Beta-2 Agonists

β2 agonists are generally used in the treatment of asthma and COPD (chronic obstructive pulmonary disease).  Albuterol is a short-acting β2 agonist and is used as a rescue inhaler.  β2 agonists stimulate β2 receptors and result in bronchial dilation.  With the exception of terbutaline, these medications are inhaled and are absorbed into the bronchioles at the site of action.

Salmeterol, formoterol, arformoterol, and vilanterol are long-acting beta agonists and are only used for long-term control of asthma symptoms and are not for use in "rescue" situations (asthma attack).  The long-acting beta agonists are commonly used with corticosteroids for treatment of asthma and COPD.  When used as a single medication (not in combination with a corticosteroid) the FDA requires a black box warning for the increase in risk of asthma-related death for long-acting beta agonists.

Class Drugs

• Albuterol

• Terbutaline

• Salmeterol

• Formoterol

• Arformoterol

• Vilanterol

Class Mechanism of Action

• Stimulates β2 receptors

Class Application

Asthma

COPD

Class Adverse Effects

• Tachycardia

• Tremor

• Anxiety

Drug Table

Drug Name	Application	Comments	Image
Albuterol	Acute Asthma Attack - "Rescue Inhaler"COPD	Short-acting	Weird "Al" and "Butane" torch
Terbutaline	Off-label for tocolysis (decreased uterine contractions)	Prevention of pre-term labor	"Turbine" and "Butane" and "Fishing line"
Salmeterol	Asthma Control; COPD	Long-acting; Increased asthma related death (not a rescue inhaler, delayed onset)	"Salmon" and "Meter"
Formoterol	Asthma Control; COPD	Long-acting; Increased asthma related death (not a rescue inhaler, delayed onset)	"Form" and "Motor Oil"
Arformoterol	Asthma Control; COPD	Long-acting; Increased asthma related death (not a rescue inhaler, delayed onset)	"A" and "Form" and "Motor Oil"
Vilanterol	Asthma Control; COPD	Long-acting; Increased asthma related death (not a rescue inhaler, delayed onset)	"Villain"