Approaches of bronchial asthma treatment, Drugs used

Approaches of bronchial asthma treatment:

1. Prevention of exposure to allergens
2. Reduction of bronchial inflammation and hyper reactivity
3. Dilatation of narrowed bronchi

Drugs used in Bronchial asthma

A. Bronchodilators:

1. Sympathomimetic drugs:

a. Selective β2 agonist.
Short acting (duration 4-6 hrs) –

• Salbutamol
• Terbutaline
• Metaproterenol

Long acting (duration 12 hrs or more) –

• Salmeterol
•  Fenoterol
• Formeterol
• Rimeterol
• Bitolterol

b. Non selective (β1 & β2)

•  Adrenaline
•  Ephedrine
• Isoproterenol (Isoprenaline).

2. Methyl xanthene group:

Natural –

• Theophylline
• Theobromine
• Caffeine (also used in neonatal apnoea)

Synthetic –

• Aminophylline. (Na salt of Theiophylin)

3. Antimuscarinic bronchodilator:

• Ipratropium
• Oxitropium

B. Anti-inflammatory

1. Corticosteroids: 

• Hydrocortisone. (Inj.)
• Prednisolone. (Oral)
• Beclomethasone
• Budesonide
• Triamcinolone
• Flunisolide
• Fluticasone
• Mometason

   

2 . Mast cell stabilizer:

• Nedocromil sodium
• Cromolyn sodium ( disodium chromoglycate) drugs 

C. Others:

1. Leukotrine pathway inhibitor –

• Zileuton
• Zafirlukast
• Montelukast

2.  Calcium channel blocker –

•  Nifedipine
• Verapamil
• Amlodipine

3. Anti IgE monoclonal antibody:

• Omalizumab

4. Histamin (H1 ) receptor blocker:

• Ketotifen