellent for providing brief relief from symptoms that occur in asthma attacks.
  • In most cases they are used through nebulisation or inhalation, as in this way they have a faster and more efficient effect.

Prolonged beta-2 agonists

  • They are often taken on a regular basis, mostly to control or in that case prevent the contraction of the bronchial muscles.
  • It is important to know that every time it will not act quickly, it must be administered together with a short-acting bronchodilator or steroids to avoid exaggerated inflammation of the bronchi, which could lead to the death of the patient with asthma.

Anti-cholinergics

  • They are often used in treatments for emphysema or COPD (chronic obstructive pulmonary disease).
  • One of the symptoms of this disease is wheezing, small sounds that resemble whistling and that predominate during inspiration of air. In these patients, it is recommended to use short-term bronchodilators, they are more effective and avoid the sudden appearance of some characteristic symptoms of these diseases.
  • Its use is not recommended in patients with asthmatic disease.

Theophylline

Surely you have ever heard this name, it is a substance that has a certain similarity to caffeine, frequently used in the prevention of asthmatic attacks in long-term patients with this disease, or very serious asthmatic people.

It exerts a long-acting bronchodilator effect, according to the similarity with caffeine and other substances known as methylxanthines (tea, chocolate), it is recommended that the specialist doctor monitor or reduce the consumption of these other substances, so that it does not affect the metabolism and the effects of theophylline.

Other bronchodilators

In ancient times, before the wonderful discovery of bronchodilators, there was some knowledge that some psychostimulant substances, for example, amphetamine, cocaine and methamphetamine, had some degree of bronchodilator effect, and that is why they were used very frequently for the treatment of asthma.

Currently bronchodilators are more recommended and of course their advances have left behind the use of other substances.

How should bronchodilators be administered?

There are three special techniques for the administration of bronchodilators, in fact, these techniques are intended to achieve the highest efficiency in the treatment of respiratory diseases such as asthma, COPD, emphysema, among others.

The techniques are:

Inhalation of aerosols

  • Shake the substance to be inhaled very well.
  • Blow in such a way that all the air contained in the lungs can be expelled.
  • Orient the spray in the mouth and closing the lips on the device, without using force, much less trying to bite it.
  • Press the spray and simultaneously take a very deep breath.
  • Hold your breath and then take a deep breath.
  • If more than one inhalation must be done, it is advisable to wait a minute of slow breaths and repeat the procedure.

Dry powder inhalers

  • Orient the inhaler vertically.
  • Twist the screw at the bottom of the inhaler twice, once to the right and once to the left until you hear a sound similar to a “click”. The same is done in case there are several doses and the instrument must be loaded.
  • Blow gently while expelling all the air that may be inside the lungs.
  • Direct the mouthpiece of the inhaler instrument to your mouth, close your lips and inhale very deeply.
  • Remove the instrument and hold your breath for a few seconds.
  • Breathe gently over the course of a minute.

Inhalation chambers

  • The camera indicates which end to place the inhaler and mouthpiece, in this case, adjust both ends correctly.
  • Shake it with great care and caution.
  • Press the aerosol taking into account the dose recommended by the specialist.
  • The correct thing is that the substance is locked in the chamber.
  • Here you proceed to breathe gently, and release all or most of the air contained in the lungs.
  • Position the inhalation chamber on the face so that there is no leakage of the substance to be inhaled.
  • Breathe in deeply, hold your breath and in this case, you must expel the air into the same inhaler chamber.
  • This content must be inspired again without pressing the inhaler again.
  • Keep the count of the inhaled doses and the doses prescribed by the specialist, since they must be the same.

Side effects of bronchodilators

Although not all people with medical treatments of this type get to have side effects, it is important to know about them:

  • He retched.
  • Sickness.
  • Headache.
  • Restlessness.
  • Hyperactivity
  • Nervousness.
  • Difficulty getting to sleep.
  • Muscular weakness.
  • Bone weakness
  • Vision problems
  • Weight loss or weight loss.
  • Increase in normal blood pressure figures in the person.

conclusion

Bronchodilators are drugs that have set the standard in the medicinal field of chronic respiratory diseases, their importance is evident, their use must be done in a regulated way and according to the specialist’s indications to avoid complications and improve your health condition when passing the weather.

Samantha Robson
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Dr. Samantha Robson ( CRN: 0510146-5) is a nutritionist and website content reviewer related to her area of ​​expertise. With a postgraduate degree in Nutrition from The University of Arizona, she is a specialist in Sports Nutrition from Oxford University and is also a member of the International Society of Sports Nutrition.

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