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Antimuscarinic drugs are used to relieve, or at least partially reverse, bronchoconstriction that is refractory to β receptors in the bronchioles. This effectively prevents bronchoconstriction in response to parasympathetic stimulation.

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The usual route of excretion is via the kidneys and rate of elimination depends on rate of urine production, pH of urine and transport mechanisms. Although drugs do appear in faeces, expired air, sweat and breast milk, these are normally minor routes of excretion.

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Disadvantages of systemic corticosteroids are widely recognized and perhaps the most serious is suppression of the pituitary-adrenal axis. The addition of exogenous corticosteroids to the systemic circulation is detected by the pituitary gland.

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In this situation, the patient shows a response, which can be described under one of the classical definitions of allergic response (that is, type see below). Such reactions require initial exposure to the drug to cause sensitization, after which, subsequent exposure to the same drug triggers an immunological reaction.

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