Nonselective α, β₁, and β₂ agonist; bronchodilation plus all other sympathomimetic effects on cardiovascular and other systems

Tachycardia, arrhythmias, worsening angina pectoris

Acute vasodilation, shock, and bronchospasm of anaphylaxis

β₁ and β₂ agonist; bronchodilation & powerful cardiovascular effects

Cardiac arrhythmias from high doses ↑ mortality

Asthma, but β₂ selective preferred

Selective β₂ agonist; prompt bronchodilation

Tremor, tachycardia, overdose arrhythmias

Asthma, COPD, drug of choice in acute asthmatic bronchospasm

Selective β₂ agonist; prompt bronchodilation

Tremor, tachycardia, overdose arrhythmias

Asthma, COPD, drug of choice in acute asthmatic bronchospasm

Only β₂ agonist available for subcutaneous injection

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Broad anti-inflammatory efficacy, inhibit production of cytokines; inhibit infiltration of asthmatic airways by lymphocytes, eosinophils, and mast cells

Dysphonia

Oropharyngeal candidiasis (opportunistic mucosal fungal infection) – patients must gargle and spit after each use;
hoarseness

Do not relax smooth muscle directly but reduce bronchial reactivity and frequency of asthmatic exacerbations if taken regularly

Broad anti-inflammatory efficacy, inhibit production of cytokines; inhibit infiltration of asthmatic airways by lymphocytes, eosinophils, and mast cells

Dysphonia

Oropharyngeal candidiasis (opportunistic mucosal fungal infection) – patients must gargle and spit after each use;
hoarseness

Do not relax smooth muscle directly but reduce bronchial reactivity and frequency of asthmatic exacerbations if taken regularly

Systemic, anti-inflammatory

*Adrenal suppression
Significant adverse side effects – psychiatric and GI symptoms, etc.

Many inflammatory diseases including asthma and COPD

Must be taken prophylactically;

alters function of delayed Cl^- channels, thus inhibiting inflammatory cell activation

Minor and localized – throat irritation, cough, mouth dryness

Allergic rhinoconjunctivitis

not as potent as corticosteroids

Uncertain - phosphodiesterase inhibition, adenosine receptor antagonist;  bronchodilation, cardiac stimulation, ↑ skeletal muscle strength (diaphragm)

Anorexia, nausea, vomiting, abdominal discomfort, headache, anxiety (15-20mg/L plasma);
Seizures or arrhythmias (40mg/L)

Asthma, COPD

narrow therapeutic window

Block leukotriene D₄ receptors; block airway response to exercise and antigen challenge

minimal

Prophylaxis of asthma, especially in children and in aspirin-induced asthma

Inhibits lipoxygenase, reduces synthesis of leukotrienes

Occasional liver toxicity

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Inhibits binding of IgE to mast cells but does not activate IgE already bound to these cells; reduce frequency and severity of asthmatic exacerbations

Severe asthma inadequately controlled by other agents

Competitively inhibit the effect of acetylcholine at muscarinic receptors; block contraction of airway smooth muscle and the ↑ in secretion of mucus that occurs in response to ACh release from vagal nerves; does not enter CNS

Dry mouth, sedation

Less effective than β-agonist in reversing asthmatic bronchospasm, but enhances bronchodilation;  COPD

Longer-acting, selective antimuscarinic agent

Dry mouth, throat irritation

COPD