Therapy:
Levosalbutamol: Bronchodilators
Ipratropium Bromide: Bronchodilators
Class:
Levosalbutamol: Beta2-Adrenergic Receptors Agonist
Ipratropium Bromide: Muscarinic Receptor Antagonists (Anticholinergic)
Mechanism of Action:
Levosalbutamol:
It activates beta2-adrenergic receptors on airway smooth muscle leads to the activation of adenyl cyclase and to an increase in the intracellular concentration of cyclic-3′, 5′-adenosine monophosphate (cyclic AMP). The increase in cyclic AMP is associated with the activation of protein kinase A, which, in turn, inhibits the phosphorylation of myosin and lowers intracellular ionic calcium concentrations, resulting in muscle relaxation. It relaxes the smooth muscles of all airways, from the trachea to the terminal bronchioles. Increased cyclic AMP concentrations are also associated with the inhibition of the release of mediators from mast cells in the airways.
Ipratropium Bromide (Anticholinergic):
It is an anticholinergic (parasympatholytic) agent & appears to inhibit vagally mediated reflexes by antagonizing the action of acetylcholine, the transmitter agent released at neuromuscular junctions in the lung. It increases in intracellular concentration of cyclic guanosine monophosphate (cyclic GMP) which are caused by interaction of acetylcholine with the muscarinic receptor on bronchial smooth muscle.
Indications:
- Bronchial Asthma
- Chronic obstructive pulmonary disease
- Chronic bronchitis
- Emphysema
Dosage & Administration:
Two inhalations three to four times a day
HOW SUPPLIED:
DUOTWIST RESPULES is available as Respules in 2.5ml pack.
DUOTWIST LD RESPULES is available as Respules in 2.5ml pack.
References:
- Donohue JF, Parsey MV, Andrews C, D’Urzo T, Sharma S, Schaefer K, Claus R, Baumgartner RA; Levalbuterol COPD Study Group. Evaluation of the efficacy and safety of levalbuterol in subjects with COPD. COPD. 2006 Aug;3(3):125-32.
- Milgrom H, Skoner DP, Bensch G, Kim KT, Claus R, Baumgartner RA; Levalbuterol Pediatric Study Group. Low-dose levalbuterol in children with asthma: safety and efficacy in comparison with placebo and racemic albuterol. J Allergy Clin Immunol. 2001 Dec;108(6):938-45.
- Xu H, Tong L, Gao P, Hu Y, Wang H, Chen Z, Fang L. Combination of ipratropium bromide and salbutamol in children and adolescents with asthma: A meta-analysis. PLoS One. 2021 Feb 23;16(2):e0237620. doi: 10.1371/journal.pone.0237620. PMID: 33621253; PMCID: PMC7901745.