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BRONCHODILATORS, ADRENERGIC (Oral/Injection)
Some commonly used brand names are:
In the U.S.—
Other commonly used names are:
Adrenergic bronchodilators are medicines that stimulate the nerves in many parts of the body, causing different effects.
Because these medicines open up the bronchial tubes (air passages) of the lungs, they are used to treat the symptoms of asthma, bronchitis, emphysema, and other lung diseases. They relieve cough, wheezing, shortness of breath, and troubled breathing by increasing the flow of air through the bronchial tubes.
Epinephrine injection (including the auto-injector but not the sterile suspension) is used in the emergency treatment of allergic reactions to insect stings, medicines, foods, or other substances. It relieves skin rash, hives, and itching; wheezing; and swelling of the lips, eyelids, tongue, and inside of the nose.
These medicines may be also used for other conditions as determined by your doctor.
Ephedrine capsules are available without a prescription. However, check with your doctor before taking ephedrine.
All of the other adrenergic bronchodilators are available only with your doctor"s prescription.
These medicines are available in the following dosage forms:
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For adrenergic bronchodilators taken by mouth or given by injection, the following should be considered:
Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to albuterol, ephedrine, epinephrine, isoproterenol, metaproterenol, or terbutaline. Also, tell your doctor if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy—Some of these medicines can increase blood sugar, blood pressure, and heart rate in the mother, and may increase the heart rate and decrease blood sugar in the infant. Before taking any of these medicines, make sure your doctor knows if you are pregnant or may become pregnant.
Some of these medicines also relax the muscles of the uterus and may delay labor.
Children—There is no specific information comparing use of isoproterenol, metaproterenol, or terbutaline in children with use in other age groups.
Excitement and nervousness may be more common in children 2 to 6 years of age who take albuterol than in adults and older children.
Infants and children may be especially sensitive to the effects of epinephrine.
Older adults—Older adults may be more sensitive to the side effects of these medicines, such as trembling, high blood pressure, or fast or irregular heartbeats.
Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking adrenergic bronchodilators, it is especially important that your health care professional know if you are taking any of the following:
Other medical problems—The presence of other medical problems may affect the use of these medicines. Make sure you tell your doctor if you have any other medical problems, especially:
Proper Use of This Medicine
Use this medicine only as directed . Do not use more of it and do not use it more often than your doctor ordered, do not use more than recommended on the label unless otherwise directed by your doctor. To do so may increase the chance of side effects.
If you are using this medicine for asthma, you should use another medicine that works faster than this one for an asthma attack that has already started. If you do not have another medicine to use for an attack or if you have any questions about this, check with your doctor.
For patients taking albuterol extended-release tablets :
For patients using epinephrine injection :
For patients using epinephrine injection for an allergic reaction emergency :
Dosing—The dose of these medicines will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.
The number of capsules or tablets or teaspoonfuls of solution or syrup that you take, or the amount of injection that you use, depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking it .
Missed dose—If you are using this medicine regularly and you miss a dose, use it as soon as possible. Then use any remaining doses for that day at regularly spaced intervals. Do not double doses.
Storage—To store this medicine:
Precautions While Using This Medicine
It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.
Do not take other medicines unless they have been discussed with your doctor. This especially includes over-the-counter (nonprescription) medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems, since they could increase the unwanted effects of this medicine.
For patients with diabetes:
For patients taking this medicine for asthma:
For patients who are using epinephrine injection :
For patients who are using the epinephrine auto-injector :
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur :
Possible signs of an allergic reaction
Hoarseness; large hive-like swellings on eyelids, face, genitals, hands or feet, lips, throat, tongue; sudden trouble in swallowing or breathing; tightness in throat
Possible signs of a severe reaction that has occurred in children taking albuterol by mouth
Bleeding or crusting sores on lips; chest pain; chills; fever; general feeling of illness; muscle cramps or pain; nausea; painful eyes; painful sores, ulcers, or white spots in mouth or on lips; red or irritated eyes; skin rash or sores, hives, and/or itching; sore throat; vomiting
Check with your doctor as soon as possible if any of the following side effects occur:
Fast heartbeat; irregular heartbeat
Chest pain; convulsions (seizures); fainting (with isoproterenol); hives; increase in blood pressure (more common with ephedrine or epinephrine); mental problems; muscle cramps or pain; nausea or vomiting; trouble in urinating; unusual tiredness or weakness
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
Anxiety (with epinephrine); headache; nervousness; tremor
Dizziness; feeling of constant movement of self or surroundings; sweating; trouble in sleeping
Although not all of the side effects listed above have been reported for each of these medicines, they have been reported for at least one of them. All of these medicines are similar, so many of the above side effects may occur with any of the medicines.
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, some of the adrenergic bronchodilators are used in certain patients with the following medical conditions:
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.
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