Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAME: (Tornalate: This brand no longer is available in the U.S.)
DRUG CLASS AND MECHANISM: Bitolterol is a bronchodilator used in the
treatment of asthma. It is similar to albuterol (Ventolin). Asthma is a disorder
of breathing in which there is narrowing of the airways that carry air to the
lungs including the bronchi. This narrowing is caused by muscle spasm and
inflammation within the airways. Bitolterol relaxes the smooth muscles
surrounding these airways, increasing the diameter and easing the flow of air
through the airways. Bitolterol probably does not affect inflammation in the
lung either with asthma or other inflammatory lung disorders such as bronchitis.
Nevertheless, if spasm of the airways occurs because of bronchitis, bitolterol
may be useful therapy for the asthmatic component of the illness. Bitolterol is
unique in that it is a "prodrug;" It must first be converted by the body into
its active form. Bitolterol has a rapid onset of action (2-5 minutes), and its
effects may last up to 6-8 hours. The FDA approved bitolterol in December 1984.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Inhaler: 0.37 mg/Inhalation; Solution for Inhalation: 0.2%
STORAGE: Bitolterol should be stored at room temperature, 15 to 30 C (59
to 86 F).
PRESCRIBED FOR: Bitolterol is used for the relief of bronchospasm due to
asthma and other respiratory illnesses.
DOSING: The recommended adult dose for treating asthma is 2 inhalations every
8 hours. Maximum dose is 2 inhalations every 4 hours or 3 inhalations every 6
hours.
DRUG INTERACTIONS: Tricyclic antidepressants [for example, amitriptyline
(Elavil, Endep), monoamine oxidase inhibitors (for example, tranylcypromine)
should not be combined with bitolterol because of their additive effects on the
vascular system (increased blood pressure, heart rate, etc.). A period of two
weeks should elapse between treatment with bitolterol and tricyclic
antidepressants or monoamine oxidase inhibitors.
Use of bitolterol with other stimulant medications is discouraged because of
their combined effects on heart rate, blood pressure, and the potential for
causing chest pain in patients with underlying coronary heart disease.
Beta-blockers, for example, propranolol (Inderal, Inderal LA), block the
effect of bitolterol and may induce bronchospasm in asthmatics. Bitolterol may
cause hypokalemia (low potassium). Therefore, combining bitolterol with loop
diuretics, for example, furosemide (Lasix), which lowers potassium levels in the
blood, may increase the likelihood of hypokalemia.
PREGNANCY: There are no adequate studies in
pregnant women.
NURSING MOTHERS: It's not known if bitolterol is excreted in
breast milk.
SIDE EFFECTS: Side effects of bitolterol include nervousness, tremor,
headache, palpitations, fast heart rate,
elevated blood pressure, nausea,
dizziness, and
heartburn. Throat irritation and
nosebleeds can also occur.
Allergic reactions may occur rarely and may manifest as rash, hives,
swelling, anaphylaxis, or
shock. Worsening of diabetes and lowering of potassium have
also been reported. In rare patients, inhaled bitolterol can paradoxically
precipitate life-threatening bronchospasm.
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
Patients who have infrequent, mild bouts of asthma attacks may use over-the-counter (OTC) medications to treat their asthma symptoms. OTC asthma medicines are limited to epinephrine and ephedrine. These OTC drugs are best used with the guidance of a physician, as there may be side effects and the drugs may not be very effective.
Asthma, the main cause of chronic illness in children, has signs and symptoms in children that include frequent coughing spells, low energy while playing, complaints of chest "hurting," wheezing while breathing, shortness of breath, and feelings of tiredness. Treatment will involve a doctor creating an asthma action plan which will describe the use of asthma medications and when to seek emergency care for the child.
There are many unusual symptoms of asthma, including sighing, difficulty sleeping, anxiety, chronic cough, recurrent walking pneumonia, and rapid breathing. These symptoms may vary from individual to individual. These asthma complexities make it difficult to accurately diagnose and treat asthma.
There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC drugs like Primatene Mist and Bronkaid.
Doctors and asthma specialists recognize that asthma has two main
components: airway inflammation and acute bronchoconstriction (constriction of
the airways). Research has shown that reducing and preventing further
inflammation is the key to preventing asthma attacks, hospitalizations, and
death from asthma.
Long-term control asthma medications are taken daily over an extended period
of time to achieve and maintain control of persistent asthma (asthma that
causes symptoms more than twice a week and frequent attacks that affect
activity).
The most effective long-term control asthma medications are those that stop
airway inflammation (anti-inflammatory drugs), but there are others that are
often used along with anti-inflammatory drugs to enhance their effect.
Long-term control asthma medications include:
Corticosteroids (The inhaled form is the anti-inflammatory dru...
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