1.salbutamol sulfate (Ventolin):- the molecular formula of salbutamol sulfate (Ventolin) is (C13H21NO3)2 • H2SO4 o Mechanism of action:- It stimulates 2 adrenergic receptors. It has a bronchodilator effect. It causes the activation of enzyme adenyl cyclase, adenyl cyclase enzyme form cyclic AMP (adenosine-mono-phosphate) from ATP (adenosine-tri-phosphate). Bronchial smooth relaxes in the prsence of high level of cyclic AMP by which airway resistance decreases by lowering intracellular ionic calcium concentrations. Release of bronchoconstrictor mediators such as histamine, leukotreine from the mast cells in the airway inhibited by the high level of cyclic AMP. o side effects/adverse effects :-Its side effects/adverse effects depends on its dosage and route of administration. The most common side effects of salbutamol is found a fine tremor of skeletal muscle of hands and nervousness. Palpitation, tachycardia, chest discomfort, headache, muscle cramps, hypokalemia, difficulty in micturition and paradoxical bronchospasm also caused by salbutamol. o potential medication interactions:- It can be given as tablet, syrup, inhaler, nebulizer solution and intramuscular or intravenous injectable form. The medication of oral salbutamol is 2 to 4 mg three times a day in adult and 1 to 2 mg three times a day in children. As per the requirement the One to two puffs (100 to 200 microgram) of salbutamol metered dose inhaler is inhaled. As nebulizer solution 1 to 2 ml of salbutamol nebulizer solution should be diluted with normal saline to final volume of 2-4 ml is inhaled from a nebulizer. In severe acute attack, 5 to 10 ml (each ml contain 50 microgram) of salbutamol injection can be given by intramuscularly or intravenously. 2.Advair Diskus:- It is a combination of a corticosteroid and a beta2-adrenergic bronchodilator. Mechanism of action:- It contains both fluticasone propionate and salmeterol. They both have seprate mechanism of action given below:- For Fluticasone Propionate:- It has anti-inflammatory activity and it is a synthetic trifluorinated corticosteroid .In vitro it exhibit a binding affinity for the human glucocorticoid receptor. Asthma caused by inflammation, Corticosteroids acts on actions on multiple cell types like, mast cells, etc. For Salmeterol Xinafoate:- It is is a selective LABA.In vitro, it is 50 times more selective for beta2-adrenoceptors than albuterol. They are predominant adrenergic receptors found in bronchial smooth muscle. And in heart beta1-adrenoceptors are predominant, it is comprising 10% to 50% of the total beta-adrenoceptors. The beta2-adrenoceptor agonist drugs contains salmeterol, stimulates the intracellular adenyl cyclase, adenyl cyclase enzyme form cyclic AMP (adenosine-mono-phosphate) from ATP (adenosine-tri-phosphate). Higher level of c-AMP causes relaxation of bronchial smooth muscle and release of mediators is inhibited by immediate hypersensitivity from cells, especially from mast cells. salmeterol is a potent.

1. 1.salbutamol sulfate (Ventolin):- the molecular formula of salbutamol sulfate (Ventolin) is
(C13H21NO3)2 • H2SO4
o Mechanism of action:- It stimulates 2 adrenergic receptors. It has a bronchodilator effect. It
causes the activation of enzyme adenyl cyclase, adenyl cyclase enzyme form cyclic AMP
(adenosine-mono-phosphate) from ATP (adenosine-tri-phosphate). Bronchial smooth relaxes in
the prsence of high level of cyclic AMP by which airway resistance decreases by lowering
intracellular ionic calcium concentrations. Release of bronchoconstrictor mediators such as
histamine, leukotreine from the mast cells in the airway inhibited by the high level of cyclic
AMP.
o side effects/adverse effects :-Its side effects/adverse effects depends on its dosage and route of
administration. The most common side effects of salbutamol is found a fine tremor of skeletal
muscle of hands and nervousness. Palpitation, tachycardia, chest discomfort, headache, muscle
cramps, hypokalemia, difficulty in micturition and paradoxical bronchospasm also caused by
salbutamol.
o potential medication interactions:- It can be given as tablet, syrup, inhaler, nebulizer solution
and intramuscular or intravenous injectable form. The medication of oral salbutamol is 2 to 4 mg
three times a day in adult and 1 to 2 mg three times a day in children. As per the requirement the
One to two puffs (100 to 200 microgram) of salbutamol metered dose inhaler is inhaled. As
nebulizer solution 1 to 2 ml of salbutamol nebulizer solution should be diluted with normal
saline to final volume of 2-4 ml is inhaled from a nebulizer. In severe acute attack, 5 to 10 ml
(each ml contain 50 microgram) of salbutamol injection can be given by intramuscularly or
intravenously.
2.Advair Diskus:- It is a combination of a corticosteroid and a beta2-adrenergic bronchodilator.
Mechanism of action:- It contains both fluticasone propionate and salmeterol. They both have
seprate mechanism of action given below:-
For Fluticasone Propionate:- It has anti-inflammatory activity and it is a synthetic trifluorinated
corticosteroid .In vitro it exhibit a binding affinity for the human glucocorticoid receptor.
Asthma caused by inflammation, Corticosteroids acts on actions on multiple cell types like, mast
cells, etc.
For Salmeterol Xinafoate:- It is is a selective LABA.In vitro, it is 50 times more selective for
beta2-adrenoceptors than albuterol. They are predominant adrenergic receptors found in
bronchial smooth muscle. And in heart beta1-adrenoceptors are predominant, it is comprising
10% to 50% of the total beta-adrenoceptors. The beta2-adrenoceptor agonist drugs contains
salmeterol, stimulates the intracellular adenyl cyclase, adenyl cyclase enzyme form cyclic AMP
(adenosine-mono-phosphate) from ATP (adenosine-tri-phosphate). Higher level of c-AMP

