Table 1. Beta 2 Specific Sympathomimetic Bronchodilators

Generic Name Brand Names	Routes of Administration	Normal Adult Dosage	Onset of Action (Min.)	Duration (Hours)
Albuterol Proventil Ventolin	Nebulizer	2.5 - 5 mg Q4-6 Hrs	5	4 to 6
	MDI (90mcg/puff)	1-3 puffs Q4-6 Hrs	5	4 to 6
	Tablets	2 to 4 mg Q6-12 Hrs	30	6 to 12
Levalbuterol Xopenex	Nebulizer	.63-1.25mg Q6-8 Hrs	5 to 10	6 to 8
Bitolterol Tornalate	Nebulizer	2.5 mg Q6-8 Hrs	4	6 to 8
	MDI (0.37mg/puff)	2 puffs Q6-8 Hrs
Pirbuterol Maxair	MDI (0.2mg/puff)	2 puffs Q4-6 Hrs	5	5
Terbutaline Brethaire Brethine Bricanyl	MDI (0.2 mg/puff)	2 puffs Q4-6 Hrs	5	4 to 8
	Tablets	2.5 to 5 mg TID	30	6 to 8
	Subcutaneous	.25mg Q 8 Hrs	5	6 to 8
Salmeterol Serevent	MDI (25mcg/puff)	2 puffs Q12 Hrs	20	12
	DPI Diskus (25mcg/puff)	2 puffs Q 12 Hrs	20	12

Table 2. Other Sympathomimetic Bronchodilators

Generic Name Brand Names (*Receptors)	Routes of Administration	Normal Adult Dosage	Onset of Action (Minutes)	Duration (Hours)
Isoetherine Bronkosol Bronkometer (B2++, B1+)	Nebulizer	2.5-5 mg Q4-6 Hrs	5	4
	MDI (340mcg/puff)	2 puffs QID
Metaproterenol Metaprel Alupent (B2++, B1+)	Nebulizer	15 mg Q 4 Hrs	5	3 to 4
	MDI (.65mg/puff)	2-3 puffs Q 4 Hrs	5	3 to 4
	Tablets	10-20 mg Q6-8 Hrs	30	6 to 8
Isoproterenol Isuprel (B1++, B2++)	Nebulizer	.25 to .5 cc PRN	1	1
Racemic Epinephrine Vaponefrin micoNephrine (A+, B1+, B2+)	Nebulizer	.25 to .5 cc PRN	10	1 to 4
Epinephrine (A++,B1++,B2++)	I.V. or Intratracheal	.05 to 1.0 mg PRN	1	1 to 3
	(.1% solution)	&/or 1-4 mcg/min
	SQ (.1% solution)	.1 to .5 cc PRN	1	1 to 3
	Nebulizer (1% sol)	2.5 to 5 mg PRN	1	1 to 3
*Receptors - Describes the specificity of the drug for certain receptors. A= alpha, B1= beta 1, B2= beta 2. ++ Strong stimulation of receptor. + Moderate stimulation of receptor.
Racemic epinephrine is used primarily for the alpha effects of reducing edema in the upper airway, reducing stridor, and treating croup.
Epinephrine is used primarily in emergency situations, such as status asthmaticus and cardiopulmonary arrest.

Table 3. Parasympatholytic (Anticholinergic) Bronchodilators

Generic Name Brand Names	Routes of Administration	Normal Adult Dosage	Onset of Action (Minutes)	Duration (Hours)
Ipratropium bromide Atrovent	Nebulizer	0.5 mg QID	20	5 to 8
	MDI (18mcg/puff)	2 puffs QID
Atropine sulfate	I.V. or Intratracheal	0.5-2.0mg PRN	5	1 to 4
	Nebulizer	1.0 mg QID	5 to 20	1 to 4

Xanthines

Xanthine drugs inhibit the enzyme phosphodiesterase, which degrades cyclic AMP. This results in relaxation of the bronchial airways and pulmonary blood vessels. Xanthines have other effects including cardiac stimulation, coronary vasodilation, diuresis, cerebral stimulation, and skeletal muscle stimulation.

The most commonly used xanthines are theophylline and aminophylline. Theophylline (Theo-Dur, Slo Bid, Theovent, Uniphyl) is given orally by tablet, capsule, or syrup. Aminophylline is given via I.V. (intravenously). The normal adult loading dosage for emergency relief of bronchospasms is 5 to 7.5 mg. given intravenously.

The normal adult dosage for maintenance therapy is:

• Orally: 300 to 1200 mg daily divided into doses every 6 to 8 hours.
• Oral sustained release tablets are given every 12 to 24 hours.
• I.V.: 0.5 to 0.9 mg/kg hourly.