Bronchodilator in COPD-
Ans. is 'a' i.e., Anticholinergics Anticholinergic bronchodilatorso Ipratropium and tiotropium are anticholinergic bronchodilators.o These synthetic compounds are permanently charged molecules (ionized), unlike atropine - Not absorbed after inhalation and thus minimises antimuscarinic (anticholinergic) side effects,o Tiotropium is longer acting than ipratropium.o Anticholinergic acts on receptors located mainly in the larger central airways (Contrast sympathomimetics whose primary site of action is peripheral bronchioles).o Parasympathetic tone is the major reversible factor in COPD - anticholinergics are more effective than sympathomimetics.o Inhaled ipratropium /tiotropium are bronchodilators of choice in COPD.o They are less efficacious than sympathomimetics for asthma.o They produce slower response than inhaled sympathomimetics and are better suited for regular prophylactic use.o They are bronchodilators of choice in patients of bronchial asthma on b-blockers as b2 agonists will be ineffective due to blockade of b2 receptors.Why do anticholinergic bronchodilators are less efficacious than b2-agonists in acute asthma ?o Anticholinergic bronchodilators inhibit only the cholinergic reflex component of bronchoconstriction, while b2-agonists prevent all bronchoconstrictor mechanisms.
Anticholinergics
Antiadrenergic
Cholinergic
Alfa agonists
Asthma