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There are many formulations of selective β 2-agonists; inhalation is the route of choice because it is the most rapidly effective and is associated with minimum side effects. [12] Sulfate conjugates are the main metabolites; protein binding is rather weak and only insignificant interactions have been found with other drugs. [13]
Salbutamol, also known as albuterol and sold under the brand name Ventolin among others, [1] is a medication that opens up the medium and large airways in the lungs. [8] It is a short-acting β 2 adrenergic receptor agonist that causes relaxation of airway smooth muscle . [ 8 ]
The most common side effects include headache, oral candidiasis, cough, and difficulty speaking. [2] Salbutamol/budesonide was approved for medical use in the United States in January 2023. [2] [3] It is the first combination of an inhaled corticosteroid and a short-acting beta-agonist to be approved by the US Food and Drug Administration (FDA ...
Salbutamol or albuterol and some other β 2 agonists, such as formoterol, also are sold in a solution form for nebulization, which is more commonly used than inhalers in emergency rooms. [9] Nebulizers continuously deliver aerosolized drug and salbutamol delivered through nebulizer was found to be more effective than IV administration. [10]
Ipratropium bromide/salbutamol, sold under the brand name Combivent among others, is a combination medication used to treat chronic obstructive pulmonary disease (COPD). [1] [4] [5] It contains ipratropium (an anticholinergic) and salbutamol (albuterol, a β 2-adrenergic agonist).
The mechanisms of sympathomimetic drugs can be direct-acting (direct interaction between drug and receptor), such as α-adrenergic agonists, β-adrenergic agonists, and dopaminergic agonists; or indirect-acting (interaction not between drug and receptor), such as MAOIs, COMT inhibitors, release stimulants, and reuptake inhibitors that increase the levels of endogenous catecholamines.
Other side effects include headaches and essential tremor. Hypoglycemia was also reported due to increased secretion of insulin in the body from activation of β 2 receptors. [citation needed] In 2013, zilpaterol, a β agonist sold by Merck, was temporarily withdrawn due to signs of sickness in some cattle that were fed the drug. [8]
A 2013 systematic review of the drug's use as a treatment for acute asthma found that it "was not superior to albuterol regarding efficacy and safety in subjects with acute asthma." The review concluded: "We suggest that levalbuterol should not be used over albuterol for acute asthma." [2] Levalbuterol is notably more costly. [4] [5]
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