China 
Africa 
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Asthma Epidemiology, Etiology, Pathophysiology and Management in the Current Scenario
Published in Suvardhan Kanchi, Rajasekhar Chokkareddy, Mashallah Rezakazemi, Smart Nanodevices for Point-of-Care Applications, 2022
Manu Sharma, Aishwarya Rathore, Sheelu Sharma, Kakarla Raghava Reddy, Veera Sadhu, Raghavendra V. Kulkarni
Another class of bronchodilators available in the market is anticholinergic bronchodilators. These bronchodilators block the action of acetylcholine neurotransmitters on the M3 receptor and result in bronchodilation. Marketed anticholinergics include Atrovent HFA (ipratropium bromide) and Spiriva (tiotropium bromide). Atrovent HFA should be administered four times a day whereas Spiriva is administered only once a day. They cannot be used as a rescue medication and their side effects include dry throat, constipation, urinary retention, dizziness, etc. [20].
Lipase-Mediated Biocatalysis as a Greener and Sustainable Choice for Pharmaceutical Processes
Published in Peter Grunwald, Pharmaceutical Biocatalysis, 2020
Monika Sharma, Tanya Bajaj, Rohit Sharma
Formetorol or 2’-hydroxy-5’-(1-hydroxy-2-((p-methoxy-α-methylphenethyl) amino) ethyl) formanilide is a long-lasting β2-adrenergic receptor agonist. It is used as an efficient bronchodilator to treat or prevent wheezing and troubled breathing caused due to some chronic respiratory disorders. It is generally commercialized as a diastereomeric mixture and thus suffers from low efficacy of the desired stereoisomer. The molecule has two stereogenic centers and thus four different stereoisomers, the order of their pharmacological potencies being R, R > R, S >> S, R > S, S (Murase et al., 1978). The (R,R)- stereoisomer can be resolved by carrying out two different reactions to obtain two different chiral moieties which are then coupled to give rise to the formoterol structure (Fig. 1.6). The enantio-differentiation was carried out by Pseudomonas cepacia (lipase PS) for the first chiral moiety, an epoxide while the same was carried out by the Candida antarctica lipase (CAL B) for the second chiral moiety that is an unprotected primary amine (Campos et al., 2000).
Nanocomposite Microparticles (nCmP) for Pulmonary Drug Delivery Applications
Published in Raj K. Keservani, Anil K. Sharma, Rajesh K. Kesharwani, Drug Delivery Approaches and Nanosystems, 2017
Zimeng Wang, Elisa A. Torrico-Guzmán, Sweta K. Gupta, Samantha A. Meenach
As seen in Table 9.1, diseases that most commonly incorporate DPIs in treatment regimens are asthma and chronic obstructive pulmonary disease (COPD). COPD affects over 5% of the U.S. population and kills 120,000 individuals each year, ranking it as the third-leading cause of death. Management for asthma and COPD consists of short-acting bronchodilators for acute exacerbations and in more severe disease, daily maintenance therapy with bronchodilators and anti-inflammatory medications. Tiotropium bromide is an anticholinergic bronchodilator given to COPD patients via DPI in the U.S.A. meta-analysis of various clinical trials found tiotropium to significantly improve mean quality of life and significantly reduce the number of participants suffering from exacerbations (Karner et al., 2014).
World Trade Center Health Program best practices for diagnosing and treating chronic obstructive pulmonary disease
Published in Archives of Environmental & Occupational Health, 2023
James E. Cone, Rafael E. de la Hoz
In patients with coexisting asthma and COPD, GOLD advises to treat the asthma component first (ie emphasize inhaled corticosteroid), and then the COPD component as outlined above. We are not aware of high-quality treatment guidelines for chronic nonspecific bronchitis; however, treatment generally relies on inhaled corticosteroids and bronchodilators.