HealthCare

DOXOFYLLINE is a  Methylxanthines group of drug which are phosphodiesterase inhibitors. The other type of methylxanthines are caffeine, theobromine, as well as, theophylline. Doxofylline is a new generation long acting oral methylxanthine derivative. The bronchodilating activities of doxofylline have been clearly demonstrated in  patients with either bronchial asthma or chronic obstructive pulmonary disease ( COPD). Unlike other bronchodilators doxofylline does not have of direct stimulatory effects. This is import because the arrhythmogenic actions of bronchodilators may have a negative impact on the survival of patients with respiratory diseases. Currently Methylxanthines are used as second line of treatment for Asthma.

Doxofylline  Methylxanthines is used for the maintenance therapy in patients suffering with Asthma and Chronic Obstructive Pulmonary Disease (COPD). The normal dosage for adult is 400mg once a day. Single dose administration in the evening reduces nocturnal symptoms and helps to keep the patients complaint free during the day. However in certain cases 400mg twice daily is recommended on the basis of the clinical response.

Contraindications of Doxofylline  Methylxanthines include Hypersensitivity,doxofulline and other methylxanthine derivatives.Methylxanthines are not recommended for therapy for asthma exacerbations.

There are no major Side effects and warnings of Doxofylline  Methylxanthines. It has has a prolonged

bronchodilator effects,and unlike theophylline it has least adenosine interactions. It has no CNS and

CVS side effects.There is no sleep disturbances and no effects on gastric secretions with doxofylline.It is highly safe in smokers. The side effects of doxofylline are similar to taking excess amount of caffeine. The common side effects are Stomach upset, Heartburn,Trouble sleeping (insomnia), Headache, Nervousness or irritability, Rapid heart rate (tachycardia) and Rapid breathing (tachypnea).People taking doxofulline  medication may be able to reduce these side effects by avoiding caffeine.Serious (toxic) side effects are seen in some people like Nausea and vomiting.,Seizures,Low blood sugar and  Irregular heartbeat (arrhythmia).

Bambuterol is an oral prodrug of terbutaline with a prolonged duration of bronchodilator action that allows once-daily administration. It is an inactive site-specific prodrug that delivers active terbutaline only to the target tissue i.e., lung. It is a very effective long acting beta-adrenoceptor agonist. Clinical studies have shown that bambuterol is as effective as other oral and inhaled i2-agonists including salbutamol, terbutaline and Salmeterol, and theophylline(both conventional and controlled release formulations). Bambuterol is commercially available from the pharmacy major AstraZeneca under the trade names Bambec and Oxeol.

Bambuterol is used in maintenance treatment of bronchial asthma, Nocturnal asthma, and Chronic Obstructive Pulmonary Disease (COPD) . The typical dosage for adults is 10mg tablet once daily in the evening, may be increased to 20mg after 1-2 weeks.

Contraindications: Hypersensitivity to any of the ingredients or terbutaline, Hepatic impairment liver, cirrhosis or severely impaired liver function. Special Precautions: Dose should be reduced in patient with severely impaired renal function; care should be taken while prescribing bambuterol in patients with genetic deficiencies of plasma cholinesterase, caution should be implemented in patients with severe ischaemic heart failure. In case of Pregnancy and lactation: it is not recommended. Side effects include Tremor, headache, muscle cramps, palpitation, fatigue and insomnia. Generally, these effects were mild in nature and their incidence decreased with time.

Drug Interactions: Bambuterol reversibly inhibits plasma cholinesterase which prolongs the neuromuscular blockade induced by succinylcholine by upto four times. Hypertensive crisis and other adverse effects occur frequently with the concur rent use of bambuterol with monoamine oxidase inhibitors, bambuterol may partly or totally inhibit
the effect of p-blockers.

SALMETEROL is a selective long acting beta -2 adrenoceptor agonist. Provides effective protection against histamine induced bronchodilation . Its effect lasts for as much as 12hrs. Salmeterol is marketed  by GlaxoSmithKline under the brand name SEREVENT . The other popular inhaler Advair is a salmeterol fluticasone formulation.

Salmeterol is used in the treatment of chronic obstructive pulmonary disease (copd) and reversible airways obstructions in asthma. It is available as metered dosage inhaler. Dosage: For Adults: 2 inhalations (50 microgram) twice daily. And for Severe airway obstruction: 4 inhalations (100 micrograms) twice daily.

Contra-1ndlcations of Salmeterol include Hypersensitivity. Special precautions to be taken in patients  and their lung function should be monitored while taking Salmeterol  as it is not a replacement for oral or inhaled corticosteroids but use is complimentary to them. Salmeterol is not designed to relieve acute asthma symptoms. Serevent/ Salmeterol inhalers not recommended for children under 4 years and in Pregnant women & those lactating it should be used only when clearly indicated.
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Side effects of Salmeterol include Tremor, tachycardia, subjective palpitations and headache. Salmeterol has Drug Interactions with steroid and Diuretics causing Hypokalemia. Its Effects are antagonized by non-selective betablockers and less so by cardioselective betablockers.  It also has potentiation of vascular effects with MAOIs and tricyclic antidepressants. In November of 2005, the American FDA released a health advisory alerting the public to findings that show the use of Long-acting ß2-agonists like Salmeterol could lead to a worsening of symptoms, and in some cases death.