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?
Serevent
Is salmeterol available as a generic drug?
No
Do I need a prescription for salmeterol?
Yes
What are the side effects of salmeterol?
Side effects include:
-
palpitations,
fast heart rate,
elevated blood pressure,
tremor,
nervousness, and
headache.
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 .