Beta2-adrenergic agonists are drugs that act on the beta2-adrenergic receptor.
Patient information
What are beta agonists?
It's a drug that acts on a receptor, that is usually activated by adrenaline. It does things like relax smooth muscles, and dilate the bronchi and bronchioles, which we call bronchodilation.
Classification
SABA (Short-acting beta2-adrenergic receptor agonist) is used in the Tx of asthma and COPD. Rescue/emergency inhalers are SABA's. Examples include:
Salbutamol/albuterol (Ventolin), which is to be stretched as deemed appropriate by respiratory assessment, but by no more than 1 hourly intervals at a time (e.g. 1->2 hours, 2->3 hours, 3->4 hours), except where stretch is denied by a consultant
What different sorts of drugs are there to act on beta receptors that are usually activated by adrenaline?
There are short acting, and long acting.
When you say short vs long, what do you mean?
We mean 4-6 hours, as supposed to 12 hours. So the long acting ones lasts 2-3 times as long, therefore only requiring a puff twice a day, rather than every few hours for the short acting ones.
Already, I'm ready for the sales pitch. Hit me with the common brand names?
So under SABA's, there's salbutamol (brand name Ventolin). Under LABA's, there's salmeterol, which can be combined with fluticasone (brand name Seretide). Symbicort is another combination, of budesonide and formoterol.
Side effects
Especially in parental administration, e.g. inhalation or injection:
Tachycardia, secondary to peripheral vasodilation and cardiac stimulation. It can be accompanied by palpitations
Tremor
Excessive sweating
Anxiety
Insomnia
Agitation
More severe effects are exceptional, including:
Pulmonary edema
Myocardial ischemia
Cardiac arrhythmia
Asthma aggravation, in patients using large doses of beta2 agonists, but it is not known if it results from the spontaneous course of the disease, or adverse effects of the drugs. The excipients, particularly sulfite, could contribute to the adverse effects
Patient information
What bad things can happen because of beta agonists? Why do we wean patients from beta agonists when they're in hospital?
Given that beta agonists work on the receptor activated by adrenaline, we'd expect a fight or flight response. So if this is overly crazy, it's things like fast heart rate, tremor, excessive sweating, anxiety, inability to sleep, agitation. It can also make asthma worse, we don't know why that happens, because, as we know, it's meant to HELP it, not make things worse!
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