The regulation of the work of organs is carried out through the parasympathetic division of the autonomic nervous system, therefore, the treatment of some serious diseases is carried out by the method of influencing it.
In some cases, doctors prescribe m- anticholinergics to relieve an attack of bronchial asthma. Substances of this group are effective in combating the disease and are part of many well-known drugs.
What are m- anticholinergics
M- anticholinergics are ester substances consisting of an organic base and aromatic acid.
They weaken the action of acetylcholine, which transmits a signal to the cholinergic receptors responsible for the contraction of the bronchial muscles. Due to this etheric connection, their activation is blocked and bronchospasm is prevented.
This substance helps to reduce muscle tone and reduce bronchial hyperreactivity. For this reason, preparations based on m- anticholinergics are successfully used to treat asthma.
The mechanism of action of m- anticholinergics
M- cholinolytics block the corresponding cholinoreactive structures. Due to this, the supply of impulses to the vagus nerve, which innervates the bronchi, is stopped.
First of all, anticholinergics are indicated for bronchial asthma of the cholinergic type. In addition, the drugs are recommended for use in chronic obstructive bronchitis and attacks of bronchial asthma .
Compared with β2-adrenergic agonists, acting as bronchodilators , m- anticholinergics are considered less effective. This is due to several reasons:
- the more distally the bronchus is located, the fewer the corresponding receptors in it. Because of this, anticholinergics are not so effective in neutralizing bronchiole spasm;
- due to the inhibition of M3-cholinergic receptors, a decrease in tone occurs. M2 receptors are located on the surface membrane of nerve fibers. Due to their blockade, the release of acetylcholine increases, which displaces M- anticholinergics . As a result of these processes, the bronchodilator effect of the drug decreases.
M- anticholinergics for the treatment of bronchial asthma
Medicines for relieving spasms are natural anticholinergics such as belladonna and atropine. They can be used alone or in combination therapy.
Often, patients diagnosed with bronchial asthma are treated with synthetic m- anticholinergics , which have an antispasmodic and analgesic effect.
A similar effect is obtained by the use of antihistamines and local anesthetics . Even ordinary diphenhydramine has a similar effect.
These medications are preferred in case of ineffectiveness of previous treatment or in case of intolerance to inhaled adrenostimulants . Also, the indications include increased secretion of phlegm in the bronchi, psychogenic spasms and seizures that occur due to the use of beta-blockers.
Doctors recommend using ipratropium bromide or atropine to make breathing easier . The second type of drug is administered as a solution by inhalation or subcutaneously. The first agent can be used as an aerosol or inhalation method.
There are many types of anticholinergics that help with bronchial asthma. These are platifillin , atropine, belladonna medications, the well-known ipratropinium bromide.
Most often, the doctor prescribes anticholinergic substances if, in addition to asthma, ischemic disease is diagnosed. Also taken into account intolerance to sympathomimetics .
M- anticholinergics can stop an attack of suffocation in bronchial asthma, but is used only in rare cases.
This may be due to the risk of side effects, which include tachycardia, increased viscosity of bronchial secretions, intestinal atony, dry mouth, worsening accommodation, and difficulty urinating.
The most effective anticholinergic is ipratropium bromide. It selectively affects the respiratory tract, almost no side effects, unlike platifillin or atropine.
Features of selective and non-selective m- anticholinergics
Tiotropium bromide is also among the selective m- anticholinergics . Inhalation medicine is prescribed for patients with vagotonic nervous activity, in which parasympathetic tone often predominates.
Such disorders can be primary, often congenital, or develop again against the background of the influence of environmental factors, pathologies of viral or bacterial origin.
For bronchospasm, ipratropium bromide, which is considered a competitive antagonist of acetylcholine, is effective . Under the influence of the drug, the biochemical structures of the cells are blocked on smooth muscle cells, and the process of contraction of the bronchial muscles is suppressed.
Unlike atropine, the substance has a selective effect on the m- cholinergic receptors . As a result, it better relieves bronchial spasm, while less affecting the density and amount of secretion secreted by the glands of the bronchi.
When using the drug through inhalation, the absorption of active substances into the blood does not occur.
The necessary antispasmodic effect occurs half an hour after the procedure. The maximum effect of the drug is noted after one and a half to two hours and lasts up to 6 hours.
Ipratropium bromide should not be used to relieve a sudden attack in patients with cardiovascular disease and severe bronchitis.
In addition to ipratropium bromide, tiotropium bromide may also be prescribed . A distinctive feature of the second drug is that it does not affect the M2-cholinergic receptors and does not provoke the release of acetylcholine.
Due to this, the duration of exposure to the drug can be up to 12 hours. However, this drug is used with great caution in asthma , since one of its side effects is paradoxical bronchospasm.
This medication should not be used as an emergency treatment. It is worth being careful and not allowing it to enter the eyes. Inhaling the medicine is necessary only with an inhaler.
Beta 2 agonists are more effective than anticholinergic antagonists . This is due to the relatively slow onset of exposure to the latter and insignificant bronchodilator activity.
Contraindications and side effects of anticholinergics
When using any medication, there is a risk of side effects. Many anticholinergics of the atropine series, which have an effect on the central nervous system, cannot be used if it is intended to drive vehicles or engage in a hazardous type of work that requires a high concentration of attention and a quick reaction.
These funds cannot be used in such cases:
- paralytic ileus;
- ulcerative colitis;
- megacolon toxic;
- glaucoma;
- hepatic and renal diseases;
- hypertension;
- intestinal atony;
- delay in urination;
- pregnancy and lactation;
- thyrotoxicosis.
After inhalation with the use of anticholinergics , the patient may experience a decrease in attention and reaction speed. If the recommendations are not followed, the symptoms can worsen. In case of side effects, you should stop taking the drug and consult your doctor.
The most common side effects are:
- tachycardia;
- dryness in the mouth;
- constipation;
- insomnia, headache:
- dizziness;
- fever;
- increase in blood pressure.
These symptoms cannot be neglected, as more serious consequences may develop.
Finally
M- anticholinergics are prescribed for the treatment of bronchial asthma. Under the influence of these medications, the tone of the bronchi decreases and their hyperreactivity decreases.
When choosing a drug, it is worth considering that some of them are not suitable for providing emergency care for sudden attacks of suffocation. For these purposes, adrenergic agonists are mainly used.