Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Reliever Asthma Medications

Short-acting ß2-agonists (Sabutamol, Terbutaline)

  • Rapid onset of action (within 1-2 minutes).
  • Children who need a short-acting ß2-agonist several times a day require urgent reassessment with a view to increasing anti-inflammatory therapy (Boulet et al., 2001).
  • Anticholinergic

    • Atrovent (ipratropium bromide) is not recommended as first line therapy but may be used as a reliever when short-acting ß2-agonists are not well tolerated due to side effects (Boulet et al., 1999).
    • It is less effective than short-acting ß2-agonists in relieving symptoms and has a limited role in paediatric asthma (Spahn & Szefler, 1998).
    • Atrovent in addition to ß2-agonist is safe and effective during the first 2 hours of a severe acute asthma exacerbation (Boulet et al., 2001; BTS/SIGN, 2003)

    Teaching Tips for Nurses:

    • Ask how often the reliever is used on a daily/weekly basis. Other than pre-exercise, relievers should only be used for symptoms.
    • During an asthma exacerbation, coach parents to have their children re-assessed if they are requiring a reliever more than every 4 hours or the reliever is not effective.