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Salmeterol (Serevent) indications for use:serevent.ibreathe.com:"SEREVENT is used for long-term, twice-daily (morning and evening) maintenance treatment of asthma, including nighttime asthma, in patients who require regular treatment with inhaled, short-acting beta2-agonists (e.g., albuterol). SEREVENT is also used for the prevention of exercise-induced bronchospasm. SEREVENT Inhalation Aerosol is for patients 12 years of age and older. SEREVENT DISKUS is for patients 4 years of age and older."
http://serevent.ibreathe.com/?a=77&rotation=928-6180-2060-0

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Salmeterol (Serevent) clinical pharmacology:rxlist:"Salmeterol is a long-acting beta-adrenergic agonist. In vitro studies and in vivo pharmacologic studies demonstrate that salmeterol is selective for beta2-adrenoceptors compared with isoproterenol, which has approximately equal agonist activity on beta1- and beta2-adrenoceptors. In vitro studies show salmeterol to be at least 50 times more selective for beta2-adrenoceptors than albuterol. Although beta2-adrenoceptors are the predominant adrenergic receptors in bronchial smooth muscle and beta1-adrenoceptors are the predominant receptors in the heart, there are also beta2-adrenoceptors in the human heart comprising 10% to 50% of the total beta-adrenoceptors. The precise function of these receptors has not been established, but they raise the possibility that even highly selective beta2-agonists may have cardiac effects. The pharmacologic effects of beta2-adrenoceptor agonist drugs, including salmeterol, are at least in party attributable to stimulation of intracellular adenyl cyclase, the enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3',5'-adenosine monophosphate (cyclic AMP). Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells."
http://www.rxlist.com/cgi/generic/salmeterol_cp.htm

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Salmeterol (Serevent) onset of action and duration:nationaljewish.org:"Salmeterol, with its slow onset of action and long duration of action, is not intended for use as a "rescue" medication. Therefore it should not be used for relief of acute symptoms such as coughing, wheezing, chest tightness or shortness of breath. Salmeterol's longer onset of action, the time it takes to begin working, means that you may not feel immediate relief after taking a treatment. Thus, you should continue to use your shorter-acting agent for relief of symptoms, especially those that occur suddenly. Because salmeterol is a long-acting bronchodilator, you may feel relief for a longer period of time and may require fewer treatments of your shorter-acting bronchodilator. It is very important to keep track of the number of times you need to use the "rescue" inhaler and talk with your health care provider about this. You should not, however, reduce or stop any other medications, particularly inhaled anti-inflammatory medications (cromolyn sodium [Intal®], nedocromil sodium [Tilade®], or inhaled steroids, including: beclomethasone dipropionate [Beclovent® or Vanceril®], flunisolide [Aerobid®], and triamcinolone acetonide [Azmacort®]) or oral steroids (prednisone, methylprednisolone [Medrol®]) unless directed to do so by your health care provider. These medications are important to your treatment as they help reduce and prevent inflammation in the airways, which is necessary for long-term asthma control"
http://www.nationaljewish.org/medfacts/salmeterol.html

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Uses of Salmeterol (Serevent):nursespdr:"Metered Dose Aerosol Inhaler, Powder for Inhalation Maintenance of bronchodilation, prevention of symptoms of asthma, including nocturnal asthma. Adults and children over 12 years of age: Two inhalations (42 mcg) using the aerosol b.i.d. (morning and evening, approximately 12 hr apart). Children 4 years and over: 1 inhalation (50 mcg) using the inhalation powder b.i.d. (morning and evening, approximately 12 hr apart). Prevention of exercise-induced bronchospasms. Adults and children over 12 years of age: Two inhalations (42 mcg) of the aerosol or 1 inhalation (50 mcg) of the inhalation powder at least 30-60 min before exercise. Additional doses should not be used for 12 hr. Maintenance treatment of asthma or bronchospasm associated with COPD. Adults and children over 12 years of age: Two inhalations (42 mcg) of the aerosol b.i.d. in the morning and evening (about 12 hr apart). NOTE: Even though the metered dose inhaler and the inhalation powder are used for the same conditions, they are not interchangeable."
http://www.nursespdr.com/members/database/ndrhtml/salmeterolxinafoate.html

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Salmeterol (Serevent) drug class and mechanism:focusonasthma.com:"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."
http://www.focusonasthma.com/script/main/Art.asp?li=MNI&ArticleKey=832

