Which medications in the drug class Beta2 Agonists are used in the treatment of Smoke Inhalation Injury?

Updated: Oct 15, 2021
  • Author: Keith A Lafferty, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Beta2 Agonists

These agents relieve reversible bronchospasm by relaxing smooth muscles of the bronchi. Increased resistance from airway edema and reflex bronchoconstriction from irritation of airway receptors contribute to airway obstruction.

Bronchodilators are important in the treatment of bronchoconstriction and bronchorrhea. Toxic smokes can cause bronchoconstriction, especially if the exposed individual has underlying asthma or chronic obstructive pulmonary disease (COPD). In patients with profound bronchoconstriction and wheezing, subcutaneous epinephrine has been helpful in stabilizing mast cells and halting or reversing potentially fatal bronchoconstriction.

Albuterol (Proventi HFAl, Ventolin HFA, VoSpire ER, ProAir HFA)

Albuterol is a beta-agonist that is useful in treatment of bronchospasm refractory to epinephrine. It relaxes bronchial smooth muscle by acting on beta2-receptors, while having little effect on cardiac muscle contractility. Airway resistance is decreased, and ventilation is improved.

Epinephrine racemic (AsthmaNefrin, S2)

Racemic epinephrine alleviates airway edema and reflex bronchospasm. Although it has not been directly studied in smoke inhalation, inhaled racemic epinephrine can theoretically provide relief from both airway edema and reflex bronchospasm in this setting.

Terbutaline

Terbutaline is used for severe bronchoconstriction, especially in patients with underlying reactive airways disease. This agent acts directly on beta2-receptors to relax bronchial smooth muscle, relieving bronchospasm and reducing airway resistance.

Epinephrine (Adrenalin, EpiPen, Adrenaclick)

Epinephrine is used for severe bronchoconstriction, especially in patients with underlying reactive airways disease. This agent has alpha-agonist effects that include increased peripheral vascular resistance, reversed peripheral vasodilatation, systemic hypotension, and vascular permeability. The beta-agonist effects of epinephrine include bronchodilation, chronotropic cardiac activity, and positive inotropic effects.


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