multi class comparison

Asthma/COPD Inhaler Comparison: Bronchodilators vs Corticosteroids vs Leukotriene Modifiers

A patient grabs their fluticasone inhaler during an acute asthma attack — it does nothing to open the airways, and precious minutes are lost. The NCLEX tests whether you know which drug rescues, which controls, and which one is swallowed, not inhaled.

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Comparison

Side-by-side3 compared
Comparevs
Dimension
Bronchodilators
Inhaled Corticosteroids
Leukotriene Modifiers
Class & mechanism
  • β2-agonist/anticholinergic relax airway muscle
  • Corticosteroid then ↓ airway inflammation
  • Block leukotrienes then ↓ bronchoconstriction
Indications
  • ★SABA = rescue/acute relief — carry at all times
  • ★Controller/maintenance — NOT for acute attack
  • Controller
  • allergic & exercise-induced asthma
Route & onset
  • Inhaled
  • SABA fast onset (minutes)
  • Inhaled
  • scheduled daily, no quick relief
  • Oral, not inhaled
  • taken once daily
Key assessment
  • Assess respiratory status & peak flow
  • Assess respiratory status & peak flow
  • Assess respiratory status & peak flow
Monitoring
  • Monitor HR
  • ↑ albuterol use = poor control
  • Monitor for thrush
  • growth in children
  • Monitor mood & behavior changes
Adverse effects
  • Tachycardia, tremor, jitteriness
  • Oral candidiasis (thrush), hoarseness
  • Headache
  • GI upset
Black box / safety
  • ★LABA never monotherapy in asthma (death risk)
  • Use spacer
  • taper if long-term high dose
  • ★Neuropsychiatric effects — suicidality (black box)
Contraindications & cautions
  • Caution: tachydysrhythmias, hyperthyroidism
  • Caution: active oral/respiratory infection
  • Caution: history of psychiatric disorder
Patient teaching
  • Demonstrate correct inhaler technique
  • Use SABA first, wait, then other inhalers
  • Demonstrate correct inhaler technique
  • Rinse mouth after each use
  • Take daily even when symptom-free
Class & mechanism

Bronchodilators

  • β2-agonist/anticholinergic relax airway muscle

Inhaled Corticosteroids

  • Corticosteroid then ↓ airway inflammation
Indications

Bronchodilators

  • ★SABA = rescue/acute relief — carry at all times

Inhaled Corticosteroids

  • ★Controller/maintenance — NOT for acute attack
Route & onset

Bronchodilators

  • Inhaled
  • SABA fast onset (minutes)

Inhaled Corticosteroids

  • Inhaled
  • scheduled daily, no quick relief
Key assessment

Bronchodilators

  • Assess respiratory status & peak flow

Inhaled Corticosteroids

  • Assess respiratory status & peak flow
Monitoring

Bronchodilators

  • Monitor HR
  • ↑ albuterol use = poor control

Inhaled Corticosteroids

  • Monitor for thrush
  • growth in children
Adverse effects

Bronchodilators

  • Tachycardia, tremor, jitteriness

Inhaled Corticosteroids

  • Oral candidiasis (thrush), hoarseness
Black box / safety

Bronchodilators

  • ★LABA never monotherapy in asthma (death risk)

Inhaled Corticosteroids

  • Use spacer
  • taper if long-term high dose
Contraindications & cautions

Bronchodilators

  • Caution: tachydysrhythmias, hyperthyroidism

Inhaled Corticosteroids

  • Caution: active oral/respiratory infection
Patient teaching

Bronchodilators

  • Demonstrate correct inhaler technique
  • Use SABA first, wait, then other inhalers

Inhaled Corticosteroids

  • Demonstrate correct inhaler technique
  • Rinse mouth after each use

★ marks the fact that sets a column apart.

Clinical Pearl

Bronchodilator first to open, steroid second to calm — never reverse the order in an acute attack.

Component Topics

Albuterol & Short-Acting Beta-2 AgonistsLeukotriene ModifiersInhaled Corticosteroids

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