Use of parasympatholytics

Abstract

The role of the vagus in bronchial asthma implicates to suggest that parasympatholytics are potent drugs in asthma therapy. The most important parasympatholytics today are ipratropium and oxitropium bromide. They are effective by blocking the cholinergic or muscarinic receptors of the bronchial smooth muscle and thereby inhibit cholinergic bronchomotor tone. Although they are generally somewhat less effective broncholdilators compared to beta 2-adrenergics, they are potent antiasthmatic drugs especially in infants and small children, in whom beta 2-adrenergics seem to be not so much effective. As with inhaled beta 2-adrenergics a correct inhalation technique is required for an optimal effect with parasympatholytics as well, but it could be shown that both groups of substances do have a good antiobstructive effect even when just sprayed into the mouth. Apart from the theoretical implications discussed the clinical importance of these findings for the antiobstructive treatment of those patients unable to inhale properly including infants and small children is emphasized.