Which medications in the drug class Beta2-adrenergic agonist agents are used in the treatment of Asthma?

Updated: Jan 07, 2019
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Beta2-adrenergic agonist agents

Beta2 agonists (albuterol sulfate [Proventil HFA, Ventolin HFA, ProAir HFA; pirbuterol acetate [Maxair Autohaler]; levalbuterol [Xopenex]) relieve reversible bronchospasm by relaxing the smooth muscles of the bronchi. These agents act as bronchodilators and are used to treat bronchospasm in acute asthmatic episodes and to prevent bronchospasm associated with exercise-induced asthma or nocturnal asthma.

In December 2018, the US Food and Drug Administration (FDA) approved the ProAir Digihaler (albuterol), the first digital and mobile-connected inhaler. The built-in sensors detect when the device is used and measure the strength of the user’s inhalation. The inhaler sends the user’s data to its mobile app companion and their healthcare provider.

Albuterol sulfate (Proventil HFA, Ventolin HFA, ProAir HFA, ProAir RespiClick, ProAir Digihaler)

This beta2-agonist is the most commonly used bronchodilator that is available in multiple forms (eg, solution for nebulization, metered-dose inhaler, oral solution). This is most commonly used in rescue therapy for acute asthmatic symptoms and is used as needed. Prolonged use may be associated with tachyphylaxis due to beta2-receptor down-regulation and receptor hyposensitivity.

Levalbuterol (Xopenex, Xopenex HFA)

A nonracemic form of albuterol, levalbuterol (R isomer), is effective in smaller doses and is reported to have fewer adverse effects (eg, tachycardia, hyperglycemia, hypokalemia). The dose may be doubled in acute severe episodes when even a slight increase in the bronchodilator response may make a big difference in the management strategy (eg, in avoiding patient ventilation).


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