Bile Acid Sequestrants


Serotonin 5-HT Receptor Agonists




Para-aminobenzoic Acid

Vitamin B6


Xanthine Derivatives

Uses of Sympathomimetics

Type of Drug:

Bronchodilators, "rescue" medicines. Drugs that make breathing easier by opening breathing tubes (bronchial tubes) of the lung.

How the Sympathomimetics Product Works:

Sympathomimetics dilate (open) the bronchioles (air tubes) of the lung by relaxing the smooth muscle around the bronchioles. They are also used to prevent spasms or contractions of the smooth muscles around the bronchioles. This allows easier airflow into and out of the lungs. This may also assist in removing (expectorating) mucus and other debris causing congestion in the lungs.

Uses of Sympathomimetics:

To treat and prevent reversible bronchospasm associated with bronchial and nocturnal (nighttime) asthma, chronic bronchitis,emphysema, exercise-included bronchospasm and other obstructive airway disease of the lungs.

To treat serious allegoric reactions (epinephrine injection only)


Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible risks to the fetus.

Breastfeeding: It is not known if these drugs appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Aerosol- Safety and effectiveness for use of albuterol, bitolterol, meta- proterenol, pirbuterol, salmeterol, and terbutaline in children younger than 12 years of age (younger than 4 years of age for Ventolin) have not been established. Consult a doctor about the use of epinephrine in children younger than 4 years of age.

Oral doseforms _ Safety and effectiveness of albuterol have not been established for children younger than 2 years (syrup) and younger than 6 years (tablets and extended-release tablets) of age. Ephedrine is rarely used alone in children. Metaproterenol is not recommended for use in children younger than 6 years of age. Terbutaline is not recommended for use in children younger than 12 years of age.

powder for inhalation _ Safety and effectiveness of albuterol and salmeterol have not been established in children younger than 4 years of age.

Solutlon for inhalation - Safety and effectiveness of albuterol, bitolterol,epinephiren ,isoeptharine and lealbuterol have not been eastlished in childern younger 12 years of age (younger than 2 years of age for ventilator) .Safety and effectiveness of metaproternol not i have not been established in children younger than 6 years of age.

Sulfites: Some of these products may contain sulfite preservatives, which can cause allergic reactions in certain individuals. Check package label when available or consult your doctor or pharmacist.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over­the-counter or prescription medications or dietary supplements while taking sympathomimetics. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with sympathomimetics:

  • Beta blocking agents (eg, propranolol)

  • Digoxin (eg, Lanoxin)

  • Diuretics, non-potassium sparing (eg, loop diuretics, thiazide)

  • Ergot alkaloids (eg,Hydergine) (epinephrine only)

  • Furazolidone (Furoxone) (ephedrine only)

  • Guanethidine (eg, lsmelin) (ephedrine and epinephrine only)

  • Methyldopa (eg, Aldomet) (ephedrine and epinephrine only)

  • MAG inhibitors (eg, phenelzine)

  • Phenothiazines (eg, chlorpromazine) (epinephrine only)

  • Rauwolfia alkaloids (eg, reserpine) (ephedrine and epineph rine only)

  • Tricyclic antidepressants (eg, amitriptyline)

  • Urinary acidifiers (eg, ammonium chloride) (ephedrine only)

  • Urinary alkalinizers (eg, sodium bicarbonate) (ephedrine only)

Side Effects:

Every drug is capable of producing side effects. Many sympathomimetic bronchodilator users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; vomiting; appetite changes; heartburn; diarrhea; stomach pain; dry mouth; indigestion; constipation; mouth fungal infection; mouth or throat irritation; gastrointestinal distress; belching; gas.

Nervous System: Vertigo (feeling of whirling motion); dizziness; lightheadedness; headache; anxiety; tension; tremor; drowsiness; weakness; fatigue; nervousness; unstable emotions; aggressive behavior; restless­ness; excitement; hyperactivity; sleeplessness; agitation; nightmares; irritability; shakiness.

Circulatory System: Changes in heart rate or rhythm; changes in blood pressure; chest pain or discomfort; pounding in the chest; irregular pulse.

