MOA
- Acts direcly on B2 receptors, causing smooth muscle relaxation and dilation of airways.
- Expands airways
they are agonists, opposite to beta-blockers
2 types
SABA
LABA
SABA: examples
- Salbutamol
- Terbutraline
Salbutamol inhalers examples
- pMDI: Salamol, Ventolin Evohaler, Airomir
- DPI: EasyHaler, Ventolin Accuhaler, Salbulin Novolizer
Terbutraline inhalers examples
- DPI: Bricanyl
Duration of action: SABA
Onset: 15 mins
4 hrs
LABA examples
Always in combo with ICS
- Salmeterol
- Formoterol
- COPD = olodaterol, indacaterol, vilanterol
Formoterol inhalers examples
DPI: EasyHaler (Formoterol), Foradil, Oxis
MDI: Atimos
With Beclometasone: Fostair
With Budesonide: DuoResp, Symbicort
2. Indacaterol
Indacaterol inhalers examples
DPI: Onbrez
Olodaterol inhalers examples
MDI: Striverdi Respimat
Salmeterol inhalers examples
- DPI: Serevent
- MDI: Serevent Evohaler, Neovent, Soltel, Vertine
- With fluticasone: Seretide, Sereflo, Sirdupla, Avenor, Combisal, Airflusal
Vilanterol inhaler example
- with fluticasone = Relvar Ellipta
- with Umeclinidium = Anoro ellipta
Duration of action: LABA
12 hours
What types of inhalers are there available for beta-2 agonists?
Pressurised metered dose inhaler (pMDI)
- Administered SLOW and
GENTLE
Dry powder inhaler (DPI)
- Administered** FAST and
QUICK**
Both involve deep administration
What is the dose of salbutamol as an inhaler?
1-2 pufts up to QDS when required (MAX 8 puffs per day)
What are the side effects of Beta-2 agonists?
- Hypokalaemia
- Fine tremor
- Palps
- Anxiety
- Arrythmias
Knowing the side effects, which patients should beta-2
agonists be used in caution with?
- Cardiovascular disease
- Beta-2 agonists increase risk of arrhythmias and QT prolongation
- This is due to the hypokalaemia side effect - Hyperthyroidism
- Diabetes mellitus
- Beta-2 agonists can cause hyperglycaemia - Hypokalaemia - effect potentiated by theophylline, CS, diuretics. Hypokalaemia = QT prolongation
- Digoxin - incresaed risk of toxicity due to hypokalaemia
