Long-Acting Beta Agonists: Salmeterol and Formeterol

Salmeterol and Formeterol
Two long-acting ß 2 -adrenergic agonists (LABAs), salmeterol and formoterol, have been demonstrated to be safe and effective agents in children, both in terms of bronchodilation and prevention of exercise-induced bronchospasm. Their onsets of action differ, with formoterol having an onset similar to albuterol (3 minutes), while salmeterol has a slower onset of action (10–20 minutes). Following a single-dose administration, both agents demonstrate durations of action up to 12 hours. Following regular twice-daily administration, bronchodilation remains effective; however, a level of tolerance (or tachyphylaxis) (more…)

Long Acting Agonist (ß2) Therapy to Inhaled Corticosteroids in Persistent Asthma?

long acting agonist
Current internationally recognized guidelines indicate that symptomatic asthmatics using a low to medium inhaled corticosteroid dose (400–800 µg/day of beclomethasone or equivalent) alone should preferentially be commenced on a long-acting agonist ß2 prior to an leukotriene receptor antagonists LTRA (British guideline on the management of asthma 2003; GINA Workshop Report 2004). However, two recent large trials have performed head to-head comparisons of add-on long-acting ß2 agonist versus LTRA as therapeutic adjuncts to inhaled corticosteroids, using exacerbation frequency (rather than lung function and symptoms) as the primary end point. (more…)

Budesonide Inhalation Dose versus Maintenance Treatment in Asthma Exacerbations

budesonide inhalation
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid during an asthma exacerbation. This study investigated whether doubling the dose of budesonide inhalation in patients on regular inhaled budesonide would be beneficial during an asthma exacerbation. (more…)

Budesonide Formoterol Inhaler Therapy Safety in Moderate To Severe Asthma

Budesonide Formoterol
This study evaluated budesonide formoterol efficacy and safety of a novel asthma management strategy for both maintenance and symptom relief (Symbicort Single Inhaler Therapy) – compared with a higher maintenance dose of budesonide in patients with moderate to severe asthma. (more…)

Formoterol-Budesonide Combination Therapy forReliever Medication In Asthma

Formoterol-Budesonide
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require reliever medication for breakthrough symptoms. Periodic fluctuations in symptoms and airway inflammation are characteristics of asthma, which means that treatment requirements, especially reliever use, can vary over time. (more…)

Long Acting Beta-Agonist Bronchodilator Tolerance

Regular use of ß-agonists has been known to lead to tolerance to their bronchodilator effects. It is not known how quickly tolerance develops or how long it lasts after stopping ß-agonist therapy.

Bronchodilator tolerance occurs after even a single dose and reaches a maximum after 1 week of regular formoterol. Sensitivity recovers 3 days after stopping treatment. (more…)