- Beta2-adrenergic agonist
Beta2-adrenergic agonists, also known as Beta2-adrenergic receptor agonists, are a class of drugs used to treat
asthmaand other pulmonary disease states.
They act on the
Beta-2 adrenergic receptor, thereby causing smooth muscle relaxation resulting in dilation of bronchial passages, vasodilationin muscle and liver, relaxation of uterine muscle and release of insulin. Side effects such as insomnia, anxiety, and tremor occur in some patients. All β2 agonists are available in inhaler form (either metered-dose inhalers, which aerosolize the drug, or dry powder which can be inhaled).
Salbutamol (known as albuterol in the U.S.) also comes in a solution form for nebulization, which is more commonly used in emergency rooms than inhalers. Salbutamol and terbutaline are also both available in oral forms.
In addition, several of these medications are available in intravenous forms including both
salbutamoland terbutaline. It can be used in this form in severe cases of asthma, but more commonly it is used to suppress premature labor because it also relaxes uterine muscle, thereby inhibiting contractions.
On November 18, 2005,
Food and Drug Administration(FDA) alerted health care professionals and patients that several long-acting bronchodilator medicines have been associated with possible increased risk of worsening wheezing (bronchospasm) in some people, and requested that manufacturers update warnings in their existing product labeling.
On June 29, 2006,
Cornell Universityand Stanford Universityresearchers reported that a meta-analysisthey conducted found that "regularly inhaled beta-agonists ( Orciprenaline/metaproterenol [Alupent] , formoterol[Foradil] , Fluticasone/salmeterol[Serevent, Advair] and Salbutamol/albuterol [Proventil, Ventolin, Volmax and others] ) increased the risk of respiratory death more than twofold, compared with a placebo," while used to treat chronic obstructive pulmonary disease(COPD). [Ramanujan K. Common beta-agonist inhalers more than double death rate in COPD patients, Cornell and Stanford scientists assert. "Chronicle Online". June 29, 2006. Available at: http://www.news.cornell.edu/stories/June06/Salpeter.COPD.kr.html. Accessed June 30, 2006.]
They can be divided into short-acting and
long acting beta-adrenoceptor agonist(LABA) groups:
hort-acting beta2 agonists
Long-acting beta2 agonists
Ultra long-acting beta2 agonists
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