Breathing and Bleeding drugs

Question 1

Salbutamol drug class and clin ind

Answer 1

Beta 2 agonist

Asthma: SABA for breathlessness. As a LABA in combo with ICS
COPD: For breathlessness
Hyperkalaemia: Nebulised salbutamol + insulin, glucose and calcium gluconate for the urgent treatment of high serum potassium

Question 2

Salbutamol MOA

Elimination

Answer 2

Normally found on SM of bronchi, GIT, uterus and blood vessels
Stimulation of G-protein coupled receptor= smooth muscle relaxation

SABAS: Salbutamol, terbutaline
LABAS: Salmetrol and formoterol

Eliminated via kidneys in urine

Question 3

Salbutamol Contraindications

Answer 3

CVD pts: tachycardia may provoke anginas or arrythmias

Question 4

Salbutamol SEs

Answer 4

Tachycardia
Palpitations 
Anxiety 
Tremor 
At high levels may cause a rise in serum lactate

Question 5

Salbutamol interactions

Answer 5

Beta Blockers: may reduce the effect of B2A

Theophyline and corticosteroids: With high dose B2A= hypokalaemia- serum potassium concentrations should be monitored

Question 6

Salbutamol dose

Answer 6

Inhaled SABAS are prn: 100-200micrograms- inhale as required

COPD/ Asthma exacerbations:2.5mg-5mg salbutamol nebulised 4 hourly

Question 7

How would you explain to a pt what salbutamol is for?

Pro tip re nebulised salbutamol therapy

Answer 7

Salbutamol will help their airways relax and improve breathing. If they need B2A frequently they should seek medical advice or increase other treatments e.g. inhaled corticosteroids

O2 should be used for asthma whereas medical air should be used in COPD exacerbations due to risk of c02 retention