Bronchial asthma is a condition in which their is an inflammation in Bronchus which causes activation of mast cells.These mast cells secrete histamine and leukotrines which causes spasm in Bronchus and increase secretion in the Bronchus which leads to obstruction in the pathway of air passage in Bronchus.
To treat this condition we need such drugs which can in any way realxes the Bronchus (like Beta 2 agonist,Anti Cholinergic drugs,Methyl xanthines) or drugs which decreases inflammation in Bronchus (like anti inflammatory drugs) or the drugs which can stop mast cell or stabilizes the mast cell to secrete controlled amount of histamine and leukotrines which doesn’t create any problem in breathing (like mast cell stabizers) of the drugs which directly inhibits the leukotrines.
So we have various such drugs which are listed below-
A)Beta 2 agonist
These are the adrenergic drugs which acts on beta 2 receptors of Bronchus and causes bronchodilation.
Salbutamol
Salmetrol
Formoterol
B)Anticholinergic drugs
These are the drugs which acts on muscarinic receptors of Bronchus and causes bronchodilation in bronchus.
Ipatropium bromide
C) Methyl Xanthines
These are very famous group of drugs they just acts on the smooth muscles of Bronchus and causes relaxation in Bronchus muscles.
Theophylline
Aminophylline
Caffeine
Talking about Theophylline
Theophylline also acts on other muscles of body like it acts on muscles of leg and increases their power so athlete’s can’t use theophylline and go for their performance.Also it acts on heart cells and causes increase in HR and FOC.So it is sometime used as cardiac stimulant in chronic cardiac diseases.It also stimulates Brain and so relieves fatigue.
Overdose Toxicity of Theophylline may cause-
Arrythmia
Stomach ulcer – C/O abdominal pain
Seizures
Sometime even vomiting centre gets stimulated which may lead to nausea and vomiting.
D) Anti Inflammatory Drugs
Prednisolone
Budesonide
Fluticasone
Hydrocortisone
Beclomethasone
Hemisuccinate
In severe conditions like that of Status Asthamaticus, in which patient is so serious that he can’t even speak, dyspnea occurs.So in such conditions we may use IV injection of Hydrocortisone/Hemisuccinate.
E) Mast Cell Stabilizers
Ketolifen
Na-chromoglycate
The problem with these drugs is that they take much longer time to help in controlling asthma i.e they are just used as prophylaxis in asthma they are not given to abort attack of asthma.Like in any child we know that the problem will occur more in October-November so we start giving this drug from 2-3 months prior.These drugs are used when we want to avoid using steroids in the children.
F)Leukotrine Inhibitors
Like,Montelukast
Montelukast is used as prophylactic drug.
It can cross Blood Brain Barrier in small amount.
Adverse effects :-
Agitation, Abnormal behaviour, Vasculitis, Neuropathy, Muscular injury, Skin rashes
These problems may occur as an adverse effect of Montelukast.
Contributor- Medico Anant Singh Nanda