- Body system
- Respiratory
- Name stem
- -terol, -tropium
- Drug cards
- 2 in this guide
Drugs in this class
- AlbuterolProAir HFA, Ventolin HFA, Proventil HFA, AccuNeb
- IpratropiumAtrovent HFA, Combivent Respimat (with albuterol)
Other examples: Levalbuterol, Salmeterol, Formoterol, Tiotropium, Umeclidinium, Theophylline.
How bronchodilators work
Beta-2 agonists relax bronchial smooth muscle by stimulating beta-2 receptors. Anticholinergics (antimuscarinics) block acetylcholine-mediated bronchoconstriction. Theophylline is a methylxanthine.
Uses
- Acute bronchospasm (short-acting beta-2 agonists)
- COPD maintenance (long-acting beta-2 agonists and anticholinergics)
- Asthma maintenance (long-acting beta-2 agonist combined with an inhaled corticosteroid)
Adverse effects
- Tachycardia, palpitations and tremor (beta-2 agonists)
- Hypokalemia
- Dry mouth and urinary retention (anticholinergics)
- Narrow therapeutic range and toxicity: nausea, tachycardia, seizures (theophylline)
Nursing considerations
- Assess breath sounds, work of breathing, oxygen saturation and heart rate before and after.
- When a bronchodilator and an inhaled corticosteroid are both due, give the bronchodilator first.
- Long-acting beta-2 agonists are not rescue drugs and are not used without an inhaled corticosteroid in asthma.
Patient teaching
- Use correct inhaler technique and a spacer when prescribed.
- Increasing use of the rescue inhaler means asthma is not controlled.
- Keep the rescue inhaler with you at all times.
Bronchodilators NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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A patient has an acute asthma attack. Which inhaler should be used?
Show answer
Answer B: Albuterol Albuterol is a short-acting beta-2 agonist that opens the airways within minutes. The others are long-term controllers.
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A patient is due for albuterol and fluticasone inhalers. In what order should they be given?
Show answer
Answer A: Albuterol first, then fluticasone after a short wait The bronchodilator opens the airways first so that the corticosteroid can reach deeper into the lungs.
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Which adverse effect is expected after albuterol?
Show answer
Answer B: Tremor and tachycardia Beta-2 stimulation causes tremor and some beta-1 stimulation raises the heart rate; it also lowers potassium.
Frequently asked questions
What are bronchodilators?
Bronchodilators open the airways. Short-acting beta-2 agonists such as albuterol are rescue drugs; long-acting agents are for maintenance and are never used alone in asthma.
How do bronchodilators work?
Beta-2 agonists relax bronchial smooth muscle by stimulating beta-2 receptors. Anticholinergics (antimuscarinics) block acetylcholine-mediated bronchoconstriction. Theophylline is a methylxanthine.
What are examples of bronchodilators?
Albuterol, Ipratropium, Levalbuterol, Salmeterol, Formoterol, Tiotropium, Umeclidinium and Theophylline.
What are the nursing considerations for bronchodilators?
Assess breath sounds, work of breathing, oxygen saturation and heart rate before and after. When a bronchodilator and an inhaled corticosteroid are both due, give the bronchodilator first.