B-Agonists
sympathomimetic bronchodilator |
for acute attacks |
reduce airway constriction and restore normal airflow |
Stimulate β2-adrenergic receptors throughout the lungs |
3 types
Nonselective (a, B1, B2) |
epinephrine; acute |
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longer acting |
Nonselective B-adrenergic (B1, B2) |
isoproterenol |
Selective (B2) |
salbutamol |
Mechanism of Action
activation of B2 receptors activates cAMP |
bronchodilation and airflow |
Indications
bronchospasms (asthma, bronchitis, other pulmonary disease) |
hypotension and shock |
uterine relaxation (prevent premature labour) |
hyperkalemia (K+ into the cell) |
contraindications
known drug allergy |
uncontrolled cardiac dysrhythmias |
risk of stroke (vasoconstrictive action) |
Adverse Effects
Nonselective (a, B1, B2) Epinephrine |
insomnia, restlessness, anorexia (long term), headache, hyperglycemia, tremor, cardiac stim. |
Nonselective B-adrenergic (B1, B2) isoproterenol |
cardiac stim., tremor, anginal pain, headache, hypotension |
Selective (B2) albuterol/salbutamol |
hypotension/hypertension, tremor, headache |
Interactions
risk for hypertension |
risk for cardiac toxicity |
require an adjustment to antihyperglycemic drugs |
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Anticholinergic Drugs
-pium |
ipratropium (Atrovent) |
tiotropium (Spriva) |
Mechanism of Action
ACh causes bronchial constriction and narrowing of airways |
bind to ACh receptors |
ACh to receptors
|
slow and prolonged |
bronchoconstriction
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Adverse Effects
dry mouth or throat |
nasal congestion |
heart palpitations |
GI distress |
headache |
coughing |
anxiety |
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Xanthine Derivatives (Methylxanthine)
natural xanthines: alkaloids, caffeine, theobromine, and theophylline |
theophylline only used a bronchodilator |
synthethic: aminophylline (phyllocontin) & oxtriphylline |
Mechanism of Action
cAMP by phosphodiesterase (enzyme that breaks down cAMP) |
SM relaxation, bronchodilation, airflow |
Drug Effects
contractility, HR CO & blood flow to kidney |
stimulate cardio and CNS system |
Indications
asthma, chronic bronchitis, & emphysema (COPD) |
mild to moderate cases of acute asthma |
adjunct drug for COPD |
Contraindications
known drug allergy |
uncontrolled cardiac dysrhythmias |
seizure disorders |
hyperthyroidism |
peptic ulcers |
Adverse Effects
nausea, vomiting, anorexia |
GI reflux during sleep |
tachycardia, extra systole, palpitations, ventricular dysrhythmias |
transient urination |
Interactions
not used often due to many drug interactions |
Several drugs increase serum levels of xanthine derivatives |
used with sympathomimetics can increase and CNS stimulation |
St. John's wort and cigarette smoking enhance rate of metabolism |
charcoal broiling & keto diet xanthine effect |
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