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AEROCORT INHALER: DESCRIPTION
Aerocort Inhaler (Levalbuterol, Beclomethasone) is a combination of beclomethasone dipropionate and levosalbutamol, which have different modes of action and show additive effects.
Levosalbutamol is the active (R)-enantiomer of the racemate, salbutamol. It is a single-isomer, beta2-agonist that differs from racemic salbutamol by the elimination of (S)-salbutamol, which is inactive. Levosalbutamol has a highly selective action on the receptors in bronchial muscle, resulting in bronchodilation.
Beclomethasone dipropionate is a synthetic glucocorticoid with a potent anti-inflammatory activity and weak mineralocorticoid activity. This combination of levosalbutamol and beclomethasone dipropionate is specially provided for those patients who require regular doses of both drugs for treatment of their obstructive airways disease.
Levalbuterol leads to activation of beta2-adrenergic receptors on airways smooth muscle leads to the activation of adenylate cyclase and to an increase in the intracellular concentration of cAMP. The increase in cAMP is associated with the activation of protein kinase A, which in turn, inhibits the phosphorylation of myosin and lowers intracellular ionic calcium concentrations, resulting in muscle relaxation and bronchodilation. Levosalbutamol relaxes the smooth muscles of all airways, from the trachea to the terminal bronchioles. Increased cAMP concentrations are also associated with the inhibition of the release of mediators from mast cells in the airways.
The precise mechanisms of glucocorticoid action in asthma are unknown. Inflammation is recognized as an important component in the pathogenesis of asthma. Glucocorticoids have been shown to inhibit multiple cell types (e.g., mast cells, basophils, eosinophils, lymphocytes, macrophages, and neutrophils) and mediator production or secretion (e.g., histamine, leukotrienes, eicosanoids, and cytokines) involved in the asthmatic response. These anti-inflammatory actions of glucocorticoids may contribute to their efficacy in asthma.
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