Short-acting beta2-agonists for quick relief of asthma symptoms

Examples

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Prescription short-acting beta₂-agonists for asthma include:

Brand Name	Chemical Name
Ventolin	albuterol

Brand Name	Chemical Name
Xopenex	levalbuterol

Brand Name	Chemical Name
Alupent	metaproterenol sulfate

Brand Name	Chemical Name
Maxair	pirbuterol acetate

Brand Name	Chemical Name
Brethine	terbutaline sulfate

Short-acting beta₂-agonists are available in inhaled, pill, liquid, and injectable forms. The inhaled form is available in metered-dose inhalers (MDIs) and as a liquid for compressor-driven nebulizers. Inhalers may be used differently, depending on the medication used. Always consult the directions to be sure you are using the inhaler correctly. Short-acting beta₂-agonists are also available without a prescription (such as Primatene).

How It Works

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Short-acting beta₂-agonists are bronchodilators. They relax the muscles lining the airways that carry air to the lungs (bronchial tubes) within 5 minutes, increasing airflow and making it easier to breathe. They relieve asthma symptoms for 3 to 6 hours. They do not control the inflammation .

Why It Is Used

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Short-acting beta₂-agonists are used to:

• Provide quick relief of symptoms during asthma attacks.
• Prevent asthma symptoms before exercise.
• Treat symptoms in mild intermittent asthma.

How much of the medication you use depends on how severe your symptoms are. For more information, see:

• Asthma medications for adults, teens, and children older than age 5.
• Asthma medications for children age 5 and younger.

How Well It Works

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Short-acting beta₂-agonists are the treatment of choice for relieving symptoms during asthma attacks and for treating intermittent asthma symptoms.¹ They are also used to relieve symptoms caused by exercise.

Research indicates that combining short-acting beta₂-agonists and ipratropium in acute, severe asthma episodes, compared with using only beta₂-agonists, resulted in:²

• Fewer hospital visits.
• Improved lung function.

Side Effects

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Side effects of short-acting beta₂-agonists are more likely to occur when using the pill, liquid, or injectable forms than when using the inhaled form. Side effects may include:

• Rapid heartbeat or palpitations.
• Headache and dizziness.
• Nausea, vomiting, and diarrhea.
• Anxiety.
• Hives and skin rash.
• Nervousness or tremor (such as unsteady, shaky hands).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Research indicates that frequent use of inhaled beta₂-agonists may result in needing more of the medication to get the same results (tolerance) and may be associated with less effective control of asthma.³

If you need to use short-acting beta₂-agonists more than 2 times a week (except before exercise) or use more than 1 canister every 3 months, you may need to start or increase long-term therapy. Discuss this with your health professional.

Levalbuterol is approved for use in children age 6 and older and in adults.

Nonprescription short-acting beta₂-agonists (such as Primatene) should not be used to treat asthma symptoms without first talking with your health professional. Overuse of these products can delay medical care when it is really needed.

Short-acting beta₂-agonists are the best treatment for quick relief of asthma episodes and for emergency situations. Using the inhaled form of a short-acting beta₂-agonist is preferred for asthma treatment because it:

• Opens (dilates) bronchial tubes better than the pill or liquid form and does so at lower doses.
• Causes fewer side effects throughout the body than the oral form.
• Acts faster and lasts about as long as the oral form.

Because short-acting beta₂-agonists work quickly to reduce symptoms, people sometimes overuse these medications instead of using the slower-acting long-term medications. But overuse of quick-relief medications has harmful effects, such as decreasing the future effectiveness of these medications.³

Try to avoid giving your child an inhaled medication when he or she is crying. In this case, not as much medication is delivered to the lungs.

Short-acting beta₂-agonists should be used for mild intermittent asthma and quick relief of symptoms. They should not be used alone for persistent asthma.

Colds or other upper respiratory infections can cause asthma episodes in some people. Some health professionals recommend that people who have mild intermittent asthma use a short-acting beta₂-agonist at the first sign of cold symptoms.⁴

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Cydulka RK, Jarvis HE (2000). New medications for asthma. Emergency Medicine Clinics of North America, 18(4): 789–801.

2. Dennis RJ, et al. (2005). Asthma, search date May 2004. Online version of Clinical Evidence (14): 1847–1877.

3. Salpeter SR, et al. (2004). Meta-analysis: Respiratory tolerance to regular beta₂-agonist use in patients with asthma. Annals of Internal Medicine, 140(10): 802–813.

4. Mellins RB, et al. (2000). Developing and communicating a long-term treatment plan for asthma. American Family Physician, 61(8): 2419–2426.

Credits

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Author	Maria G. Essig, MS, ELS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman
Primary Medical Reviewer	Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer	Harold S. Nelson, MD - Allergy and Immunology
Last Updated	May 15, 2007