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Salmeterol (Serevent) description:medlineplus:"Fluticasone (floo-TIK-a-sone) and salmeterol (sal-ME-te-role)is a combination of two medicines that are used to help control the symptoms of asthma and improve lung function. However, this medicine will not relieve an asthma attack that has already started. Inhaled fluticasone belongs to the family of medicines known as corticosteroids (cortisone-like medicines). It works by preventing certain cells in the lungs and breathing passages from releasing substances that cause asthma symptoms. It will not relieve an asthma attack that has already started. Inhaled salmeterol is a long-acting bronchodilator and it belongs to the family of medicines known as bronchodilators. Bronchodilators are medicines that are breathed in through the mouth to open up the bronchial tubes (air passages) of the lungs. Salmeterol is different than other bronchodilators because it does not act quickly enough to relieve an asthma attack that has already started. This medicine must be used with a short-acting beta2 agonist (e.g. albuterol) for the treatment of an asthma attack or asthma symptoms that need immediate attention. This medicine is available only with your doctor's prescription, in the following dosage form: Inhalation powder (U.S. and Canada)"
U.S. National Library of Medicine
8600 Rockville Pike, Bethesda, MD 20894
custserv@nlm.nih.gov
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202095.html

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Salmeterol (Serevent) Precautions:cheshire-med:"This drug should not be used during pregnancy unless clearly needed. Consult with your doctor before breast-feeding. Before you use this drug, tell your doctor if you are pregnant or breast-feeding or if you have heart disease, high blood pressure, an overactive thyroid gland, epilepsy or diabetes. Tell your doctor if you ever had a bad reaction to albuterol, bitolterol, ephedrine, epinephrine, isoetharine, isoproterenol, terbutaline, metaproterenol or pseudoephedrine. Some nonprescription medications contain these drugs, (e.g., diet pills and medication for colds and asthma), so check the labels carefully. Do not take any of these medications without consulting your doctor (even if you never had a problem taking them before). Do not allow anyone else to use this medication. This medication is not meant to treat an acute asthma attack. If you should have an acute asthma attack, a shorter acting inhaler must be used. If you need to use 4 or more puffs a day of a shorter acting inhaler on a regular basis or if you need to use more than 1 shorter acting inhaler every 8 weeks, tell your doctor or pharmacist"
http://12.42.224.168/Library/HealthGuide/DrugGuide/topic.asp?HWID=multumd03759a1

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Possible side effects of Salmeterol (Serevent):drugs.com:"Stop using salmeterol inhalation and seek emergency medical attention if you experience any of the following serious side effects: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); or chest pain or irregular heartbeats. Other, less serious side effects may be more likely to occur. Continue to use salmeterol inhalation and talk to your doctor if you experience headache, dizziness, lightheadedness, or insomnia; tremor or nervousness; sweating; nausea, vomiting, or diarrhea; or dry mouth. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome."
http://www.drugs.com/xq/cfm/pageID_0/htm_D03759A1.htm/bn_salmeterol%20inhalation/qx/index.htm

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Salmeterol (Serevent) Possible food and drug interactions and pregnancy precautions:gettingwell.com:"If Serevent is taken with certain other drugs, the effects of either drug could be increased, decreased, or altered. It is especially important to check with your doctor before combining Serevent with the following- Airway-opening medications such as Alupent, Proventil, and Ventolin Blood pressure medications known as beta blockers, including Inderal, Lopressor, and Tenormin MAO inhibitors such as the antidepressants Marplan, Nardil, and Parnate Tricyclic antidepressants such as Elavil and Tofranil Water pills (diuretics) such as furosemide (Lasix) and hydrochlorothiazide (HydroDIURIL). Serevent has not been adequately tested in pregnant women. Check with your doctor immediately if you are pregnant or are planning a pregnancy. Serevent's effects during breastfeeding are also unknown. You and your doctor should decide whether to discontinue nursing or give up Serevent."
http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/ser1401.shtml

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Salmeterol (Serevent) Improves Pulmonary Function In Heart Failure Patients:docguide:"Chronically inhaled salmeterol improves pulmonary function in patients with heart failure. It improves forced expiratory volume in one second (FEV1) without affecting neuroactivation or ventricular ectopy, investigators report. They also report a minor increase in rate-pressure product with chronically inhaled salmeterol therapy. However, the clinical significance of this remains to be determined. The investigators, from the Departments of Pharmacy Practice and Internal Medicine at the University of Utah Health Sciences Center in Salt Lake City, Utah, United States, conducted a prospective, randomized crossover study that included eight symptomatic heart failure patients. Patients had a left ventricular ejection fraction below 40 percent and FEV1 less than or equal to 80 percent."
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256C020062CF52

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