Which of the following drug is a long-acting beta-2 agonist
**Core Concept**
Long-acting beta-2 agonists (LABAs) are a class of medications used primarily in the management of asthma and chronic obstructive pulmonary disease (COPD). These drugs stimulate the beta-2 adrenergic receptors in the lungs, causing bronchodilation and relaxation of bronchial smooth muscle.
**Why the Correct Answer is Right**
Salmeterol is a long-acting beta-2 agonist that exerts its effects by binding to the beta-2 adrenergic receptors in the lungs. This binding causes an increase in intracellular cyclic AMP (cAMP), leading to relaxation of bronchial smooth muscle and bronchodilation. Salmeterol has a long duration of action, typically lasting 12 hours, making it suitable for once-daily dosing.
**Why Each Wrong Option is Incorrect**
**Option A:** Albuterol is a short-acting beta-2 agonist (SABA), not a long-acting one. It has a shorter duration of action, typically lasting 4-6 hours.
**Option B:** Fluticasone is an inhaled corticosteroid (ICS), not a LABA. It reduces inflammation in the airways but does not have bronchodilatory effects.
**Option C:** Montelukast is a leukotriene receptor antagonist (LTRA), not a LABA. It prevents the action of leukotrienes, which are involved in the pathogenesis of asthma, but does not cause bronchodilation.
**Clinical Pearl / High-Yield Fact**
Long-acting beta-2 agonists like salmeterol should not be used as monotherapy in asthma management. They should be used in combination with inhaled corticosteroids to reduce the risk of exacerbations and improve lung function.
**Correct Answer:** C. Salmeterol