Drugs for Asthma and COPD

Key points

• • Asthma drugs are often described as relievers, which open narrowed airways quickly, and preventers (mainly inhaled corticosteroids), which reduce the underlying inflammation and are now central to control.
• • Beta-2 agonists such as salbutamol relax airway smooth muscle by raising cyclic AMP; short-acting ones relieve attacks, while long-acting ones are used together with an inhaled corticosteroid, not alone, in asthma.
• • Inhaled corticosteroids are the main preventers, reducing airway inflammation and the twitchiness of the airways over time.
• • Muscarinic antagonists such as ipratropium and tiotropium widen the airways by blocking vagal tone and are especially useful in chronic obstructive pulmonary disease.
• • Leukotriene receptor antagonists such as montelukast and the methylxanthine theophylline give added bronchodilator or anti-inflammatory effects.