2. causes relaxation of bronchial smooth muscle and release of mediators is inhibited by immediate
hypersensitivity from cells, especially from mast cells. salmeterol is a potent inhibitor of release
of mast cell mediators. It inhibits histamine-induced plasma protein extravasation, platelet-
activating factor. It induces eosinophil accumulation in the lungs of guinea pigs.
o side effects/adverse effects :- Side effects of Advair Diskus include:-Hoarseness, throat
irritation, headache, or stomach upset may occur, upper respiratory tract infections, dizziness,
nausea, vomiting, diarrhea, infection of mouth, stuffy nose, sinus pain and cough.
o potential medication interactions:- Advair Diskus is 1 inhalated twice daily, approximately 12
hours apart by the patients aged 12 years and older,It may interact with amiodarone, diuretics
(water pills), HIV medicines, MAO inhibitors, antidepressants, antibiotics, antifungal
medications, or beta-blockers.
3.warfarin sodium (Coumadin):- Its empirical formula is C19H15NaO4
o mechanism of action:- It inhibits the synthesis of vitamin K-dependent clotting factors,
including Factors II, VII, IX, and X, and the anticoagulant proteins C and S. Vitamin K is
important for the post ribosomal synthesis of the vitamin K-dependent clotting factors.
biosynthesis of -carboxyglutamic acid residues in the proteins is stimulated by vitamin K.
Warfarin interferes with clotting factor synthesis by inhibition of the C1 subunit of vitamin K
epoxide reductase (VKORC1) enzyme complex, thereby regeneration of vitamin K1 epoxide
reduces.
o side effects/adverse effects :- common side effects are nausea, vomiting, mild stomach
pain;bloating, gas; or altered sense of taste. Less common side effects are abdominal or stomach
pain with cramping, bleeding gums, blood in the urine., bloody stools, blurred vision, burning,
crawling, itching, numbness, prickling, "pins and needles", or tingling feelings. chest pain or
discomfort,confusion.
o potential medication interactions: It is available as tablets for oral use and injection for
intravenous use.
4.metoprolol (Lopressor):- It is a beta1-selective (cardioselective) adrenergic receptor blocker.
o mechanism of action: it is a adrenergic receptor blocker. It inhibits beta2-
adrenoreceptors,mainly found in the bronchial and vascular musculature, by which heart rate and
cardiac output at rest and upon exercise,and systolic blood pressure upon exercise reduces. It
inhibits the isoproterenol-induced tachycardia, and reduction of reflex orthostatic tachycardia. It
blocks the effect of adrenaline and slows the heart rate.
o side effects/adverse effects:- Common metoprolol side effects are dizziness, tired feeling;
confusion, memory problems;nightmares, trouble sleeping; diarrhea; or mild itching or rash. It
slows the heart rate.
potential medication interactions:-For oral administration, each tablet contains 25 mg, 50 mg or

