title: Tolerance & resistance to β₂-agonist bronchodilators.
abstract: For the past half-century, β₂-agonists have been the mainstay of treatment of the bronchoconstriction associated with asthma. Although their usefulness in reversing acute bronchospasm remains undiminished, there is increasing evidence that chronic use may lead to development of tolerance and thus, potentially increasing morbidity and even mortality. In addition, genetic studies have shown that certain individuals carrying specific mutations may be prone to developing resistance to β₂-agonists regardless of the duration of treatment. This article reviews the current evidence regarding the underlying mechanisms that cause or contribute to the development of the resistance, as well as the strategies for the evaluation and management of patients who are at risk for or have developed tolerance to β₂-agonists.
authors.affiliation: Division of Pulmonary & Sleep Medicine, Children's National Medical Center/George Washington University, Wahington DC, USA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Yim
authors.forename: Anastassios C
authors.initials: AC
authors.lastname: Koumbourlis
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D016084:Bronchoconstriction / Q000187:drug effects* / Q000235:genetics; D001993:Bronchodilator Agents / Q000494:pharmacology / Q000627:therapeutic use; D004351:Drug Resistance / Q000187:drug effects / Q000502:physiology; D004361:Drug Tolerance / Q000235:genetics / Q000502:physiology*; D006801:Humans; D011110:Polymorphism, Genetic; D018343:Receptors, Adrenergic, beta-2 / Q000187:drug effects* / Q000502:physiology*
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D018343:Receptors, Adrenergic, beta-2; D000420:Albuterol
keywords: Resistance; Tolerance; β(2)-agonists