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Expert Opin Pharmacother. 2011 May;12(7):1133-41. doi: 10.1517/14656566.2011.571210. Epub 2011 Apr 1.

(R)-salbutamol in the treatment of asthma and chronic obstructive airways disease.

Author information

1
Wishaw Hospital, Department of Respiratory Medicine, Lanarkshire, UK. manishpatel2@nhs.net

Abstract

INTRODUCTION:

Asthma and chronic obstructive pulmonary disease (COPD) are inflammatory disorders that have an increasing prevalence and associated morbidity and mortality. β(2)-adrenoceptor agonists (β(2)-agonists) act by stimulating the β(2)-adrenoceptor present on airway smooth muscle and other cells in the airway, resulting in bronchodilatation. β(2)-agonists are among the most commonly used drugs in the world and remain pivotal in the treatment of symptoms in patients with asthma and COPD. Salbutamol is a chiral drug with (R)- and (S)- isomers. Almost all β(2)-agonists that are used at present are racemic mixtures of (R)- and (S)-salbutamol.

AREAS COVERED:

In this review the authors show that (R)-salbutamol alone (generically known as levosalbutamol) provides beneficial β(2)-agonist effects at a cellular level and in experimental models of airways disease. In addition the authors demonstrate that (S)-salbutamol opposes the desirable effects of (R)-salbutamol and can actually cause features of asthma and COPD in vitro and in experimental asthma.

EXPERT OPINION:

Despite this strong body of experimental evidence, (R)-salbutamol has not shown consistent superiority over (S)- or racemic salbutamol in human asthma or COPD.

PMID:
21453221
DOI:
10.1517/14656566.2011.571210
[Indexed for MEDLINE]
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