Salmeterol and formoterol
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| Drug monograph · NCLEX study reference | |
| Trade names | Serevent |
|---|---|
| Therapeutic class | Bronchodilator |
| Pharmacologic class | Long-acting beta-2 agonists (LABA) |
| Onset / peak / duration | Salmeterol slower onset; formoterol faster; duration about 12 hours. |
| Half-life / level | Variable; no routine level. |
| Routes | Inhaled |
| High-alert (ISMP) | No |
| Black box warning | Yes (see Safety) |
| Antidote / reversal | Supportive care. |
| Pregnancy / lactation | Use if needed. |
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Salmeterol and formoterol (brand name Serevent) — Bronchodilator; Long-acting beta-2 agonists (LABA).
Identification
- Therapeutic class: Bronchodilator.
- Pharmacologic class: Long-acting beta-2 agonists (LABA).
Pharmacology
- Mechanism of action: Prolonged beta-2 stimulation for sustained bronchodilation.
- Onset / peak / duration: Salmeterol slower onset; formoterol faster; duration about 12 hours.
- Half-life / therapeutic level: Variable; no routine level.
Clinical use
- Indications: Asthma (only combined with an inhaled steroid) and COPD maintenance.
- Usual dose, route, frequency: Inhaled twice daily.
- Maximum dose / adjustments: Not for acute symptoms; in asthma must be paired with an inhaled corticosteroid.
Safety
- Contraindications: Asthma monotherapy, acute bronchospasm.
- Black box warning: LABA used as the only controller in asthma increases the risk of asthma-related death; combination inhaled-steroid products no longer carry this boxed warning.
- Interactions: Beta blockers, other sympathomimetics, QT-prolonging drugs, diuretics (hypokalemia).
- Pregnancy / lactation: Use if needed.
- High-alert: No.
Adverse effects
- Common side effects: Tremor, headache, palpitations.
- Serious effects to report: Paradoxical bronchospasm, arrhythmia.
- Antidote / reversal: Supportive care.
Nursing process
- Assessment before administration: Respiratory status, current controller therapy.
- Interventions during therapy: Confirm an inhaled steroid is also prescribed for asthma.
- Monitor: Respiratory status, heart rate.
- Evaluation / expected outcome: Improved control and fewer symptoms.
Patient teaching
- Patient teaching: This does not relieve sudden attacks; never use alone for asthma.
- Notify provider if: Worsening symptoms or increased rescue use.
- Administration tips: Twice daily; keep using the rescue inhaler separately.