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Pharmacology of the Airways

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Principles and Practice of Anesthesia for Thoracic Surgery

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Abstract

Short-acting beta-2 adrenergic agonists are administered for the acute relief of bronchospasm, wheezing, and airflow obstruction. Long-acting beta-2 adrenergic agonists are for long-term control of symptoms. Inhaled anticholinergics are first-line therapy in COPD. They are useful for both maintenance therapy and in acute exacerbations. Inhaled corticosteroids are used to control inflammation in asthma and COPD. In asthma, they can be used as monotherapy. In COPD, they are used in conjunction with long-acting beta-adrenergic agonists. Systemic corticosteroids are used for the reduction of inflammation in asthma and COPD exacerbations and are not typically prescribed as maintenance therapy. Leukotriene modifiers, mast cell stabilizers, and methylxanthines are alternative therapies used in asthma when symptoms are not well-controlled on first-line therapy. Volatile and intravenous anesthetics provide a degree of bronchodilation that may be useful in treating intraoperative bronchoconstriction. Helium/oxygen mixtures, antihistamines, and magnesium sulfate are alternative therapies used when bronchospasm does not respond to conventional therapies.

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Authors and Affiliations

  1. Department of Anesthesiology, University of Cincinnati, Cincinnati, OH, USA

    Paul J. Wojciechowski MD & William E. Hurford MD

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  1. Paul J. Wojciechowski MD
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  2. William E. Hurford MD
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  1. University of Toronto, Staff Anesthesiologist, Professor of Anesthesia, Toronto, M5G 2C4, Ontario, Canada

    Peter Slinger, MD, FRCPC

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Wojciechowski, P.J., Hurford, W.E. (2011). Pharmacology of the Airways. In: Slinger, MD, FRCPC, P. (eds) Principles and Practice of Anesthesia for Thoracic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0184-2_8

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