Short-acting beta2-agonists for quick relief of asthma symptoms
Prescription short-acting beta2-agonists for asthma include:
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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 medicine 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
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
Short-acting beta2-agonists are used to:
- Provide quick relief of symptoms during asthma attacks.
- Prevent asthma symptoms before exercise.
- Treat symptoms in intermittent asthma.
Medicine treatment for asthma depends on a person’s age, his or her type of asthma, and how well the treatment is controlling asthma symptoms.
- Children up to age 4 are usually treated a little differently than those 5 to 11 years old.
- The least amount of medicine that controls the asthma symptoms is used.
- The amount of medicine and number of medicines are increased in steps. So if asthma is not controlled at a low dose of one controller medicine, the dose may be increased. Or another medicine may be added.
- If the asthma has been under control for several months at a certain dose of medicine, the dose may be reduced. This can help find the least amount of medicine that will control the asthma.
- Quick-relief medicine is used to treat asthma attacks. But if you or your child needs to use quick-relief medicine a lot, the amount and number of controller medicines may be changed.
Your doctor will work with you to help find the number and dose of medicines that work best.
How Well It Works
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 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
Research indicates that frequent use of inhaled beta2-agonists may result in needing more of the medicine 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 on more than 2 days a week (except before exercise), you may need to start or increase long-term therapy. Discuss this with your doctor.
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 doctor. 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 medicines instead of using the slower-acting, long-term medicines. But overuse of quick-relief medicines has harmful effects, such as decreasing the future effectiveness of these medicines.3
Try to avoid giving your child an inhaled medicine when he or she is crying. In this case, not as much medicine is delivered to the lungs.
Short-acting beta2-agonists should be used for 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 doctors recommend that people who have intermittent asthma use a short-acting beta2-agonist at the first sign of cold symptoms.4
- National Institutes of Health (2007). National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (NIH Publication No. 08–5846). Available online: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm.
- Dennis RJ, et al. (2007). Asthma in adults, search date October 2006. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- 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.
- Mellins RB, et al. (2000). Developing and communicating a long-term treatment plan for asthma. American Family Physician, 61(8): 2419–2426.
Last Updated: April 21, 2009