1
MARCH 2021
1. Describe the classification, preparation, clinical uses and adverse effects of
bronchodilators?
Classification of bronchodilators:
BRONCHODILATOR
β2 agonist Anticholinergics Methylxanthine
Ipratropium
Short acting- Theophylline,
bromide,
Salbutamol, Aminophylline,
Tiotropium
Terbutaline Doxophylline
bromide
Long acting –
Salmeterol,
Formoterol
Ultra long
acting
Indacaterol
Vilanterol
Preparation of bronchodilators:
Salbutamol Tablet- 2mg,4mg, syrup- 2mg/5ml, Metered dose inhaler-
100mcg, Respules- 5mg/ml
Terbutaline Tablet- 2.5mg,5mg, syrup- 3mg/5ml, Metered dose inhaler-
250mcg,
Salmeterol Metered dose inhaler- 25 mcg/puff, rotacap
Formoterol Metered dose inhaler- 12 to 24 mcg/ puff, rotacap
Ipratropium Metered dose inhaler- 20, 40mcg/puff
bromide
Theophylline SR tablet- 100 to 300mg TDS
Aminophylline Tablet- 100mg, injection- 250mg/10ml
Doxophylline Tablet- 400mg, Syrup- 100mg/5ml
, 2
Clinical uses:
1. Short acting β2 agonist – reversal of acute exacerbation
2. Long acting β2 agonist:
Bronchial asthma
COPD
3. Methylxanthines:
• Bronchial asthma and COPD- acute relief
• Apnea in premature infants- Theophylline is mostly used.
4. Anticholinergics:
• 1st line drug in COPD
• Nebulized ipratropium and salbutamol are used in refractory asthma.
• Used to control rhinorrhea in perennial rhinitis and common cold
Management of status asthmatics:
➢ O2
➢ Hydrocortisone hemisuccinate 100mg I.V stat followed by 100- 200mg 4-8th hourly
infusion
➢ Nebulized Salbutamol 2.5-5mg along with O2
➢ Salbutamol/ Terbutaline 0.4mg IM/S.C if needed
➢ Intubation and mechanical ventilation
Adverse effects:
1. Beta2 agonist:
• Tremors- most common
• Palpitation
• Restlessness
• Nervousness
• Throat irritation
• Ankle oedema- rarely
2. Anticholinergics
• Dry mouth
• Constipation
• Blurred vision
• Urinary retention
3. Methylxanthine
Theophylline have narrow therapeutic index. Adverse effects of theophylline highly
vary with its therapeutic concentration.
MARCH 2021
1. Describe the classification, preparation, clinical uses and adverse effects of
bronchodilators?
Classification of bronchodilators:
BRONCHODILATOR
β2 agonist Anticholinergics Methylxanthine
Ipratropium
Short acting- Theophylline,
bromide,
Salbutamol, Aminophylline,
Tiotropium
Terbutaline Doxophylline
bromide
Long acting –
Salmeterol,
Formoterol
Ultra long
acting
Indacaterol
Vilanterol
Preparation of bronchodilators:
Salbutamol Tablet- 2mg,4mg, syrup- 2mg/5ml, Metered dose inhaler-
100mcg, Respules- 5mg/ml
Terbutaline Tablet- 2.5mg,5mg, syrup- 3mg/5ml, Metered dose inhaler-
250mcg,
Salmeterol Metered dose inhaler- 25 mcg/puff, rotacap
Formoterol Metered dose inhaler- 12 to 24 mcg/ puff, rotacap
Ipratropium Metered dose inhaler- 20, 40mcg/puff
bromide
Theophylline SR tablet- 100 to 300mg TDS
Aminophylline Tablet- 100mg, injection- 250mg/10ml
Doxophylline Tablet- 400mg, Syrup- 100mg/5ml
, 2
Clinical uses:
1. Short acting β2 agonist – reversal of acute exacerbation
2. Long acting β2 agonist:
Bronchial asthma
COPD
3. Methylxanthines:
• Bronchial asthma and COPD- acute relief
• Apnea in premature infants- Theophylline is mostly used.
4. Anticholinergics:
• 1st line drug in COPD
• Nebulized ipratropium and salbutamol are used in refractory asthma.
• Used to control rhinorrhea in perennial rhinitis and common cold
Management of status asthmatics:
➢ O2
➢ Hydrocortisone hemisuccinate 100mg I.V stat followed by 100- 200mg 4-8th hourly
infusion
➢ Nebulized Salbutamol 2.5-5mg along with O2
➢ Salbutamol/ Terbutaline 0.4mg IM/S.C if needed
➢ Intubation and mechanical ventilation
Adverse effects:
1. Beta2 agonist:
• Tremors- most common
• Palpitation
• Restlessness
• Nervousness
• Throat irritation
• Ankle oedema- rarely
2. Anticholinergics
• Dry mouth
• Constipation
• Blurred vision
• Urinary retention
3. Methylxanthine
Theophylline have narrow therapeutic index. Adverse effects of theophylline highly
vary with its therapeutic concentration.
