Salbutamol, Terbutaline and Bambuterol (similar to turbutaline but it is a prodrug)

SELECTIVE B2 AGONISTS

The selective B2 agonists have replaced non-selective B-agonists because they have the following advantages:

  • They induce selective effect on airway with least systemic effect, so they can be given to hypertensive patients ORAL - Preferable.

  • These agents are used to treat acute episodes of bronchial asthma and prophylactically to prevent airway obstruction.

  • The short acting selective β2 (salbutamol, terbutaline, fenoterol) can given by inhalation , orally, SC and by I.V infusion.

  • The long acting (salmeterol & formoterol) have long duration of action (12 hrs) and administrated by inhalation only.  

Adverse effects:

  • Tremors of skeletal muscle, nervousness and weakness.
  • Tachycardia secondary to hypotension produced by skeletal vasodilatation.
  • Hypokalemia
  • Tolerance may occur with prolonged use but temporary cessation of drug restores its original effectiveness.
  • All selective B2-agonists lose its selectivity when it is given in large frequent doses especially in aerosols.