Bronchodilators (SABA, LABA, ICS, LAMA) on the NCLEX
Albuterol, salmeterol, ipratropium, tiotropium: asthma stepwise therapy, when to use each.
Asthma and COPD inhalers come in four classes. The NCLEX tests when to use each and the stepwise approach.
SABA (short-acting beta agonist)
Albuterol, levalbuterol. Rescue inhaler. Onset minutes. Use as needed. Increased use = poorly controlled asthma.
LABA (long-acting beta agonist)
Salmeterol, formoterol. Maintenance. Never alone in asthma (black box, increased death risk). Pair with ICS.
ICS (inhaled corticosteroid)
Fluticasone, budesonide, beclomethasone. Maintenance. Foundation of asthma control. Rinse mouth after use (thrush prevention).
LAMA (long-acting muscarinic antagonist)
Tiotropium (Spiriva), umeclidinium. Maintenance for COPD primarily. Dry mouth, urinary retention. Cautious in glaucoma, BPH.
Combination inhalers
ICS + LABA (Advair, Symbicort, Breo). ICS + LABA + LAMA (Trelegy).
Frequently asked
Order of inhalers?
SABA first (open airway), then ICS, then LABA. Rinse mouth after ICS.
LABA without ICS in asthma?
Never. Increased mortality. Must be combined with ICS.
Quick check
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