The Rundown of Respiratory Medications

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Picture of Danelle Howard
Danelle Howard
Registered Respiratory Therapist, cross-trained in the Pulmonary Lab, caring for critically ill patients one breath at a time. Professional interests: mechanical ventilation, capnography, and waveforms.

Short-acting Beta-2 Agonist are used as a bronchodilator for quick relief and recommended as the first line of defense with intermittent asthma.  This group of medications is known as your “rescue inhaler”.  SABAs work by activating the Beta-2 receptors of the airway which in turn relaxes the smooth muscles of the airway resulting in improved breathing.  Some possible side effects from the medication are nervousness, trembling, heart palpitations, tachycardia and sore throat.  

  • ProAir HFA
  • ProAir Respiclick
  • ProAir Digihaler
  • Proventil HFA
  • Ventolin HFA
  • Xopenex HFA
  • Albuterol nebulization solution
  • Racemic epinephrine

Short-acting Muscarinic Antagonist is used as a bronchodilator for quick relief in COPD.  This medication blocks the effects of acetylcholine on muscarinic receptors on smooth airway muscles resulting in bronchodilation.  The duration of action of SAMAs is greater than SABAs.  Some possible side effects from the medication are dry mouth and blurred vision if in contact with the eye.  

  • Atrovent HFA
  • Ipratropium nebulization solution

A combination of these two medications can be used as a bronchodilator in COPD.  The two short-acting bronchodilators combined are better at improving FEV1 than Albuterol or Ipratropium alone while decreasing exacerbations.  

  • Combivent Respimat
  • Ipratropium and albuterol nebulization solution

Long-acting Beta-2 Agonist is used as a bronchodilator with a duration of twelve to twenty-four hours.  This medication relaxes tight muscles in airways while offering lasting relief of symptoms for at least twelve hours.  However, unlike the SABAs and SAMAs full effect may not be seen for up to thirty minutes.  This category of medications should be used on a regular basis and be taken with an inhaled corticoid steroid. Taken every day, LABAs relax airway smooth muscle.  Some possible side effects of this medication are tachycardia, tremors, nervousness, and chest pain.  

  • Serevent Diskus
  • Striverdi Respimat
  • Perforomist 
  • Brovana

Long-acting Muscarinic Antagonist is a long lasting bronchodilator with a duration of twelve hours. A muscarinic antagonist interferes with a neurotransmitter called acetylcholine that cause smooth muscles to contract.  This medication prevents airways from contracting while helping them to relax.  This medication is beneficial to stable COPD and has been shown to reduce exacerbations.  However, this medication should be taken with an inhaled corticosteroid.  Some possible side effects of this medication are dry mouth, constipation, and urinary retention.  

  • Incruse Ellipta
  • Spiriva Handihaler
  • Spiriva Respimat
  • Tudorza Pressair
  • Yupelri

A combination which uses both  adrenergic and cholinergic pathways in the airway smooth muscle to maximize long lasting bronchodilation.  Recommended in COPD with persistent symptoms.  Has been shown to improve lung function, lung hyperinflation, exercise capacity, quality of life, and exacerbation frequency thereby slowing down disease progression in COPD.   

  • Anoro Ellipta
  • Bevespi Aerosphere
  • Duaklir Pressair
  • Stiolto Respimat

Inhaled Corticosteroids reduces the number of inflammatory cells including eosinophils and T-lymphocytes.  This medication suppresses swelling of the airway tissue

while also reducing airway hyperresponsiveness in asthma.  When used every day the degree and severity of asthma attacks are decreased.  It is important to note that this medication does not relieve an asthma attack.  This medication is most effective in suppressing inflammation in asthma.  Some side effects of this medication include dysphonia, oropharyngeal candidiasis, pneumonia in COPD patients, adrenal suppression, and metabolic abnormalities.

  • Alvesco
  • ArmonAir Digihaler
  • Arnuity Ellipta
  • Asmanex twisthaler
  • Asmanex HFA
  • Flovent Diskus
  • Flovent HFA
  • Pulmicort Flexhaler
  • QVAR RediHaler
  • Budesonide nebulization solution

A combination of the two is an effective option for the management of asthma and COPD. 

  • Breo Ellipta 
  • Dulera 
  • Advair Diskus
  • Advair HFA
  • AirDuo RespiClick
  • Symbicort HFA
  • AirDuo Digihaler
  • Wixela Inhub
  • Atectura Breezhaler

A triple combination therapy  is effective in preventing COPD exacerbations. 

  • Trelegy Ellipta
  • Breztri Aerosphere
  • Enerzair Breezhaler


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