What is salmeterol, and how does it work (mechanism of action)?
Asthma is a breathing problem involving narrowing of the airways. Airways are breathing passages that allow air to move in and out of the lungs. In patients with asthma, airways can be narrowed by accumulation of mucus, spasm of the muscles that surround these airways, or swelling of the lining of the airways. Airway narrowing lead to symptoms of shortness of breath, wheezing, cough, and congestion. Medications used in treating asthma open airways are called bronchodilators. Salmeterol is a bronchodilator of the beta-2 agonist type. Beta-2 agonists are medications that stimulate beta-2 receptors on the smooth muscle cells that line the airways, causing these muscle cells to relax, thus, opening airways.
Certain allergens (such as pollen) can cause airway narrowing by inducing release of histamine by mast cells. Histamine is a natural chemical that causes tissue swelling and other allergic reactions in the body when released into the tissue. Mast cells belong to a class of immune cells located around the airways. Salmeterol is an inhaled medication that blocks the release of histamine by the mast cells, thus preventing airway narrowing when exposed to allergens.
What brand names are available for salmeterol?
Is salmeterol available as a generic drug?
Do I need a prescription for salmeterol?
What are the side effects of salmeterol?
Side effects include:
Throat and upper airway irritation can occur.
Use of long acting drugs like salmeterol may increase the risk of asthma-related death. Therefore, salmeterol should only be used in patients uncontrolled by other agents and who are using other long-term asthma-controlling medications such as an inhaled corticosteroid.
What is the dosage for salmeterol?
Salmeterol inhalations should not be used more often than prescribed (twice per day) and proper techniques of inhalation closely followed. Salmeterol is metabolized by the liver and should be used with caution in patients with liver dysfunction. Salmeterol is not meant to be used in treating acute asthma attacks; short acting inhaler medications are used for acute attacks. When using salmeterol in preventing exercised induced asthma, the medication is administered 30 to 60 minutes before exercise. Salmeterol does not take the place of oral or inhaled corticosteroids.
Which drugs or supplements interact with salmeterol?
Salmeterol can increase heart rate, blood pressure, and cause chest pain and excitement, especially if used in higher doses than recommended or used in those with coronary heart disease or high blood pressure. Tricyclic antidepressants and salmeterol should not be combined because of additive effect on the vascular system. In rare instances, salmeterol can induce paradoxical worsening of bronchospasm (which can be life-threatening). If this occurs, salmeterol should be discontinued, and the doctor notified immediately. Rare allergic reactions to salmeterol can cause skin rash, hives, swelling, bronchospasm, and anaphylaxis. Worsening of diabetes and lowering of potassium have also been described.
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Is salmeterol safe to take if I'm pregnant or breastfeeding?
Adequate studies of salmeterol during pregnancy have not been done. In some, but not all, pregnant animal models exposure to very high doses of oral salmeterol has led to offspring with birth defects. The concentrations of salmeterol in the blood after these very high doses, however, were much higher than the concentrations observed after inhalation. Salmeterol inhalation should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
In rats, salmeterol is excreted in milk. Therefore, caution should be exercised when salmeterol is administered to nursing women.
What else should I know about salmeterol?
What preparations of salmeterol are available?
Canisters (13g with 120 inhalations and 6.5g with 60 inhalations).
How should I keep salmeterol stored?
Salmeterol should be stored from 36 F to 86 F (2.2 C to 30 C). The canister should be kept away from heat or flame and not punctured; it should not be frozen or placed in direct sunlight .
Salmeterol (Serevent) is a bronchodilator medication prescribed for the maintenance of asthma, and in preventing bronchospasm (spasm of the airways). Side effects, drug interactions, pregnancy information, dosing, and patient information should be reviewed prior to taking any medication.
Related Disease Conditions
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Emphysema is a COPD (chronic obstructive pulmonary disease) that often occurs with other obstructive pulmonary problems and chronic bronchitis. Causes of emphysema include chronic cigarette smoking, exposure to secondhand smoke, air pollution, and in the underdeveloped parts of the world. Symptoms of emphysema include chronic cough, chest discomfort, breathlessness, and wheezing. Treatments include medication and lifestyle changes.
Neutropenia is a marked decrease in the number of neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled with neutrally-staining granules, tiny sacs of enzymes that help the cell to kill and digest microorganisms it has engulfed by phagocytosis. Signs and symptoms of neutropenia include gum pain and swelling, skin abscesses, recurrent ear and sinus infections, sore mouth, low-grad fever, pneumonia-like symptoms, and pain and irritation around the rectal area. Neutropenia has numerous causes, for example, infections (HIV, TB, mono); medications (chemotherapy); vitamin deficiencies (anemia); bone marrow diseases (leukemias), radiation therapy, autoimmune destruction of neutrophils, and hypersplenism. Treatment of neutropenia depends upon the cause and the health of the patient.
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least 3 months, 2 years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
Asthma is a condition in which hyperreactive airways constrict and result in symptoms like wheezing, coughing, and shortness of breath. Causes of asthma include genetics, environmental factors, personal history of allergies, and other factors. Asthma is diagnosed by a physician based on a patient's family history and results from lung function tests and other exams. Inhaled corticosteroids (ICS) and long-acting bronchodilators (LABAs) are used in the treatment of asthma. Generally, the prognosis for a patient with asthma is good. Exposure to allergens found on farms may protect against asthma symptoms.
COPD (Chronic Obstructive Pulmonary Disease)
COPD or chronic obstructive pulmonary disease is a lung condition caused by smoking tobacco, exposure to secondhand smoke, and/or air pollutants. Conditions that accompany COPD include chronic bronchitis, chronic cough, and emphysema. Symptoms of COPD include shortness of breath, wheezing, and chronic cough. Treatment of COPD includes GOLD guidelines, smoking cessation, medications, and surgery. The life expectancy of a person with COPD depends on the stage of the disease.
COPD vs. Emphysema
COPD (chronic obstructive pulmonary disease) is the term doctors and other healthcare professionals use to describe a group of serious, progressive (worsens over time), chronic lung diseases that include emphysema, chronic bronchitis, and sometimes asthma. The number one cause of COPD or emphysema, is smoking, and smoking is the third leading cause of death in the US.
There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered-dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC asthma drugs like Primatene Mist and Bronkaid.
Exercise-induced asthma is asthma triggered by vigorous exercise. Symptoms include coughing, shortness of breath, chest tightness, wheezing, and fatigue while exercising. Preventing exercise-induced asthma attacks involves using inhaled medicines before exercising, performing warm-up exercises and cooling down afterward, avoiding exercising outdoors when pollen counts are high, restricting exercise when you have a viral infection, and wearing a mask over your nose and mouth when exercising in cold weather.
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