LEVOLIN INHALER

Indications

• Clinical term 1
• Common term 1
• Clinical term 2
• Common term 2

Dosage

Children: Refer to the BNF for Children for specific paediatric dosing guidelines.

Adults: Refer to the BNF for specific adult dosing guidelines.

Mechanism of action

Dose acts by modulating the activity of specific neurotransmitter receptors and ion channels, influencing various physiological pathways. Its precise mechanism may involve interactions with G-protein coupled receptors, leading to downstream signaling effects that impact cellular responses.

Pharmacodynamics

Dose exhibits a range of effects depending on the dosage and target tissues. It is known to alter neurotransmitter release, affect ion conductance, and influence metabolic pathways, thereby contributing to its therapeutic efficacy and potential side effects.

Pharmacokinetics

Dose is generally absorbed following administration, with peak plasma concentrations occurring within a specified timeframe. Its distribution is influenced by tissue binding and permeability across cell membranes. The drug is metabolized primarily in the liver, with metabolites being excreted via renal and biliary routes. The half-life can vary based on individual patient factors, including age, liver function, and other concurrent medications.

Indications

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Bronchospasm

Dosage

Children: Refer to the BNF for Children for specific dosing information.

Adults: Refer to the BNF for specific dosing information.

Mechanism of action

Levosalbutamol activates β2 adrenergic receptors on airway smooth muscle, which are coupled to the Gs protein. This activation stimulates adenylate cyclase, resulting in increased levels of intracellular cyclic adenosine monophosphate (cAMP). Elevated cAMP activates protein kinase A, which inhibits myosin phosphorylation and decreases intracellular calcium concentrations, leading to muscle relaxation. Additionally, increased cAMP levels can inhibit the release of inflammatory mediators from mast cells in the airways, aiding in the management of asthma.

Pharmacodynamics

Levosalbutamol works by relaxing bronchial smooth muscle, thereby increasing airflow and alleviating symptoms of acute shortness of breath. It is effective in providing rapid relief from bronchospasm associated with conditions such as asthma and chronic obstructive pulmonary disease (COPD).

Pharmacokinetics

The pharmacokinetics of levosalbutamol include a rapid onset of action, typically within 15 minutes of administration, with a duration of effect lasting up to 6 hours. It is absorbed well following inhalation, with peak plasma concentrations reached quickly. The drug undergoes hepatic metabolism, primarily through conjugation, and is excreted mainly via the urine.

Adverse effects

• Tremor
• Headache
• Palpitations
• Tachycardia
• Hypokalaemia
• Nausea

Precautions

• Use with caution in patients with cardiovascular disorders
• Monitor potassium levels in patients receiving high doses or those with risk of hypokalaemia

Pregnancy

Use in pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Levosalbutamol is excreted in breast milk, caution should be exercised when administered to a nursing mother.

Storage

Store below 25°C, protect from light and moisture.

Formulations

• Inhalation solution
• Inhaler

Mechanism of action

β2 adrenergic receptors on airway smooth muscle are Gs coupled and their activation by levosalbutamol leads to activation of adenylate cyclase and to an increase in the intracellular concentration of 3',5'-cyclic adenosine monophosphate (cyclic AMP). Increased cyclic AMP activates protein kinase A which itself inhibits the phosphorylation of myosin produces lower intracellular ionic calcium concentrations, inducing muscle relaxation. Increased cyclic AMP concentrations are also associated with the inhibition of the release of mediators from mast cells in the airways, potentially contributing to its benefit in asthma attacks.

Pharmacodynamics

It acts by relaxing smooth muscle in the bronchial tubes to increase air flow and relieve acute shortness of breath.