salbutamol [Ventolin] Flashcards
Classification
salbutamol
- bronchodilator
- sympathomimetic
INDICATIONs
salbutamol
EMR
- bronchospasm in asthma or COPD
ACP
- adjunctive management of hyperkalemia
EMR requires scope expansion education
CONTRAINDICATIONs
salbutamol
- HYPERSENSITIVITY
hemodynamically significant tachycardia
Dosage - Adult
salbutamol
EMR
4 x 100 mcg dose via MDI w/ spacer
5mg nebulized - repeat back to back as necessary
MDI w/ space strongly recommened for ILI pts or other infectious respiratory conditions
repeat - PRN
NO MAX dose - assess for signs of toxicity
Dosage - Pediatric
salbutamol
EMR
via NEB
< 1y/o - 2.5mg
1y/o and up - 5mg
via MDI
< 10kg - NOT indicated
10-20kg - 5 x 100mcg per course; repeat x 3
>20kg - 10 x 100mcg per course; repeat x 3
Pharmacodynamic
salbutamol
- selective β2 stimulation = bronchodilation // vasodilation
- Some β1 effects @ higher doses
- Little or no α stimulation
Pharmacokinetics
salbutamol
inhaled
onset - 5-15mins
peak - 60-90mins
duration - 3-6hrs
Warnings // Precautions
salbutamol
- Coronary disease (increased MVO2)
- COPD pts with degenerative heart disease
- Diabetes (decreases the effectiveness of insulin)
ADVERSE EFFECTs
salbutamol
- restlessness
- apprehension // fear
- weakness
- vertigo
- nausea // vomiting
- cough
- pulmonary edema
- tachycardia, dysrhythmias
- sweating // pallor // flushing
- paradoxical worsening of respiratory distress
- tremors
OVERDOSE
salbutamol
discontinue if repeated doses result in signs of TOXICITY
- HR >150 (>200 in pediatric pts)
- severe tremor
- ventricular dysrhythmias
Special Notes
salbutamol
- Also a common prescription drug – usual dose by MDI is 100 mcg inhaled per puff
- β2 selectivity is lost with high doses
- 10 mg of Salbutamol may lower serum potassium by as much as 1-1.5 mEq/L (normal K is 3.5-5.0 mEq/L) and is sometimes ordered in the setting of hyperkalemia
