bronchodilatore

Bronchodilator, or broncodilatatore in Italian, refers to drugs that dilate the bronchi by relaxing airway smooth muscle. They are central to the management of obstructive airway diseases such as asthma and chronic obstructive pulmonary disease (COPD). Most bronchodilators are inhaled, delivering medication directly to the lungs, though some are used orally or intravenously in severe cases.

The main classes include beta-2 adrenergic agonists, anticholinergics, methylxanthines, and phosphodiesterase inhibitors. Short-acting beta-2 agonists (SABA) such as albuterol (salbutamol) provide rapid relief of acute bronchospasm. Long-acting beta-2 agonists (LABA) such as salmeterol and formoterol provide sustained bronchodilation for maintenance; in asthma, LABA are recommended only in combination with an inhaled corticosteroid. Anticholinergics like ipratropium (short-acting) and tiotropium (long-acting) reduce bronchoconstriction by blocking muscarinic receptors. Methylxanthines, notably theophylline, are older agents with a narrow therapeutic window and are less commonly used today. Phosphodiesterase inhibitors such as roflumilast are used in COPD for anti-inflammatory and bronchodilatory effects, though not as rapid-relief agents.

Administration is commonly via inhalation using metered-dose inhalers or dry powder inhalers, often with spacer devices; other routes include oral or intravenous administration for specific situations. Side effects vary by class and can include tachycardia and tremor with beta-agonists, dry mouth with anticholinergics, and GI upset with methylxanthines. Proper use and, in asthma, coordinated therapy with anti-inflammatory treatment are important to maximize benefit and minimize risks.