Explaining you medicines
Smoking is not a good health habit. This message is reinforced on all packages of cigarettes where it clearly states that “The Minister of Health advises that smoking is dangerous to your health”. However there are still quite a lot of men and women who choose to continue to smoke and hence will suffer a range of health related disease conditions. One of the spin-off conditions from smoking is COPD (chronic obstructive pulmonary disease) which can be an irreversible condition in the later stages in life.
Studies done in the US show the following statistics on COPD:
•    It is the 4th leading cause of death, following lung cancer, heart disease and strokes.
•    Over 120,000 people die a year from COPD. Most of them were smokers.
•    COPD claims the lives of around 30,000 people in the UK.
•    Smoking is the biggest risk factor for developing COPD.
•    Female deaths from COPD have now overtaken male deaths since the year 2000.
•    In the US in 2002, more than 61,000 females died of COPD compared to 59,000 males.
•    Women who smoke are 13 times as likely to die of COPD than women who have never smoked.
•    Men who smoke are 13 times as likely to die of COPD than men who have never smoked.
•    There are more female sufferers of chronic bronchitis than male sufferers (50% more).
•    Around 55% of emphysema sufferers are male and 45% are female. However, the trends seem to be reversing, as the number of female sufferers is increasing (around 5%) and the number of male sufferers is decreasing (around 10%).
•    Around 600,000 people have been diagnosed with COPD in the UK.
•    Heavy smokers are 30 times as likely to develop COPD.
Firstly, before we can understand how the inhaler helps the smoker’s breathing, we need to picture how the airways respond to the toxic chemical from smoke. When you inhale normal clean air, it goes through the nasal passages then through the windpipe and into the lungs which open up into small air sacs. Surrounding the airways (or the passage through which the air flows) are smooth muscles which are controlled by the nervous system. So for example, when you inhale the toxins from cigarette the following cascading actions take place:
1.    The body produces a chemical messenger called acetylcholine (pronounced a-ce-tyl-cho-line) signalling the presence of a “foreign” particle.
2.    The acetylcholine attaches itself to a specific receptor called cholinergic (pronounced cho-lin-er-gic) receptor which causes mucus secretion and smooth muscle contraction.
3.    Contraction of the smooth muscle causes the narrowing of the airways and results in symptoms like coughing or difficult breathing.
The secretions and the constriction of the air passages are the body’s normal fight back mechanism to the toxins introduced into the lungs.

The above summarises the body’s coping mechanism to an “intruder” in the passage through which air flows. So after a prolonged period of smoking, the smoker would inevitably develop a “new normal” way to breathe due to the chronic constriction of airflow and also the excessive production of mucus. You will notice the symptoms such as wheezing, breathless, especially under physical exertion, chest tightness or simply coughing (also known as a smoker’s cough or a chesty cough).

How does Atrovent Inhaler work?
Atrovent inhaler is a bronchodilator which means that it dilates the air passages by causing relaxation of the smooth muscles in a reversible obstructive airway disease like COPD or chronic asthma.

It is classified as an “anti-cholinergic” drug which means that it stops the cascading actions described above by blocking the action of the acetylcholine on the cholinergic receptors. Additionally, it must be noted that the side effect of the atrovent inhaler works as a benefit to promote better breathing. It improves the healing process by drying up excessive mucus secretions which would have also obstructed the flow of air.

Atrovent inhaler can also be used in the management of mild asthma where the body’s response is similar to that of COPD as described above, but with inflammation when exposed to a trigger element or allergen. Asthmatics usually have hypersensitive airways, so other factors, apart from smoking can trigger such a response.

Although atrovent inhaler indicated for asthma, it  is NOT an emergency medication since its onset action of about 30 minutes. But it can be used quite comfortably in managing chronic asthma with duration of action lasting up to 4-6 hours.

The side effects are comparably safe and tolerable. There can be throat irritation, unpleasant taste or a headache. Some other very rare side effects, which are only possibly seen at high doses, are dry mouth, urinary retention and constipation.

You must take caution if you are experiencing any of the following before the use of Atrovent Inhaler; prostate problems or difficulty passing urine (usually in older men who are also targets for COPD if they have smoked over a prolonged period), pregnant or breast feeding women, glaucoma patients or persons suffering with allergy to soy or peanut.

This drug is in metered dose inhaled formulation, an effective dosage form since the drug goes directly to the site where the therapeutic action is required. It does not have to be absorbed through the blood stream first, as in the case with oral meds. Thus, any unnecessary effects are minimised although some of the drug may still be absorbed anyway.  

Atrovent Inhaler can definitely improve ease with which a smoker breathes by relaxing the smooth muscles around and drying up excessive mucus secretions in the airways, thus freeing up the passage way.

For further information on Atrovent inhaler call the pharmacist at Medicine Express located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.