Bronchodilators sympathomimetics/beta agonists

MAOIs or RIMAs + Sympathomimetics Beta-agonist bronchodilators... 

The interaction between phenylephrine and the MAOIs is dealt with elsewhere (see MAOIs orMMAs + Sympathomimetics Phenylephrine , p. 1148). Consider also MAOIs or RIMAs + Sympathomimetics Beta-agonist bronchodilators , p.ll46 and Inotropes and Vasopressors Dopamine + Selegiline , p.893, for dosing advice with when dopamine is given to patients taking MAOIs. 

Administering sympathomimetics (beta-adrenergic agonists) Sympathomimetics promote the production of cyclic AMP, which cause bronchodilation. 

Halothane is known to cause arrhythmias and it has been suggested that it may increase susceptibility to the adverse cardiac effect of beta-agonist bronchodilators, which can cause arrhythmias. Note that beta agonists such as terbutaline are sympathomimetics (see Table 24.1 , (p.879)), like adrenaline (epinephrine), which has also been shown to cause arrhythmias in the presence of halothane (see Anaesthetics, general + Inotropes and Vasopressors , p.99). 

Examples of sympathomimetic bronchodilators include albuterol (Ventolin), epinephrine (Adrenalin), salme-terol (Serevent), and terbutaline (Brethine). Many of the sympathomimetics used as bronchodilators have die subclassification of beta-2 ((32) receptor agonists (eg, albuterol, salmeterol, and terbutaline). Additional information concerning the various sympathomimetic dragp is given in the Summary Drug Table Bronchodilators. 

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... 

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