Epinephrine is used in a variety of clinical situations, and although concern has been expressed about the use of epinephrine in asthma, it is still used extensively for the management of acute attacks.
Isoproterenol is used principally by inhalation for the management of bronchospasm. It is also used intravenously for asthma and as a stimulant in cardiac arrest.
Terbutaline, albuterol, salmeterol and other ¡2-adrenoceptor agonists are used primarily in the management of asthma. Terbutaline and albuterol have very rapid onset of action and are indicated for acute symptom relief. Salmeterol, in contrast, has a slow onset of action but a long duration of action. Salmeterol is thus used as prophylactic therapy only, not to reverse acute symptoms.
In addition to its use as a bronchodilator, terbutaline is used extensively to control premature labor, since contractions of uterine smooth muscle are abolished by adrenomimetics (see Chapter 62).
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