COPD: Major Drugs

There are many drugs used to treat COPD. Cromolyn sodium is a mast cell membrane stabilizer, it prevents mast cells from dumping out histamines and mediators that cause many of the symptoms we see in COPD. It is NOT an antihistamine or bronchodilator.


The inhaled steroids are becoming the drug of choice in managing asthma because it is recognized that chronic asthma is an inflammatory condition of the bronchial tree. During an acute attack there are huge amounts of inflammatory cells in the lungs.


Theophyline is basically on its way out, it is a methyl xanthine derivative and has long been the mainstay first-line drug and is a bronchodilator. Because of toxicity and difficulty of titration and the necessity of measuring blood levels, theophyline is no longer the first-line drug of choice.


Ipatropium bromide is an atropine derivative. In many pts there is excessive cholinergic muscarinic activity in the bronchial tree, which cause bronchospasm and mucous secretion. If you can block the muscarinic receptor selectively, you have an effective drug. It is inhaled, and is more selective in the bronchial tree than oral ingestion of atropine.

Category: Pharmacology Notes