plants used for respiratory problems ii l.
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Plants Used for Respiratory Problems - II . Theophylline. Two types of bronchodilators. Adrenergic agents Increase the volume and diameter of bronchial smooth muscles by relaxing them Include norepinephrine, epinephrine, and ephedrine Theophylline drugs

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two types of bronchodilators
Two types of bronchodilators
  • Adrenergic agents
    • Increase the volume and diameter of bronchial smooth muscles by relaxing them
    • Include norepinephrine, epinephrine, and ephedrine
  • Theophylline drugs
    • Act on the bronchial muscles to relieve air way obstruction, increase coronary blood flow and stimulate respiration
  • Natural component in tea that finds pharmaceutical use as a bronchodilator, vasodilator, and a smooth muscle relaxant
  • From tip leaves of Camellia sinensis
  • Shrub or small tree native to Tibet, India, China, and Burma.
  • Still largely grown in this region of the world
  • Caffeine, theophylline, tannins and theol contribute to flavors and stimulating properties
value of tea
Value of tea
  • Stimulating effects of tea due to caffeine and theophylline present
  • Although there is some concern about caffeine intake, people who drink large amounts of green tea have low rates of cancer
  • Animal studies have shown that rates of breast and prostate cancer reduced by consumption of green tea - attributed to polyphenols in green tea
  • When caffeine metabolized in body, a small amount is actually converted to theophylline
  • Theophylline used to treat asthma since 1930s by directly relaxing the smooth muscles of the bronchial airways - thereby opening constricted airways
  • This bronchodilating action helps relieve wheezing, coughing, etc
  • Purine alkaloid
  • Also called a methyl xanthine alkaloid
  • Originally extracted from tea
  • Now chemically synthesized
  • Popular asthma drug for many years
  • One of first long term bronchodilators
  • Several trade names and is available in a variety of forms: Theo-Dur, Slo-Bid, Aminophylline are a few of the commonly known medications
side effects
Side Effects
  • Theophylline can become toxic
  • Difference between a therapeutic level and a toxic level is narrow
  • Side Effects include tachycardia, palpitations, nausea, GI upset, headache, insomnia, arrhythmias, convulsions, urticaria, erythema, dermatitis
  • Theophylline must also be used with caution in patients with cardiovascular disease, hypertension, or hepatic or renal insufficiency
history of theophylline use
History of theophylline use
  • Became standard treatment in 1930s
  • Use declined substantially since 1980s upon realization of the importance of the inflammatory component of asthma
  • Use of a Beta-2 agonist coupled with steroids became standard management tools
  • Also concerns about side effects
  • Theophylline removed from OTC oral medications - inhaled still allowed in 1995
treatment options
Treatment options
  • Anti-inflammatory effects of inhaled steroids became preferred treatment
  • For many patients these reduced need for other drugs
  • However long-term effects of inhaled steroids still unknown
  • Recent studies show that when used with inhaled steroids, theophylline improves lung function - not just brochodilation
theophylline back in picture
Theophylline back in picture??
  • Study involved patients with persistent cough, wheeze, or breathlessness despite daily use of inhaled steroids
  • Patients who received theophylline improved peak flow rates and other measures of lung function
  • Results showed that therapy combining low dose theophylline with low-dose inhaled steroids is as effective as using high dose steroids alone and avoided side effects
how theophylline works
How theophylline works
  • Dilation and relaxation of constricted airways
  • Increased contraction strength of the diaphragm
  • Increased beat frequency of the respiratory cilia
  • Central Nervous System stimulation
  • Diuretic effects
dilation and relaxation of constricted airways
Dilation and relaxation of constricted airways
  • Main reason for using theophylline
  • By relaxing the airway muscles, airways enlarge
  • In asthma, breathing becomes easier
  • In conditions where fluid or other material has accumulated in airways, dilation of the airways can suppress coughing
more on dilation and relaxation
More on dilation and relaxation
  • Smooth muscles surround the small airways and, when constricted, narrow airways
  • Theophylline inhibits cAMP phosphodiesterase, which causes the breakdown of cyclic AMP
  • Cyclic AMP causes smooth muscle relaxation
  • By inhibiting cAMP phosphodiesterase, there's more cyclic AMP around to relax smooth muscles
increased contraction strength of the diaphragm
Increased contraction strength of the diaphragm
  • The diaphragm forms the muscular floor of the chest cavity and its contractions correspond to the strength of breathing motions
  • When breathing becomes difficult, this muscle works harder against the resistance created by disease
  • Theophylline can strengthen the diaphragm
increased beat frequency of the respiratory cilia
Increased beat frequency of the respiratory cilia
  • Cells secrete a layer of mucus which captures debris we have inhaled and move debris formed by disease lower down in the lungs
  • Mucus is moved to throat by cilia on epithelial cells lining respiratory tract - cilia move the mucus and its trapped debris
  • Once the mucus reaches the throat it is either coughed up or swallowed
  • Theophylline helps cilia to beat faster and thereby more rapidly clear respiratory debris
central nervous system stimulation
Central Nervous System stimulation
  • Stimulating effects of theophylline similar to caffeine, a closely related cmpd
  • While this can considered be a negative side effect, it can be helpful in infants who suffer from sleep apnea
  • Increased urinary output that may be a problem for some individuals - however the effect is usually mild
  • May help dry excessive respiratory secretions thus help suppress coughing