2 Bronchodilators
Learn how major bronchodilator classes relieve airway narrowing, how they are used in asthma and COPD, and which adverse effects and interactions require attention.
How bronchodilators work
Bronchodilators relax airway smooth muscle to widen the airways. do this by stimulating beta₂ receptors; albuterol is an example.
provide quick relief. are used for maintenance and are not universal medicines for sudden symptoms.
in asthma
Needing albuterol much more often than usual, or getting poor relief from it, may signal worsening asthma control and warrants reassessment. Short-acting relief should not replace anti-inflammatory treatment.
In asthma, a long-acting beta₂-agonist should be used with an inhaled corticosteroid, not alone. Using a long-acting beta₂-agonist without an inhaled corticosteroid is not recommended because of the risk of serious asthma-related outcomes.
Tremor and palpitations or a fast heartbeat are recognized beta₂-agonist effects, particularly with higher exposure. Higher exposure can also lower serum potassium and contribute to cardiovascular effects.
use and eye safety
blocks muscarinic receptors, reducing cholinergic bronchoconstriction. It is used as a bronchodilator in COPD and may be combined with a short-acting beta₂-agonist during severe acute asthma.
If spray gets into the eyes, it can increase intraocular pressure and may precipitate or worsen narrow-angle glaucoma. Avoid spraying it into the eyes; eye pain or visual changes warrant prompt medical advice.
monitoring and toxicity
has a narrow safety margin and variable clearance, so monitoring is important. Toxicity may cause persistent vomiting, a rapid or irregular heartbeat, marked tremor, and seizures; suspected toxicity requires prompt medical evaluation.
Ciprofloxacin can reduce clearance and raise serum levels, increasing toxicity risk. When interacting medicines are started or stopped, concentrations and the patient’s clinical status may need closer monitoring.