PubMed · 5283055
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M Murao, M Kosaka. 1971. [Cor pulmonale].. https://pubmed.ncbi.nlm.nih.gov/5283055/
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Since the introduction of inhaled quaternary anticholinergic bronchodilators, their clinical usefulness has been explored in a variety of settings. They have emerged as the inhaled bronchodilators of first choice in the management of chronic obstructive pulmonary disease (COPD). In other countries, they have also found an adjunctive role in the management of asthma. This may be best seen in the treatment of acute asthma where the combination of anticholinergic and adrenergic bronchodilators appear more effective than single-agent inhalation therapy. This finding appears consistently in large studies, whether in adult or pediatric populations. Such combination nebulizer therapy would appear to be cost effective, but further study is required.
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Scorpion venoms contain specific toxins which block large conductance calcium-activated potassium (BKCa) channels. Use of these toxins has shown that a significant proportion of the action of bronchodilators such as beta-agonists, theophylline, and nitric oxide occurs as a result of the opening of BKCa channels. Similarly, these toxins have shown that inhibitors of airway neurotransmission also operate via BKCa channels. Drugs that open BKCa channels may be alternative bronchodilators (possibly "airway selective" and with fewer side effects) as well as inhibitors of pathophysiological neurogenic influences in asthma, chronic coughing and sneezing, and chronic bronchitis.