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.

Comparison

Side-by-side3 compared
Comparevs
Dimension
Bronchodilators
Inhaled Corticosteroids
Leukotriene Modifiers
Class & mechanism
  • β2-agonist/anticholinergic relax airway muscle
  • Corticosteroid → ↓ airway inflammation
  • Block leukotrienes → ↓ 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 → ↓ 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.

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Component Topics

Albuterol & Short-Acting Beta-2 AgonistsLeukotriene ModifiersInhaled Corticosteroids
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