LIVES Level 4 Nebulised Salbutamol PMA

Question 1

Nebulised Salbutamol
Inclusion Criteria
(4)

Answer 1

Acute asthma attack where normal inhaler therapy has failed to relieve symptoms

Expiratory wheeze associated with allergy, anaphylaxis, smoke inhalation, or other lower airway cause

Exacerbation of COPD

Shortness of breath in patients with severe breathing difficulty due to LVF (secondary Tx)

Question 2

Nebulised Salbutamol

Required Patient Assessment ABCD

Answer 2

Airway

Breathing
SpO2, PEFR, RR,

Circulatory
HR, BP

Disability
Conscious level, CBG

Question 3

Nebulised Salbutamol
Exclusion Criteria
(1)

Answer 3

Previous allergy to salbutamol (rare)

Question 4

Nebulised Salbutamol
Cautions - Medical
(5)

Answer 4

Hypertension
Angina
Hyperthyroidism
Late pregnancy (can relax uterus)
COPD (limit Rx to 6 mins)

Question 5

Nebulised Salbutamol

COPD - Rx Adjustments

Answer 5

Limit Nebulised Salbutamol Rx to 6 minutes

Question 6

Nebulised Salbutamol
Cautions - Medications
(1)

Answer 6

Beta Blockers

• can cause severe hypertension
• use half dose (unless Pt is profoundly hypotensive)

Question 7

Nebulised Salbutamol

Names, Forms, Strengths

Answer 7

Nebules containing salbutamol 2.5 mg in 2.5 mls or 5 mg in 5 mls

Question 8

Nebulised Salbutamol

Legal Category

Answer 8

Prescription Only Medication

Question 9

Nebulised Salbutamol

Route of Administration

Answer 9

Nebulised, Inhaled

via adult or child, single-use nebuliser mask attached to oxygen source at flow rate 6-8 L/min

Question 10

Nebulised Salbutamol

Adult (> 12 yrs) Dose

Answer 10

5 mg in 5 mls
(or x2 2.5 mg in 2.5 mls)

Nebulised with 6-8 L/min Oxygen

Repeat dose if no improvement in PEFR at 5 mins
No limit on repeat dosing, unless discontinuation criteria met

Question 11

Nebulised Salbutamol

Child (5 - 12 yrs) Dose

Answer 11

(If 5, give 5)

5 mg in 5 mls
(or x2 2.5 mg in 2.5 mls)

Nebulised with 6-8 L/min Oxygen

Repeat dose if no improvement in PEFR at 5 mins
No limit on repeat dosing, unless discontinuation criteria met

Question 12

Nebulised Salbutamol

Child (12 mths - 4 yrs)

Answer 12

2.5 mg in 2.5 mls

Nebulised with 6-8 L/min Oxygen

Repeat dose if no improvement in PEFR at 5 mins
No limit on repeat dosing, unless discontinuation criteria met

Question 13

Nebulised Salbutamol

Child (< 12 mths)

Answer 13

NOT SUITABLE FOR ADMINISTRATION IN CHILDREN UNDER 12 MONTHS

Question 14

Nebulised Salbutamol

Discontinuation Criteria

Answer 14

Significant Side Effects

• Tremor
• Tachycardia > 140 BPM in adults

Question 15

Nebulised Salbutamol

Adverse Effects

Answer 15

Tremor
Tachycardia
Palpitations
Headache
Feeling of tension
Peripheral vasodilation (flushing)
Muscle Cramps
Rash