β2-Agonists (SABA / LABA)

respiratory bronchodilator beta2_agonist

β2-agonists relax bronchial smooth muscle and are the primary bronchodilators used in obstructive lung disease.

They do NOT treat inflammation — they only open the airway.

SABA = rescue (fast relief)

LABA = maintenance (prevention)


Mechanism of Action

β2 receptor activation → ↑ cAMP → smooth muscle relaxation → bronchodilation

Additional effects:

Onset and duration determine clinical use.


Drug Classification

Class Onset Duration Clinical Role
SABA Minutes 3–6 hr Rescue inhaler
LABA 5–20 min 12–24 hr Controller therapy

Short-Acting β2 Agonists (Rescue)

Rapid symptom relief — used PRN for bronchospasm

Short-Acting β2 Agonist (SABA)

Clinical Uses:


Long-Acting β2 Agonists (Maintenance)

Prevent bronchospasm — NOT rescue therapy

Clinical Uses:


High-Yield Safety Rule

LABA monotherapy in asthma increases mortality Always combine with inhaled corticosteroid


Adverse Effects

Effect Mechanism
Tremor Skeletal muscle β2 stimulation
Tachycardia β1 spillover at high dose
Hypokalemia Cellular potassium shift
Hyperglycemia Hepatic glycogenolysis
Anxiety Adrenergic stimulation

Clinical Pearls


Think: β2 agonists open the airway — steroids calm the airway