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Why use long acting bronchodilators in chronic obstructive lung diseases? An extensive review on formoterol and salmeterol.

Abstract
Long-acting β2-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 β2-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.
AuthorsP Santus, D Radovanovic, P Paggiaro, A Papi, A Sanduzzi, N Scichilone, F Braido
JournalEuropean journal of internal medicine (Eur J Intern Med) Vol. 26 Issue 6 Pg. 379-84 (Jul 2015) ISSN: 1879-0828 [Electronic] Netherlands
PMID26049917 (Publication Type: Journal Article, Review)
CopyrightCopyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Chemical References
  • Bronchodilator Agents
  • Salmeterol Xinafoate
  • Formoterol Fumarate
Topics
  • Bronchodilator Agents (therapeutic use)
  • Formoterol Fumarate (therapeutic use)
  • Humans
  • Pulmonary Disease, Chronic Obstructive (drug therapy)
  • Salmeterol Xinafoate (therapeutic use)
  • Treatment Outcome

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