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Bronchodilator drugs, the primary role of such drug except for the relaxation of bronchial, control of acute symptoms of asthma.
1. β2 agonists: β2 agonist drugs dozens of varieties, can be divided into three generations. ① The first generation: non-selective β2 agonist, such as adrenaline, ephedrine and isoproterenol and so on, because of cardiovascular side effects more than just being highly selective β2 agonist replaced. ② The second generation: selective short-acting β2 agonists such as albuterol (salbutamol), terbutaline (terbutaline) and phenolic C Chuanning (fenoterol) and so on, the role of time of 4 to 6 hours, the side effects on the cardiovascular system decreased significantly. ③ The third generation: a new generation of selective long-acting β2 agonist, such as (salmeterol), Fumiteluo (Formoterol) and procaterol (procaterol) and so on. Role of the time "12 hours, especially for nocturnal asthma. However, some drugs (such as salmeterol) slower onset time. In general, β2 agonists to relieve symptoms of acute attack of first-line drugs, while the second-generation drug most commonly used. The third-generation drug is mainly used in combination with the inhaled steroid, stabilize the airway and reduce the role of attack.
Drugs for β2 agonists can be used inhalation, oral, or intravenous injection, the preferred inhalation, its role in rapid airway high dose, systemic side effects. The methods are quantitative inhalation aerosol (MDI), dry-powder inhaler and continuous inhalation. With MDI is the most commonly used. However, MDI use will require breathing synchronized spraying, careful guidance and medical staff need to regularly check the methods used in order to guarantee efficacy. In children, the elderly or critically ill patients can add storage MDI fog bottle (spacer), aerosol spray of drug remain in the bottle, the patient could easily inhaled, and reduce the droplet deposition in the oropharyngeal stimulation.
2. The general class of oral aminophylline theophylline daily dose of 5 ~ 8mg/kg, slow release theophylline per day 8 ~ 12mg/kg. Intravenous administration is mainly used in critical patients with asthma. The first doses of 4 ~ 6mg/kg and should be injected slowly, injection time should be more than 15min, the amount per hour intravenous infusion to maintain 0.8 ~ 1.0mg/kg, the daily dosage is generally not more than 750mg ~ 1000mg.
The main adverse reactions of theophylline gastrointestinal symptoms (nausea, vomiting), cardiovascular symptoms (tachycardia, arrhythmia, blood pressure drop), even may be excited about the respiratory center, severe cases can cause convulsions and death. The best medicine in the monitoring of plasma concentration of aminophylline, safe concentration of 10 ~ 20μg/ml. Fever, pregnancy, children or elderly, those with liver, heart, kidney dysfunction and hyperthyroidism are in particular need to be used with caution. Combined cimetidine, quinolones, macrolides and drugs can affect the metabolism of theophylline slowed down its excretion, dosage should be reduced.
3. Inhaled anticholinergic drugs anticholinergic drugs, such as ipratropium bromide (Ipratropine bromide) and so on, can block the postganglionic vagal nerve pathway, reducing the vagus nerve excitability sky bronchial relaxation effect, and can block reflex bronchoconstriction. Combined with β2 agonist inhalation therapy to enhance the role of bronchial dilation and durable, mainly used in β2 agonists alone failed to control symptoms of asthma patients, the merger with chronic obstructive pulmonary disease is particularly appropriate. MDI or continuous inhalation can be used day 3 to 4 times, each time 75 ~ 250μg inhalation. Onset is about 15 minutes to maintain the 6 ~ 8 hours. Fewer adverse reactions, a small number of patients with mouth pain, or dry mouth feeling.

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