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RESEARCH PRODUCT
Why use long acting bronchodilators in chronic obstructive lung diseases? An extensive review on formoterol and salmeterol
Nicola ScichiloneFulvio BraidoPierluigi PaggiaroDejan RadovanovicAlessandro SanduzziA. PapiPierachille Santussubject
AgonistChronic ObstructiveIntrinsic activitymedicine.drug_classSocio-culturaleLABASettore MED/10 - Malattie Dell'Apparato RespiratorioPharmacologyPartial agonistPulmonary DiseaseAsthma; Chronic obstructive pulmonary disease; Formoterol; LABA; Salmeterol; Internal MedicinePulmonary Disease Chronic Obstructiveimmune system diseasesFormoterol FumarateInternal MedicinemedicineHumansFormoterolSalmeterolSalmeterol XinafoateBronchodilator AgentAsthmaCOPDbusiness.industryChronic obstructive pulmonary diseaseMedicine (all)Asthma; Chronic obstructive pulmonary disease; Formoterol; LABA; Salmeterolrespiratory systemmedicine.diseaseAsthmaBronchodilator Agentsrespiratory tract diseasesTreatment OutcomeAnesthesiaFormoterolOnset of actionSalmeterolbusinessAsthma; Chronic obstructive pulmonary disease; Formoterol; LABA; Salmeterol; Bronchodilator Agents; Formoterol Fumarate; Humans; Pulmonary Disease Chronic Obstructive; Salmeterol Xinafoate; Treatment Outcome; Internal MedicineHumanmedicine.drugdescription
Abstract Long-acting β 2 -adrenoceptor agonists, formoterol and salmeterol, represent a milestone in the treatments of chronic obstructive lung diseases. Although no specific indications concerning the choice of one molecule rather than another are provided by asthma and COPD guidelines, they present different pharmacological properties resulting in distinct clinical employment possibilities. In particular, salmeterol has a low intrinsic efficacy working as a partial receptor agonist, while formoterol is a full agonist with high intrinsic efficacy. From a clinical perspective, in the presence of low β 2 -adrenoceptors availability, like in inflamed airways, a full agonist can maintain its bronchodilatory and non-smooth muscle activities while a partial agonist may be less effective. Furthermore, formoterol presents a faster onset of action than salmeterol. This phenomenon, combined with the molecule safety profile, leads to a prompt amelioration of the symptoms, and allows using this drug in asthma as an "as needed" treatment in patients already on regular treatment. The fast onset of action and the full agonism of formoterol need to be considered in order to select the best pharmacological treatment of asthma and COPD.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-01-01 | European Journal of Internal Medicine |