Respiratory System: Breathing problems; bronchospasm; respiratory infections; nasal congestion; lower respiratory infections; bronchitis; increased mucous or phlegm discharge; cough; wheezing; nosebleed; sinus headache; hoarseness (especially in children); worsening of asthma;chest discomfort; runny nose; viral infection; sneezing

Skin: Flushing; pallor; sweating; haves; rash; pain at the injection site (injection only); eczema; skin inflammation.

Other: Muscle cramps, stiffness, or soreness; unusual or bad taste; tooth pain or discoloration; painful menstruation; general body discomfort; joint, arm, neck, chest, shoulder, or back pain; low potassium levels; localized aches and pains; urinary tract infection; flu-like symptoms; allergic reaction; fever; decreased sensitivity to stimulation; accidental injury; pain; migraine; leg cramps; chills; abnormal lab tests; fainting; abnormal skin sensations; eye itch; sweating; eye inflammation.

Guidelines for Use:

  • Read and follow the patient instructions provided with the products.

  • Dosage will be individualized. Do not use more frequently or at higher doses than recommended by your doctor.

  • Do not crush or chew extended-release tablets. Swallow whole with liquids. The outer coating of the tablet may not be absorbed and may be noticeable in the stool.

  • Brand interchange - Do not change from one brand of these drugs to another without consulting your pharmacist or doctor.

  • While you are using a sympathomimetic bronchodilator, take other inhaled drugs and asthma medications only as directed by your doctor.

  • If asthma attack continues or worsens, discontinue use and contact your doctor.

  • Salmeterol - Do not use once an asthma attack begins. Use a quick­acting bronchodilator (eg, albuterol) instead. This medicine is not a substitute for inhaled or oral corticosteroids.

  • If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If several doses are missed, contact your doctor or pharmacist.

  • May cause dizziness or drowsiness. Use caution while driving or per­forming other tasks requiring alertness, coordination, or physical dexterity.

  • May cause nervousness, restlessness, or sleeplessness. Notify your doctor if the effects continue.

  • Notify your doctor if palpitations, fast heartbeat, chest pain, muscle tremors, dizziness, headache, flushing, or difficulty in urination occurs, or if difficulty breathing persists.

  • Oral doseforms - Do not exceed recommended dosage. If stomach upset occurs, take with food.

  • Nebulizer - Mix medication as directed. Do not use if solution is brown or cloudy. Dilute concentrated solution (0.5%) before use. Do not mix different types of medication, unless advised to do so by your doctor. Assemble mask or mouthpiece. Administer treatment while sitting in a comfortable, upright position. Take slow, deep breaths until medication canister is empty. Wash mask or mouthpiece and medication container with hot water. Allow to air dry.

  • Pressurized aerosol - Follow administration, storage, and disposal instructions exactly. Shake aerosol canister before each use. Use of a spacing device (eg, Aerochamber) will enhance effectiveness and decrease side effects. Protect from heat and light.Do not stop or adjust the dose unless directed by your doctor. Overuse may result in the drug losing its effectiveness. Breathe out fully through the mouth, expelling as much air from the lungs as possible. Place the mouthpiece of the inhaler (or spacer) into your mouth and, while breathing deeply and slowly through the mouth, activate the medication canister. Hold your breath for 3 to 5 seconds and then breathe out. If more than 1 inhalation per dose is necessary, wait at least 1 full minute between doses. (Administer second inhalation at 3 to 5 minutes for albuterol and epinephrine; 10 minutes for metaproterenol). If a previously effective dosage regimen fails to provide the usual relief, consult your doctor immediately. This may be a sign of seriously worsening asthma, which requires reassessment of therapy. Consult your doctor. If any of the following Occurs with the use of a short-acting beta 2 ­ agonist (eg, albuterol, bitolterol, pirbuterol, terbutaline), contact your doctor: Use of 4 or more inhalations daily for more than 2 consecutive days; use of more than 1 canister in an 8-week period (eg, canister with 200 inhalations); sudden need for increased inhalations. Do not interchange medication canisters


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