Albuterol Sulphate

Question 1

Trade Name

Answer 1

Albuterol

Proventil

Ventolin

Question 2

Class

Answer 2

Beta2 agonist

Sympathmimetic

Question 3

Actions

Answer 3

Acts on beta2 receptor sites in cells

• relaxes bronchial smooth muscle
• decrease airway resistance
• relieves bronchospasm

Beta2 selective but causes some action on

• CNS stimulation
• cardiac stimulation
• increase diuresis
• increase gastric acid

Question 4

Indications

Answer 4

1. Bronchial asthma
2. Bronchospasm in acute exasperation of COPD (chronic emphysema/bronchitis)
3. Bronchospasm associated with cardiac asthma
4. Bronchospasm in anaphylaxis, burns, toxic inhilation

Question 5

Contraindications

Answer 5

1. Hypersensitivity
2. Tachycardia
3. Croup

Question 6

Precautions

Answer 6

1. HTN
2. Lactation and pregnancy (C)
3. Diabetes
4. Seizures
5. Known cardiac disease
6. Hyperthyroidism

Question 7

Dose
ADULTS
MDI

Answer 7

1-2 inhalations, 1 min each, repeat every 15 min PRN

Question 8

Dose
ADULTS
Nebulizer

Answer 8

2.5mg, O2 flow 8L/min — takes ~8-12 min to administer. May repeat as needed

Question 9

Dose
ADULTS
Hyperkalemia (intubated)

Answer 9

4 unit doses (10mg) directly down CETT followed by hyperventilation

Question 10

Dose
PEDS
MDI & Nebulizer

Answer 10

MDI - compliance is difficult. Nebulizer recommended

Nebulizer - same as adults

Question 11

Onset

Answer 11

5-15 min

Question 12

Duration

Answer 12

3-4 hrs

Question 13

Side effects

Answer 13

Mostly sympathetic response

• palpitations, tachycardia
• dizzy
• anxiety/nervous
• HA
• N/V
• Tremors
• HTN
• Dysrhythmia
• chest pain

Question 14

Interactions

Answer 14

• antagonistic effects: beta blockers including propranolol and esmolol
• additive effects: MAOI’s, TCA’s and other sympathomimetics

Question 15

Special Notes

Answer 15

• The first dose is administered in conjunction with atrovent. Second and subsequent nebulizers are with albuterol only.
• The nebulizer system can be adapted to accommodate a mask if the patient is too fatigued or working too hard to hold the nebulizer. It can also be adapted to CETT administration. Both CETT & mask nebulizer treatments should have an O2 flow rate of 8-10 L/min.
• The medication chamber should be kept upright to ensure efficient medication administration, patients have a tendency to tilt the chamber, recheck it often. “Tap” the container toward the end of the treatment to ensure complete administration.
• Monitor for dramatic increase in heart rate, development of frequent ventricular ectopy, or development of serious CNS symptoms.
• Albuterol can cause hyperglycemia and hypokalemia. Both of these effects occur from stimulation of beta2-receptors, resulting in gluconeogenesis and intracellular movement of potassium. These effects occur most commonly with inhalation (via nebulization) of relatively large doses of albuterol (e.g., 5—10mg)