Beta-adrenergic agonists inhaled

Metaproterenol (Alupent, Metaprel) [Bronchodilator/Beta Adrenergic Agonist] Uses Asthma rev ible bronchospasm Action Sympathomimetic bronchodilator Dose AduUs. Inhal 1-3 inhal q3-4h, 12 inhal max/24 h wait 2 min between inhal PO 20 mg q6-8h Peds. Inhal 0.5 mg/kg/dose, 15 mg/dose max inhaled q4-6h by neb or 1-2 puffs q4-6h PO 0.3-0.5 mg/kg/dose... 

Metaproterenol (Alupent, Metaprel) [Bronchodilator/ Beta-Adrenergic Agonist] Uses Asthma reversible bronchospasm Action Sympathomimetic bronchodilator Dose Adults. Neb 0.2-0.3 mL in 2.5-3.0 mL of NS Peds. Neb 0.1-0.2 mL/kg of a 5% soln in 2.5 mL NS Caution [C, /-] Contra Tach, other arrhythmias Disp Aerosol 0.65 mg/inhal soln for inhal 0.4, 0.6% tabs 10, 20 mg syrup 10 mg/5 mL SE Nervousness, tremors (common), tach, HTN Interactions T Effects W/ sympathomimetic drugs, xanthines T risk of arrhythmias W/ cardiac glycosides, halothane, levodopa, theophylline, thyroid hormones T HTN W/ MAOIs effects W/ BBs EMS Separate additional aerosol use by 5 min fewer 3i effects than isoproterenol longer-acting monitor lung sounds before/after administration... 

Seale J, Harrison L 1998 Effect of changing the fine particle mass of inhaled beclomethasone dipropionate on intrapulmonary deposition and pharmacokinetics. Respiratory Medicine 92 9-15 Sears M R 1995 Is the routine use of beta-adrenergic agonists appropriate in asthma treatment American Journal of Respiratory and Critical Care Medicine 151 599-601... 

Pirbuterol, a beta-adrenergic agonist with bronchodilating properties (1 to 2 inhalations every 4 to 6 hours), is indicated in the prevention and reversal of bronchospasm and asthma... 

I. Pharmacology. Epinephrine is an endogenous catecholamine with alpha- and beta-adrenergic agonist properties, used primarily in emergency situations to treat anaphylaxis or cardiac arrest. Beneficial effects include inhibition of histamine release from mast cells and basophils, bronchodilation, positive inotropic effects, and peripheral vasoconstriction. Epinephrine is not active after oral administration. Subcutaneous injection produces effects within 5-10 minutes, with peak effects at 20 minutes. Intravenous or inhalational administration produces much more rapid onset. Epinephrine is rapidly inactivated in the body, with an elimination half-life of 2 minutes. 

Cromolyn sodium is administered by inhalation. Its mode of action involves the inhibition of the release of histamine and other inflammatory mediators from several cell types. Its main use is for the prophylactic treatment of bronchial asthma. Inhalation of a selective [beta-2]-adrenergic agonist such as albuterol is the preferred form of bronchodilator therapy for asthma. 

Enantiomer Preparations of Inhaled Drugs. There has been much interest in the differences in effects of enantiomers of many medications, and beta agonist adrenergic bronchodilators have received much attention. Evidence suggests that the (R)-enantiomer of albuterol is mainly responsible for bronchodilation while the (S)-enantiomer may stimulate airway reactivity. Data suggest, however, that after aerosol delivery, the systemic absorption for (R)-albuterol is faster than for (S)-albuterol and that, conversely, the lung retention of (S)-albuterol is longer, which may be detrimental [29]. The extent to which enantiomers will displace racemic preparations is not yet determined. 

Reisman RE. Asthma induced by adrenergic aerosols. J Allergy 1970 46 162. Nicklas RA. Paradoxical bronchospasm associated with the use of inhaled beta agonists. J AUergy CUn Immunol 1990 85 959-964. 

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