Adrenergic Bronchodilators

Question 1

-Adrenergic (Sympathomimetic) Bronchodilator

Answer 1

Adrenergic bronchodilators, agents that stimulates sympathetic nervous fibers, which allow relaxation of smooth muscle in the airways

-Also known as sympathomimetic bronchodilators or B2 agonists. Can be short or long term

-Short acting agents (SABA) indicated for relief of acute reversible airflow disease

-Termed “rescue” agents or “quick relieves”

-Duration 4-6 hours

Question 2

-Long acting agent (LABA)

Answer 2

-indicated for maintenance of bronchodilation, control of bronchospasms, and nocturnal symptoms in asthma, or other obstructive diseases.

-Timed “controller” the slow time to peak effects make poor resume drugs

-Duration 12 hours

Question 3

-Ultra Short acting Racemic Epinephrine

Answer 3

-Should only be used for its vasoconstriction effects to reduce upper airway swelling or to control bleeding

-this agent should not be used for bronchoconstriction

-Onset 3-5 mins

-Duration less than 2 hours

Question 4

-Epinephrine

Answer 4

-Trade name - Adrenalin

-Generic name epinephrine

-Concentration 1:100 solution

-Effects

	-Alpha Strong (+++)

	-Beta 1 Strong (+++)

	-Beta 2 medium (++)

-Dosage

	-Standard .25ml on 4ml of normal saline

	-Max .5 ml in 4 ml of normal saline

-Onset 3-5 min

	-Peak 5-20

	-Duration 1-3 hours

Question 5

-Epinephrine usage

Answer 5

-Is a potent catecholamine bronchodilator that stimulates both alpha and beta receptors, because epinephrine lacks Beta 2 receptors specificity, there is a high prevalence of side effects such as tachycardia, blood pressure, increase, tremor, headache, and insomnia

-Its duration of action is short due to metabolism

-It is used both by inhalation and subcutaneously to treat patients with acute sustained asthmatic episodes or anaphylaxis

-Self administered intramuscular injectable doses of .3 mg and .15 mg are marketed to control systemic hypersensitivity (anaphylactic) reaction

-Is also used as a cardiac stimulation (CPR) based on its strong beta 1 effects

Question 6

-Ultra Short Acting Adrenergic bronchodilators

Answer 6

-Racemic Epinephrine

-Trade name - Vaponephrine, micronefrin, asthmanefrin

-Generic name Racemic epinephrine

-Concentration 2.25% w/v solution

-Effects

-Alpha medium (++)

-Beta 1 Weak (+)

-Beta 2 medium (++)

-Dosage

-Standard .5 ml of 2.5 % w/v solution in 4 ml of saline

-Max 1.0 ml of 2.5% w/v solution in 4 ml of saline

-Often used either by inhaled aerosol or direct lung instillation for it strong alpha adrenergic vasoconstriction effects, to reduce airway swelling after extubation or during epiglottitis, croup, ot bronchitis

Question 7

-Short term Adrenergic bronchodilators

Answer 7

-Albuterol

-Trade name- Proventil HFA, Ventolin HFA, ProAir HFA, Vospire ER, Proair Digihaler, Respiclick, ACCNeb

-Generic name Albuterol

-Concentration:

	-SUN: 5mg/ml (.5% solution) 2.5 mg/ 3ML (.083% solution) 1.25 mg, .63 mg , all unit dose tid, qid, ect

	-MDI: 90 mcg/ puff, 2 puff tid, qid

	-Tab 2 mg, 4mg, 28mg, bid, tid, qid

	-DPI 108 mcg/ puff, 2 puff, tid, qid

	-Syrup 2 mg/ 5ml 1-2 tsp tid, qid

-Effects

	- Alpha none (0)

	-Beta 1 medium (++)

	-Beta 2 strong (+++)

-Onset: 15 mins

		-peak 30-60 min

		-duration 5-12 hours