Salbutamol

Question 1

Presentation and dosage of salbutamol?

Answer 1

Nebules containing salbutamol 2.5 milligrams/2.5ml or 5 milligrams/2.5ml

Question 2

Indications of Salbutamol?

Answer 2

Acute asthma attack where normal inhaler therapy has failed to relieve symptoms
Expiratory wheezing associated with allergy, anaphylaxis, smoke inhalation or other lower airway cause
Exacerbation of COPD

Question 3

What is COPD?

Answer 3

chronic obstructive pulmonary disease

Question 4

Actions of salbutamol?

Answer 4

Selective beta2 adrenoreceptor stimulant drug.
Has a relaxant effect on the smooth muscle medium in the smaller airways, which are in spasm in acute asthma attacks
If given by nebuliser, especially if oxygen powered, its smooth-muscle relaxing action, combined with the airway moistening effect of nebulisation, can relieve the attack rapidly

Question 5

Contra-indications of Salbutamol?

Answer 5

None in the emergency situation

Question 6

Cautions of Salbutamol?

Answer 6

Hypertension
Angina
Overactive thyroid
Late pregnancy (can relax uterus)
Severe hypertension may occur in patients on beta-blockers and half doses should be used unless there is profound hypertension
If COPD is a possibility limit nebulisation with oxygen to 6 minutes

Question 7

Side effects of Salbutamol?

Answer 7

Tremor (Shaking)
Tachycardia
Palpitations
Headache
Feeling of tension
Peripheral vasodilation
Muscle cramps
Rash

Question 8

What is tachycardia?

Answer 8

Tachycardia is a condition that makes your heart beat more than 100 times per minute

Question 9

What is Peripheral vasodilation?

Answer 9

Widening of your blood vessels in peripheral parts of your body such as your arms and legs

Question 10

In acute severe or life-threatening asthma what should be given after the first dose of salbutamol?

Answer 10

Ipratropium

Question 11

In acute asthma or COPD unresponsive to salbutamol alone, what can be given after salbutamol?

Answer 11

A single dose of Ipratropium

Question 12

What precautions should be taken after initial relief from salbutamol administration?

Answer 12

Salbutamol provides initial relief
In more severe attacks, the use of steroids by injection or orally and further nebuliser therapy will be required
DO NOT be lulled into a false sense of security by an initial improvement after salbutamol nebulisation

Question 13

What should be done regarding life threatening or acute severe asthma?

Answer 13

Undertake a time critical transfer to the nearest suitable receiving hospital
Provide nebulisation en-route

Question 14

If COPD is a possibility what time should nebulisation with oxygen be limited too?

Answer 14

6 minutes

Question 15

What may happen to children after significant doses of salbutamol, what should you do?

Answer 15

The pulse rate in children may exceed 140 after significant doses of salbutamol
This is not usually of any clinical significance and should not preclude further use of the drug

Question 16

When should repeated doses of salbutamol be discontinued?

Answer 16

If side effects are becoming significant

This is a clinical decision by the ambulance clinician

Question 17

Route of salbutamol?

Answer 17

nebuliser with 6-8 litres per minute of oxygen

Question 18

Initial does of salbutamol?

Answer 18

5 milligrams

Question 19

Can a repeat dose of salbutamol be given?

Answer 19

Yes, 5 milligrams

Question 20

Dose interval for salbutamol?

Answer 20

5 minutes

Question 21

Is there a maximum does of salbutamol that can be given?

Answer 21

No limit

Question 22

Volume of salbutamol?

Answer 22

2.5ml or 5ml

Question 23

Drug code for salbutamol?

Answer 23

SLB