Medical Health Encyclopedia

Short-Acting Beta2 Agonists. Short-acting bronchodilators are the primary agents for most COLD patients. Albuterol (Proventil, Ventolin), called salbutamol outside the US, is the standard short-acting beta2 agonist. Others include isoproterenol (Isuprel, Norisodrine, Medihaler-Iso), metaproterenol (Alupent, Metaprel), pirbuterol (Maxair), terbutaline (Brethine, Brethaire, Bricanyl), bitolterol (Tornalate), and isoetharine (Bronkometer, Bronkosol), which is available in nebulizers. Newer beta2 agonists, including levalbuterol (Xopenex), have more specific actions than the standard agents. Most are administered through inhalation and are effective for three to six hours.

Long-Acting Beta2 Agonists. Long-acting forms, salmeterol (Serevent) or formoterol (Foradil), are proving to be particularly effective for COLD. Major analyses suggest they reduce exacerbations by 20% to 25%. They may help inhibit bacteria from building up on the airways and may offer real improvements in lung function. In fact, unlike short-acting forms, these beta2 agonists may even have anti-inflammatory properties.

Inhalers that combine a long-acting beta 2 agonist and a corticosteroid (Advair, Seretide, Symbicort) are even more effective than either agent---reducing exacerbations by 30%. Some studies suggest they may offer significant improvements in lung function and even improve survival rates, but more research is needed to confirm such findings.

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Side Effects. Side effects of both long-and short-acting beta2 agonists include anxiety, tremor, restlessness, and headaches. Patients may experience fast and irregular heartbeats. A physician should be notified immediately if such side effects occur, particularly in people with existing heart conditions. Such patients face an increased risk for sudden death from cardiac related causes. This risk is higher with oral or nebulized agents, but there have also been reports of heart attacks and angina in some patients using inhaled beta2 agonists.