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module menu icon Bronchodilators

  1. SABAs: short-acting beta2 agonists (e.g. salbutamol and terbutaline) act directly on beta2 receptors, causing smooth muscle relaxation and dilatation of the airways. Commonly known as ‘relievers’ due to their rapid onset of action, the effects of SABAs last for up to four hours. They are first-line treatments in asthma and are as effective when used either regularly or as required. SABAs should be used with caution in people with cardiovascular disease (including hypertension) as beta2 agonists may cause an increased risk of arrhythmias and significant changes to blood pressure and heart rate
  2. LABAs: long-acting beta2 agonists (e.g. salmeterol and formoterol) have a duration of action of 12 hours. They are the first choice initial add-on therapy in adults. Salmeterol should not be used to relieve an asthma attack due to its slower onset of action but formoterol is licensed both for short-term relief of symptoms and for the prevention of exercise-induced bronchospasm. Adverse effects of shortacting and long-acting beta2 agonists are similar. They are usually dose related and include fine tremor, especially in the hands (often worse in the first few days of treatment). Palpitations, headache, seizures, anxiety and hypokalaemia (low level of potassium in the blood serum) can also occur.
  3. LAMAs: ipratropium bromide is a long-acting muscarinic agent (LAMA) that can be used to treat asthma in all age groups. Tiotropium is licensedas an add-on therapy for adults who have experienced one or more severe asthma exacerbations in the past year.
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