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--- respiratory:beta2_agonists:start [2026/02/15 15:04] – created andrew2393cns
+++ respiratory:beta2_agonists:start [2026/02/15 15:05] (current) – removed andrew2393cns
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-====== Short-Acting β2 Agonists (SABA) ======
-{{tag>respiratory bronchodilator beta2_agonist saba}}
-Short-acting β2 agonists are rapid bronchodilators used for immediate relief of bronchospasm.
-They are the **primary rescue medications** in obstructive lung disease.
-<WRAP center round important 70%>
-SABA = symptom relief
-They do NOT control inflammation
-</WRAP>
-----
-===== Drugs in Class =====
-  * [[respiratory:beta2_agonists:albuterol|Albuterol]]
-  * [[respiratory:beta2_agonists:levalbuterol|Levalbuterol]]
-----
-===== Mechanism of Action =====
-**Receptor**
-  * β2 adrenergic receptor activation
-**Cellular Effect**
-  * ↑ cAMP
-  * Smooth muscle relaxation
-**Physiologic Effects**
-  * Bronchodilation
-  * ↓ airway resistance
-  * ↓ mast cell mediator release
-  * ↑ mucociliary clearance
-  * Intracellular potassium shift
-Net effect:
-  * Rapid airway opening
-----
-===== Clinical Role =====
-Primary uses:
-  * Acute asthma symptoms
-  * Exercise-induced bronchospasm
-  * COPD rescue therapy
-Also used for:
-  * Hyperkalemia (temporary intracellular shift)
-SABA should always be paired with controller therapy in persistent asthma:
-  * [[respiratory:inhaled_corticosteroids:start|Inhaled Corticosteroids]]
-----
-===== Dosing Concept =====
-<WRAP center 70%>
-^ Situation ^ Meaning ^
-| Rare use | Controlled disease |
-| >2 days/week | Inadequate control |
-| Daily use | Needs escalation |
-</WRAP>
-Frequent rescue inhaler use is a marker of worsening airway inflammation — not a need for more bronchodilator.
-----
-===== Adverse Effects =====
-^ Effect ^ Mechanism ^
-| Tremor | Skeletal muscle β2 stimulation |
-| Tachycardia | β1 spillover |
-| Hypokalemia | Intracellular potassium shift |
-| Anxiety | Adrenergic stimulation |
-Dose dependent.
-----
-===== Clinical Pearls =====
-<WRAP round tip 90%>
-The rescue inhaler measures disease control.
-More SABA = more inflammation
-</WRAP>
-  * First drug used in asthma exacerbation
-  * Spacer improves delivery significantly
-  * Nebulizer is easier, not stronger
-  * Overuse predicts hospitalization risk
-----
-===== Comparison Within β2 Class =====
-^ Class ^ Role ^ Duration ^
-| [[respiratory:beta2_agonists:saba|SABA]] | Rescue | 4–6 hr |
-| [[respiratory:beta2_agonists:laba|LABA]] | Maintenance | 12–24 hr |
-----
-===== Related =====
-  * [[respiratory:beta2_agonists:start|β2 Agonists]]
-  * [[respiratory:inhaled_corticosteroids:start|Inhaled Corticosteroids]]
-  * [[respiratory:asthma|Asthma]]
-  * [[respiratory:copd|COPD]]