[Endobronchial bronchodilators]

There are two families of inhaled bronchodilators: beta-2-mimetics and vagolytics. They are equally effective in patients with chronic obstructive pulmonary disease (COPD), whereas beta-mimetics are usually superior in asthmatics. The clinical benefits linked to long acting beta-mimetics like salmeterol are already established in asthmatics. Metered dose aerosols remain the most widely used type of inhaler, eventually connected to a spacer, together with powder inhalers. Usual bronchodilators are now prescribed on demand rather than on a regular basis. There is no proof that beta-mimetics are casually related to asthma deaths. Inhaled corticosteroids, which have no acute bronchospasmolytic properties, are the first-choice chronic drug treatment of moderate to severe asthma; they are currently being evaluated in COPD.