Salbutamol (albuterol)

Question 1

What is the trade name of salbutamol?

Answer 1

Ventolin

Question 2

What is the classification of salbutamol?

Answer 2

bronchodilator

beta2-selective adrenergic agonist (sympathomimetic)

Question 3

How is salbutamol supplied?

Answer 3

2.5 mL nebule (1mg/mL)

MDI 100 mcg/spray

Combivent (Ventolin 2.5 mg/Atrovent 500 mcg)

Question 4

What is the MOA (pharmacodynamics) of salbutamol?

Answer 4

• Selectively stimulates beta-adrenergic receptors of the lungs, uterus, and vascular smooth muscle.
• Bronchodilation results from relaxation of the vascular smooth muscles, which relieves bronchospasm and reduces airway resistance.
• Higher doses will drive serum potassium (K+) into the cells.

Question 5

List the indications for salbutamol?

Answer 5

• Bronchospasm due to asthma, chronic bronchitis, other chronic broncho-pulmonary disorders and anaphylaxis
• Hyperkalemia

Question 6

What is the salbutamol dosage for Bronchospasm?

Answer 6

Adult-2.5-5.0 mg NEB – repeat prn
-MDI 10 puffs (100mcg) with spacer q 5 min.

Pediatric-<10 kg = 1.25 mg;
10 - 20 kg = 2.5 mg;
>20 kg = 5 mg
(MDI 1 – 2 puffs q4h prn if over 4 y/o)

Less then 4 y/o use nebulization only

Question 7

What is the IV/IO salbutamol dose for asthma?

Answer 7

4mcg/kg IV/IO over 2 to 5 minutes q 15 minutes PRN to a max single dose of 250mcg.

**Only given AFTER Pt has received Mag, Dex, Atrovent/Ventolin NEB/MDI and EPI x 3.

Question 8

How should a salbutamol (Ventolin) MDI be administered?

Answer 8

Wait 30 seconds between each puff to allow MDI to recharge; invert canister numerous times and depress canister 3 times, directed away from pt, prior to administration; as pt begins to inhale deliver one puff into the chamber; allow pt to breathe into the chamber 5 times before removing it; instruct pt hold their breath for 5 – 10 seconds with each inhale.

Question 9

What is the dosage for salbutamol with a hyperkalemic patient?

Answer 9

NEB 10-20 mg (preferably 5mg/ml) nebulized over 15 minutes PRN.

MDI 10 puffs (100mcg) with a spacer
q 15 minutes PRN.

IV 4mcg/kg to a single max of 250mcg over 2 – 5 minutes. Do not repeat.

Question 10

What’s the contraindication for salbutamol?

Answer 10

Hypersensitivity!

Question 11

What are some of the precautions in the use of salbutamol.

Answer 11

• Congestive heart failure
• Cardiovascular disease: Myocardial Infarction, Angina, cardiac dysrhythmias, hypertension, tachycardia associated with digitalis toxicity
• Diabetes mellitus: risk of drug induced hyperglycemia
• Hypokalemia: risk further reducing serum potassium levels and possible adverse cardiovascular events

Question 12

What are some things to note in regards to salbutamol?

Answer 12

-Administer continuously during rapid transport in patients who are in severe respiratory distress
-When used at recommended doses, short-acting-beta-agonists (SABAs) are generally devoid of adverse effects.
-Cardiac stimulation and tremors are most likely with systemic therapy and higher-dose therapies.
-Because beta2-adrenergic agonists and ipratropium bromide promote bronchodilation by different mechanisms, their beneficial effects are additive, hence combined use makes sense.
-For MDI use, alternate single puffs of
salbutamol and ipratropium bromide during recharge periods.