5.10 Beta-2 Agonists
Albuterol is an example of a short-acting Beta-2 agonist. See Figures 5.11[1], 5.12[2] and 5.13 [3]for images of an albuterol inhaler, ampule, and nebulizer.
Salmeterol is an example of a long-acting Beta-2 agonist.
See the “Autonomic Nervous System” chapter for more information regarding Beta-2 agonists.
Mechanism of Action: Albuterol and salmeterol stimulate Beta 2-adrenergic receptors in the smooth muscle of bronchi and bronchioles producing bronchodilation. Beta-1 receptors can also be inadvertently stimulated, causing tachycardia.
Indications: Short-acting albuterol is used to prevent or treat bronchospasms in people with asthma, reversible obstructive airway disease, or exercise-induced bronchospasm. Long-acting salmeterol is used to prevent bronchospasm.
Nursing Considerations: Nurses should monitor respiratory rate, oxygen saturation, and lung sounds before and after administration.
Side Effects/Adverse Effects: Beta-2 agonists can cause muscle tremor, excessive cardiac stimulation, and CNS stimulation.[4]
Health Teaching & Health Promotion: Clients should be instructed to take medication as directed and report any sustained or worsening symptoms to their health care provider. When first using an inhaler, clients should be instructed to prime the inhaler unit prior to administering their medication. Use of medications like albuterol can cause an unusual taste in the mouth, and rinsing the mouth with water after use is permitted. Clients should have an understanding of medication onset and use short-acting and long-acting inhalers appropriately.[5]
Now let’s take a closer look at the medication grid for albuterol and salmeterol in Table 5.10.[6],[7],[8],[9],[10]
Table 5.10 Albuterol and Salmeterol Medication Grid
Class/Subclass |
Prototype/Generic |
Nursing Considerations |
Therapeutic Effects |
Side/Adverse Effects |
|---|---|---|---|---|
| Short-acting Beta-2 Agonist (SABA) | albuterol | Fast onset of action for prevention or alleviation of bronchospasm | Rapid bronchodilation | CNS stimulation (excitability)
Cardiovascular stimulation (tachycardia) |
| Long-acting Beta-2 Agonist (LABA) | salmeterol | Has a slow onset of action and will not stop an acute bronchospasm
Increased risk of death with use during an “asthma attack” due to slow onset of action |
Prevention of bronchospasm | Tachycardia, dysrhythmias, hypokalemia, hyperglycemia, paradoxical bronchoconstriction, and increased risk for asthma-related death |
- “Ventolin® HFA (Albuterol Sulfate) Inhaler.jpg” by MisterNarwhal is licensed under CC BY SA 4.0 ↵
- “Albuterol 2.jpg” by Mark Oniffrey is licensed under CC BY SA 4.0 ↵
- "Nebulizer_Mouthpiece.png" by BruceBlaus is licensed under CC BY-SA 4.0 ↵
- Frandsen, G., & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
- uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
- This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice by Gloria Velarde licensed under CC BY-NC-SA 4.0 ↵
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵
- Frandsen, G., & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵
- Adams, M., Holland, N., & Urban, C. (2020). Pharmacology for nurses: A pathophysiologic approach (6th ed.). pp. 622-63. ↵