bronchodilatorsinclude

Bronchodilators include medicines that widen the airways by relaxing the smooth muscle surrounding the bronchial tubes. They are used to relieve symptoms and improve airflow in conditions such as asthma and chronic obstructive pulmonary disease (COPD), and may be part of both rescue and maintenance therapy.

The main classes are beta-2 agonists, anticholinergics, and methylxanthines. Short-acting beta-2 agonists (SABA) such as albuterol (salbutamol) provide rapid relief within minutes. Long-acting beta-2 agonists (LABA) such as salmeterol and formoterol are used for ongoing control when combined with anti-inflammatory treatments. Anticholinergic agents, including ipratropium (short-acting) and tiotropium (long-acting), reduce bronchoconstriction by blocking acetylcholine. Methylxanthines like theophylline have a wider systemic effect and are less commonly used due to narrow therapeutic ranges and interactions. Roflumilast, a phosphodiesterase-4 inhibitor, is used in some COPD cases to reduce exacerbations.

Most bronchodilators are delivered by inhalation, delivering medicine directly to the airways with rapid onset and fewer systemic effects. Inhalers, nebulizers, and other devices are common. SABA provides quick relief; LABA, when used chronically, helps maintain airway openness. Anticholinergics are especially important in COPD management but can be used in asthma in some contexts. Theophylline and roflumilast are generally reserved for specific patient needs due to potential side effects and drug interactions.

Common side effects include tremor and rapid heart rate with beta-agonists, dry mouth or urinary retention with anticholinergics, and GI upset or arrhythmias with theophylline. Proper inhaler technique and monitoring are important to maximize benefit and minimize risk.