Department of Pharmacology

BRONCHODILATOR
Dr. M. Yulis Hamidy, M.Kes.,
M.Pd.Ked

Faculty of Medicine University of Riau

Department of Pharmacology

INTRODUCTION
A bronchodilator is a substance that
dilates the bronchi and bronchioles,
increasing airflow
Bronchodilators may be endogenous
(originating naturally within the body),
or they may be medications
administered for the treatment of
breathing difficulties
Faculty of Medicine University of Riau

Department of Pharmacology

HISTORY
The history of bronchodilators goes back 4000
years to a Chinese doctor named Ma Huang,
who devised a bronchodilator using Ephedra
The first modern-day bronchodilators,
developed about 70 years ago, included
ephedrine and adrenaline
Prior to that, whisky, caffeine, tobacco, and
chloroform were used to treat paroxysms of
the bronchial tubes.
Faculty of Medicine University of Riau

Department of Pharmacology

INDICATION
Bronchial asthma is the most common
application of these drugs
They are also intended to help improve
the breathing capacity of patients with
COPD (Chronic Obstructive Pulmonary
Diseases), eg: emphysema, pneumonia
and bronchitis
Faculty of Medicine University of Riau

Department of Pharmacology

ACTION
Act on 2 receptors in bronchial smooth
muscle and bronchial mucous membranes
Bronchodilators are either short-acting or
long-acting.
Short-acting medications provide quick or
"rescue" relief from acute bronchoconstriction
Long-acting bronchodilators help to control and
prevent symptoms

Faculty of Medicine University of Riau

Department of Pharmacology

PRECAUTION
Overactive thyroid, heart disease, high blood
pressure, epilepsy, diabetes, any drug
allergies
This medication should be used only when
clearly needed during pregnancy
This drug may be excreted into breast milk
Anticholinergics are not recommended for
people with glaucoma or urinary disorders
Faculty of Medicine University of Riau

Department of Pharmacology

TYPE
1 Short-acting 2-agonists
2 Long-acting 2-agonists
3 Anticholinergics
4 Theophylline
5 Corticosteroids

Faculty of Medicine University of Riau

Department of Pharmacology

Short-acting 2-agonists
These are quick-relief or "rescue" medications that
provide fast, temporary relief from asthma symptoms
or flare-ups
Take effect within 20 minutes or less, and can last
from four to six hours
These inhaled medications are best for treating
sudden and severe or new asthma symptoms
Taken 15 to 20 minutes ahead of time, these
medications can also prevent asthma symptoms
triggered by exercise or exposure to cold air
Faculty of Medicine University of Riau

Department of Pharmacology

Long-acting 2-agonists
These are long-term medications taken routinely in order to
control and prevent bronchoconstriction
They are not intended for fast relief
Take longer to begin working, but relieve airway constriction for
up to 12 hours
Inhaled - Commonly taken twice a day with an anti-inflammatory
medication, they maintain open airways and prevent asthma
symptoms, particularly at night.
Oral - Long-acting albuterol is available in pill or syrup form.
Effective for 12 hours, albuterol is particularly helpful for
nighttime asthma symptoms. Because this medication requires
high dosing, there tend to be increased side-effects
Side-effects include increased heart rate; hyperactivity; feeling
nervous, shaky, or over-excited; and, very rarely, upset stomach
or difficulty sleeping

Faculty of Medicine University of Riau

Department of Pharmacology

Anticholinergics
Relax the muscles and reduce muscle contractions
(spasms), by interfering with nerve signals to muscles
Only available as an inhalant, ipratropium bromide
relieves acute or new asthma symptoms
It is most often paired with a short-acting 2-agonist
While it is considered a relief or rescue medication, it
can take a full hour to begin working. For this reason,
it plays a minor role in asthma treatment
Dry throat is the most common side-effect. If the
medication gets in contact with the eyes, it may cause
blurred vision for a brief time
Faculty of Medicine University of Riau

Department of Pharmacology

Theophylline
Thought to relax muscles by directly affecting the
muscle fibres
Available in oral and injectable form
A long-acting bronchodilator that prevents asthma
episodes
It belongs to the chemical class methyl xanthines
(along with caffeine)
Prescribed in severe cases of asthma or those that are
difficult to control
It must be taken 1-4 times daily, and doses cannot be
missed
Faculty of Medicine University of Riau

Department of Pharmacology

Theophylline
Side-effects can include nausea, vomiting,
diarrhea, stomach or headache, rapid or
irregular heart beat, muscle cramps, nervous
or jittery feelings, and hyperactivity. It may
promote acid reflux, by relaxing the lower
esophageal sphincter muscle
Interaction: erythromycin, can interfere with
the way theopylline works. Coffee, tea, colas,
cigarette-smoking, and viral illnesses can all
affect the action of theophylline and change
its effectiveness
Faculty of Medicine University of Riau

Department of Pharmacology

Corticosteroids
Relax muscles and reduce inflammation
Usually effective in a few days and often
reduce frequency of attacks
Next on steroids.

Faculty of Medicine University of Riau