Page 163 - COMMUNITY PHARMACY PRACTICE

02/04/2024

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Bronchodilators

SABA/relievers LABA/preventers/control

• Onset: mins/ duration:4-6 hrs • Onset: Formeterol (short-
• Exercise-induced asthma reliever)
• No anti-inflammatory properties
• Should be taken on an as- • long duration of action(up to 12
hrs)
needed or on demand basis,
rather than regularly. • used to control moderate to
• Salbutamol and terbutaline will severe asthma and to prevent
work within 5–15 minutes of nighttime symptoms.
inhalation.
• Inhaler or in tablet form. • LABAs are used on a regular
• Eg. Salbutamol in ventolin ®, schedule along with ICS for
vental ®, and terbutaline in moderate or severe persistent
bricanyl® asthma.

• Egs: Salmeterol (Serevent©
Diskus™) and Formoterol
(Foradil© Aerolizer™).

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LABA 331

The U.S. Food and Drug Administration (FDA) issued a safety
announcement because of safety concerns with LABAs.

(Chest 2006;129:15-26).

• Use of a LABA alone without another long-term asthma control medication
such as an inhaled corticosteroid (ICS) is contraindicated.

• LABAs should only be used as additional therapy for patients who are
currently taking, but whose condition is not adequately controlled with, a
long-term asthma control medication (e.g., an ICS).

• Once asthma control is achieved and maintained, patients’ condition should
be assessed at regular intervals and treatment stepped-down (e.g.,
discontinue LABA), if possible, and the patient should continue to be
treated with a long-term asthma control medication (e.g., an ICS).

• a. Regular follow-up every 1–6 months.

• b. Consider step-down if well controlled for 3 months or more.

• Pediatric and adolescent patients who require a LABA and an ICS should
use a combination product to ensure adherence to both medications.

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