LAMA

Products

LAMAs are commercially available as powders and inhalation solutions and are administered with a specially designed inhaler or with a nebulizer (nebulizer). LAMA is the acronym for , which means long-acting antagonists at muscarinic receptors.

Structure and properties

LAMAs are derived from the parasympatholytic atropine, which is a natural plant constituent found in various solanaceous plants (Solanaceae) such as belladonna and datura. The positive charge of the quaternary ammonium compound contributes to the fact that the active ingredient is predominantly effective locally in the respiratory tract and is absorbed into the systemic circulation only to a minor extent.

Effects

LAMAs (ATC R03BB) have parasympatholytic and bronchodilator properties. The effects are due to the abolition of the effects of acetylcholine on airway smooth muscle cells, which induces bronchoconstriction. The agents are selective antagonists at muscarinic acetylcholine receptors. LAMAs, as the name implies, have a long duration of action of 12 to more than 24 hours.

Indications

For the treatment of chronic obstructive pulmonary disease (COPD).

Dosage

According to the SmPC. Usually, once-daily inhalation is sufficient. Aclidinium bromide must be administered twice daily.

Active ingredients

Ipratropium bromide (Atrovent, generics) is short-acting and therefore belongs to the SAMAs, i.e .

Contraindications

LAMA are not approved for the treatment of bronchial asthma. Full precautions can be found in the drug label.

Interactions

Combination with other parasympatholytics is not recommended. Because of bronchodilatation, LAMAs may increase pulmonary absorption of other agents.

Adverse effects

The most common possible adverse effects include:

  • Headache
  • Dry mouth
  • Gastrointestinal disturbances
  • Upper respiratory tract infections, cough
  • Rapid heartbeat (tachycardia)