*B-Agonists Drugs *Anticholinergic Drugs *Xanthine (Methylxanthine) Drugs
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sympathomimetic bronchodilator
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for acute attacks
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reduce airway constriction and restore normal airflow
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Stimulate β2-adrenergic receptors throughout the lungs
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Nonselective (a, B1, B2)
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epinephrine; acute
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longer acting
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Nonselective B-adrenergic (B1, B2)
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isoproterenol
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Selective (B2)
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salbutamol
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activation of B2 receptors activates cAMP
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bronchodilation and airflow
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bronchospasms (asthma, bronchitis, other pulmonary disease)
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hypotension and shock
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uterine relaxation (prevent premature labour)
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hyperkalemia (K+ into the cell)
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known drug allergy
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uncontrolled cardiac dysrhythmias
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risk of stroke (vasoconstrictive action)
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Nonselective (a, B1, B2) Epinephrine
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insomnia, restlessness, anorexia (long term), headache, hyperglycemia, tremor, cardiac stim.
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Nonselective B-adrenergic (B1, B2) isoproterenol
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cardiac stim., tremor, anginal pain, headache, hypotension
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Selective (B2) albuterol/salbutamol
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hypotension/hypertension, tremor, headache
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risk for hypertension
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risk for cardiac toxicity
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require an adjustment to antihyperglycemic drugs
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-pium
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ipratropium (Atrovent)
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tiotropium (Spriva)
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ACh causes bronchial constriction and narrowing of airways
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bind to ACh receptors
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slow and prolonged
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dry mouth or throat
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nasal congestion
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heart palpitations
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GI distress
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headache
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coughing
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anxiety
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natural xanthines: alkaloids, caffeine, theobromine, and theophylline
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theophylline only used a bronchodilator
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synthethic: aminophylline (phyllocontin) & oxtriphylline
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cAMP by phosphodiesterase (enzyme that breaks down cAMP)
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SM relaxation, bronchodilation, airflow
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contractility, HR CO & blood flow to kidney
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stimulate cardio and CNS system
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asthma, chronic bronchitis, & emphysema (COPD)
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mild to moderate cases of acute asthma
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adjunct drug for COPD
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known drug allergy
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uncontrolled cardiac dysrhythmias
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seizure disorders
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hyperthyroidism
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peptic ulcers
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nausea, vomiting, anorexia
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GI reflux during sleep
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tachycardia, extra systole, palpitations, ventricular dysrhythmias
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transient urination
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not used often due to many drug interactions
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Several drugs increase serum levels of xanthine derivatives
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used with sympathomimetics can increase and CNS stimulation
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St. John's wort and cigarette smoking enhance rate of metabolism
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charcoal broiling & keto diet xanthine effect
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