Respiratory Medications: Bronchodilators

1. Beta-2 Adrenergic Agonists

• Medications:
  • Albuterol
  • Salmeterol
• Uses:
  • Treatment of asthma and COPD
  • Can be combined with glucocorticoids or anticholinergics (e.g., ipratropium)
• Mechanism of Action:
  • Bind to beta-2 receptors in the lungs, causing bronchodilation
  • "Two lungs, beta-2 receptors"
• Side Effects:
  • Nervousness, tremors, chest pain, palpitations
• Differences:
  • Albuterol:
    • Short-acting
    • Used for acute asthma attacks
    • Remember: "A for Albuterol, A for Acute"
  • Salmeterol:
    • Long-acting
    • Used for prevention of asthma attacks
    • Remember: "Salmon for long life, Salmeterol long-acting"
• Usage Instructions with Glucocorticoids:
  • Use bronchodilator first, wait 5 minutes, then glucocorticoid
  • Remember: "B before G"

2. Xanthines

• Key Medication: Theophylline
• Uses: Long-term control of asthma or COPD
• Mechanism of Action:
  • Increases cAMP, leading to bronchodilation
• Serious Side Effects:
  • GI upset, headache, nervousness
  • Risk for dysrhythmias, seizures
• Monitoring:
  • Regular blood draws needed
  • Therapeutic range: 10-20 mcg/mL
• Mnemonic: "Theo means god; serious side effects might make you see God sooner"

3. Anticholinergic Medications

• Key Medication: Ipratropium
• Uses:
  • COPD, rhinitis (runny nose), off-label for asthma
  • Can be combined with albuterol (DuoNeb)
• Mechanism of Action:
  • Blocks acetylcholine receptors, causing bronchodilation
• Side Effects:
  • Dry mouth, bitter taste, throat/nasal irritation
• Patient Instructions:
  • Increase fluid intake
  • Suck on candy for dry mouth
  • Note: DuoNeb contraindicated in peanut allergies

Next Topics (Upcoming Video)

• Corticosteroids (inhaled and nasal)
• Leukotriene receptor antagonists
• Antitussive medications