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Beta₂-adrenergic receptor agonists are a class of drugs used to treat asthma and other pulmonary disease states.

Contents 1 Uses 2 Risks 3 Types 4 References 5 External links

They act on the β₂-adrenergic receptor, thereby causing smooth muscle relaxation resulting in dilation of bronchial passages, vasodilation in muscle and liver, relaxation of uterine muscle and release of insulin. Side effects as insomnia, anxiety, and tremor occur in some patients. All β₂ agonists are available in inhaler form (either metered-dose inhalers, which aerosolize the drug, or dry powder which can be breathed in).

Salbutamol (known as albuterol in the U.S.) also comes in a liquid form for nebulization, which is more commonly used in emergency rooms than inhalers. Salbutamol and terbutaline are also both available in oral forms.

In addition, several of these medications are available in intravenous forms including both salbutamol and terbutaline. It can be used in this form in severe cases of asthma, but more commonly it is used to suppress premature labor because it also relaxes uterine muscle, thereby inhibiting contractions.

On November 18, 2005, Food and Drug Administration (FDA) alerted health care professionals and patients that several long-acting bronchodilator medicines have been associated with possible increased risk of worsening wheezing (bronchospasm) in some people, and requested that manufacturers update warnings in their existing product labeling.

On June 29, 2006, Cornell University and Stanford University researchers reported that a meta-analysis they conducted found that "regularly inhaled beta-agonists (metaproterenol [Alupent], formoterol [Foradil], salmeterol [Serevent, Advair] and albuterol [Proventil, Ventolin, Volmax and others]) increased the risk of respiratory death more than twofold, compared with a placebo," while used to treat chronic obstructive pulmonary disease (COPD).^[1]

They can be divided into two groups:

(1) short-acting and (2) long-acting.

Short-Acting Beta₂ Agonists

• salbutamol (albuterol)
• levalbuterol
• terbutaline
• pirbuterol
• procaterol
• metaproterenol
• fenoterol
• bitolterol mesylate

Long-Acting Beta₂ Agonists

• salmeterol
• formoterol
• bambuterol

1. ^ Ramanujan K. Common beta-agonist inhalers more than double death rate in COPD patients, Cornell and Stanford scientists assert. Chronicle Online. June 29, 2006. Available at: http://www.news.cornell.edu/stories/June06/Salpeter.COPD.kr.html. Accessed June 30, 2006.

• MeSH beta-Adrenergic+Receptor+Agonists

v • d • e Medications commonly used in asthma and COPD (primarily R03)
Anticholinergics	Ipratropium, Tiotropium
Short acting β2-agonists	Salbutamol, Terbutaline
Long acting β2-agonists (LABA)	Bambuterol, Clenbuterol, Fenoterol, Formoterol, Salmeterol
Corticosteroids	Beclometasone, Budesonide, Ciclesonide, Fluticasone
Leukotriene antagonists	Montelukast, Pranlukast, Zafirlukast
Xanthines	Aminophylline, Theobromine, Theophylline
Mast cell stabilizers	Cromoglicate, Nedocromil
Combination products	Budesonide/formoterol, Fluticasone/salmeterol, Ipratropium/salbutamol