3. 100 mg of Metoprolol tartrate.
Solution
1.salbutamol sulfate (Ventolin):- the molecular formula of salbutamol sulfate (Ventolin) is
(C13H21NO3)2 • H2SO4
o Mechanism of action:- It stimulates 2 adrenergic receptors. It has a bronchodilator effect. It
causes the activation of enzyme adenyl cyclase, adenyl cyclase enzyme form cyclic AMP
(adenosine-mono-phosphate) from ATP (adenosine-tri-phosphate). Bronchial smooth relaxes in
the prsence of high level of cyclic AMP by which airway resistance decreases by lowering
intracellular ionic calcium concentrations. Release of bronchoconstrictor mediators such as
histamine, leukotreine from the mast cells in the airway inhibited by the high level of cyclic
AMP.
o side effects/adverse effects :-Its side effects/adverse effects depends on its dosage and route of
administration. The most common side effects of salbutamol is found a fine tremor of skeletal
muscle of hands and nervousness. Palpitation, tachycardia, chest discomfort, headache, muscle
cramps, hypokalemia, difficulty in micturition and paradoxical bronchospasm also caused by
salbutamol.
o potential medication interactions:- It can be given as tablet, syrup, inhaler, nebulizer solution
and intramuscular or intravenous injectable form. The medication of oral salbutamol is 2 to 4 mg
three times a day in adult and 1 to 2 mg three times a day in children. As per the requirement the
One to two puffs (100 to 200 microgram) of salbutamol metered dose inhaler is inhaled. As
nebulizer solution 1 to 2 ml of salbutamol nebulizer solution should be diluted with normal
saline to final volume of 2-4 ml is inhaled from a nebulizer. In severe acute attack, 5 to 10 ml
(each ml contain 50 microgram) of salbutamol injection can be given by intramuscularly or
intravenously.
2.Advair Diskus:- It is a combination of a corticosteroid and a beta2-adrenergic bronchodilator.
Mechanism of action:- It contains both fluticasone propionate and salmeterol. They both have
seprate mechanism of action given below:-
For Fluticasone Propionate:- It has anti-inflammatory activity and it is a synthetic trifluorinated
corticosteroid .In vitro it exhibit a binding affinity for the human glucocorticoid receptor.
Asthma caused by inflammation, Corticosteroids acts on actions on multiple cell types like, mast
cells, etc.
For Salmeterol Xinafoate:- It is is a selective LABA.In vitro, it is 50 times more selective for
beta2-adrenoceptors than albuterol. They are predominant adrenergic receptors found in

4. bronchial smooth muscle. And in heart beta1-adrenoceptors are predominant, it is comprising
10% to 50% of the total beta-adrenoceptors. The beta2-adrenoceptor agonist drugs contains
salmeterol, stimulates the intracellular adenyl cyclase, adenyl cyclase enzyme form cyclic AMP
(adenosine-mono-phosphate) from ATP (adenosine-tri-phosphate). Higher level of c-AMP
causes relaxation of bronchial smooth muscle and release of mediators is inhibited by immediate
hypersensitivity from cells, especially from mast cells. salmeterol is a potent inhibitor of release
of mast cell mediators. It inhibits histamine-induced plasma protein extravasation, platelet-
activating factor. It induces eosinophil accumulation in the lungs of guinea pigs.
o side effects/adverse effects :- Side effects of Advair Diskus include:-Hoarseness, throat
irritation, headache, or stomach upset may occur, upper respiratory tract infections, dizziness,
nausea, vomiting, diarrhea, infection of mouth, stuffy nose, sinus pain and cough.
o potential medication interactions:- Advair Diskus is 1 inhalated twice daily, approximately 12
hours apart by the patients aged 12 years and older,It may interact with amiodarone, diuretics
(water pills), HIV medicines, MAO inhibitors, antidepressants, antibiotics, antifungal
medications, or beta-blockers.
3.warfarin sodium (Coumadin):- Its empirical formula is C19H15NaO4
o mechanism of action:- It inhibits the synthesis of vitamin K-dependent clotting factors,
including Factors II, VII, IX, and X, and the anticoagulant proteins C and S. Vitamin K is
important for the post ribosomal synthesis of the vitamin K-dependent clotting factors.
biosynthesis of -carboxyglutamic acid residues in the proteins is stimulated by vitamin K.
Warfarin interferes with clotting factor synthesis by inhibition of the C1 subunit of vitamin K
epoxide reductase (VKORC1) enzyme complex, thereby regeneration of vitamin K1 epoxide
reduces.
o side effects/adverse effects :- common side effects are nausea, vomiting, mild stomach
pain;bloating, gas; or altered sense of taste. Less common side effects are abdominal or stomach
pain with cramping, bleeding gums, blood in the urine., bloody stools, blurred vision, burning,
crawling, itching, numbness, prickling, "pins and needles", or tingling feelings. chest pain or
discomfort,confusion.
o potential medication interactions: It is available as tablets for oral use and injection for
intravenous use.
4.metoprolol (Lopressor):- It is a beta1-selective (cardioselective) adrenergic receptor blocker.
o mechanism of action: it is a adrenergic receptor blocker. It inhibits beta2-
adrenoreceptors,mainly found in the bronchial and vascular musculature, by which heart rate and
cardiac output at rest and upon exercise,and systolic blood pressure upon exercise reduces. It
inhibits the isoproterenol-induced tachycardia, and reduction of reflex orthostatic tachycardia. It
blocks the effect of adrenaline and slows the heart rate.

5. o side effects/adverse effects:- Common metoprolol side effects are dizziness, tired feeling;
confusion, memory problems;nightmares, trouble sleeping; diarrhea; or mild itching or rash. It
slows the heart rate.
potential medication interactions:-For oral administration, each tablet contains 25 mg, 50 mg or
100 mg of Metoprolol tartrate.