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Activation of beta 2adrenergic receptors on airway smooth muscle leads to the activation of adenylyl cyclase and to an increase in the intracellular concentration of cyclic-35adenosine monophosphatecyclic AMPThis increase of cyclic AMP leads to the activation of protein kinase Awhich inhibits the phosphorylation of myosin and lowers intracellular ionic calcium concentrationsresulting in relaxationAlbuterol relaxes the smooth muscles of all airwaysfrom the trachea to the terminal bronchiolesAlbuterol acts as a functional antagonist to relax the airway irrespective of the spasmogen involvedthus protecting against all bronchoconstrictor challengesIncreased cyclic AMP concentrations are also associated with the inhibition of release of mediators from mast cells in the airway.
Ipratropium bromide levels remained below detectable limitsTable 1 All Adverse Eventsin percentagesfrom Two Large Double-blindParallel12-Week Studies of Patients with COPD*
Some mixtures of medications can lead to serious and even fatal consequences.
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