Adrenergic (Sympathomimetic) Bronchodilators

Question 0

Beta 2 stimulation?

Answer 0

Bronchi- relaxes smooth muscle

Question 1

Beta 1 stimulation?

Answer 1

Heart- increases HR and force of contraction

Question 2

alpha 1 stimulation?

Answer 2

peripheral blood vessels- vasoconstriction

Question 3

alpha 2 stimulation?

Answer 3

CNS- relax

Question 4

Epinephrine onset, peak effect, and duration?

Answer 4

Onset: 1-3 min
Peak effect: 15-20 min
Duration: 1-3 hrs

Question 5

Epinephrine types?

Answer 5

Natural: Pure (R) isomer, parenteral, 1%

Synthetic: Racemic mixture, nebulized, 2.25%

Question 6

What are clinical indications for racemic epinephrine?

Answer 6

Control airway bleeding during bronchoscopy

Reduce airway swelling (upper airway)

Question 7

What can be used instead of epinephrine?

Answer 7

Isoproterenol: B1 and B2 stimulator

Available parenterally

Question 8

Metaproterenol?

Brand name, onset, duration, peak effect?

Answer 8

This is an adrenergic bronchodilator. Aka: Alupent
Onset: 1-5 min
Duration: 4-6 hrs
Peak effect: 30-60 min

Question 9

Albuterol?
Brand names, onset, duration, peak effect?
Dosages?

Answer 9

Proventil, Ventolin, ProAir, AccuNeb
Onset: 15 min
Duration: 4-6 hrs
Peak effect: 30-60 min
SVN: 2.5 mg, .63 1.25 2.5 mg or MDI: 2 puffs = 2.5 mg

Question 10

Levalbuterol?
Brand name?
Dose?

Answer 10

Levalbuterol is the pure (R) isomer or racemic albuterol.
aka: xopenex
You only need 1/2 the dose of albuterol! (Because it is a pure isomer)

Question 11

What are the short acting non-catecholamines?

Answer 11

Albuterol, metaproterenol, and levalbuterol.

Question 12

What are the long acting non-catecholamines?

Answer 12

extended release albuterol, salmeterol, formoterol, and arformoterol

Question 13

Extended release albuterol?
Brand name?
Activity time?

Answer 13

aka Vospire ER
lasts for 8-12 hours
available as 4mg or 8mg tablets

Question 14

Salmeterol?
Brand name?
Onset, peak effect, and duration?

Answer 14

Aka: Severent (DPI diskus)
Onset: slower than albuterol (>15min)
Peak effect: 3-5 hrs
Duration: 12 hrs

Question 15

Formoterol?

Brand names, onset, peak effect, duration?

Answer 15

aka: Performist or Foradil
Onset: 15 min
Peak effect: 30-60 min
Duration: 12 hrs

Question 16

What is formoterol used for?

Answer 16

Formoterol (Performist or Foradil) is used for asthma, exercise induced bronchospasms, and COPD. MAINTENANCE therapy

Question 17

Arformoterol?

Brand name and duration?

Answer 17

Aka: Brovana
Duration: 12 hrs

Question 18

What is arformoterol used for?

Answer 18

Brovana: COPD!

Question 19

What dosage do you typically use for nebulization?

Answer 19

10-15 mg/hr

Question 20

What are long acting B-adrenergic agents used for?

Answer 20

• Maintenance therapy of asthma not controlled by corticosteroids
• COPD needing a daily bronchodilator (Formoterol/arformoterol)
• NOT recommended for rescue therapy

Question 21

What are some potential complications of long acting B-adrenergics?

Answer 21

Tremors, cardiac effects, tolerance, loss of bronchoprotection, HYPOkalemia, HYPERglycemia

Question 22

What is something you can try if long acting B-adrenergics become tolerated?

Answer 22

Try combining with a corticosteroid. Corticosteroids reverse desensitization of B-receptors.

Question 23

What should the RT assess during B-agonist therapy?

Answer 23

Are the patient’s symptoms still present?
Before/after physical assessment
Monitor for 20% increase of HR
Monitor glucose/K+