PEBC: What You Need to Know: Inhaled Bronchodilators

Indications:

Asthma and COPD

Two Classes:

1) Beta Agonists

Short-Acting Beta Agonists (SABA): salbutamol and terbutaline

Long-Acting Beta Agonists (LABA): salmeterol, indacaterol, formoterol, vilanterol

2) Muscarinic Agents

Short-Acting Muscarinic Agents (SAMA): ipratropium

Long-Acting Muscarinic Agents (LAMA): tiotropium, umeclidinium, glycopyrronium, aclidinium

Dosing:

Short-Acting Agents: every 4 to 6 hours - used as rescue or reliever therapy

Long-Acting Agents: once to twice daily- used for maintenance and control therapy

Adverse Effects:

Beta Agonists: tachycardia, tremor, anxiety. Usage alone in asthma can lead to increased exacerbations (combine with inhaled corticosteroid).

Muscarinic Agents: anticholinergic! Dry mouth, abnormal taste, glaucoma if directed into eye

Combinations:

SAMA and LAMA cannot be combined due to increased anticholinergic toxicity (Ex. ipratropium and tiotropium)