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albuterol (salbutamol)
Asmol‡, Proventil, Ventolin

albuterol sulfate (salbutamol sulfate)
Aerolin Autoinhaler Airomir§, Proventil, Proventil Repetabs, Respolin Autohaler‡, Respolin Inhaler‡, Respolin Respirator Solution‡, Steri-Neb Salamol§, Ventolin, Ventolin Obstetric Injection‡, Ventolin Rotacaps, Volmax

Pregnancy Risk Category C

How supplied
albuterol
Aerosol inhaler: 90 mcg/metered spray, 100 mcg/metered spray‡
albuterol sulfate
Capsules for inhalation: 200 mcg
Tablets: 2 mg, 4 mg
Tablets (extended-release): 4 mg, 8 mg
Syrup: 2 mg/5 ml
Solution for inhalation: 0.083%, 0.5%
Injection: 1 mg/ml‡

Action
Relaxes bronchial, uterine, and vascular smooth muscle by stimulating beta2 receptors.

Indications & dosage
To prevent or treat bronchospasm in patients with reversible obstructive airway disease--
Adults and children ages 4 and older: dosage and frequency vary with dosage form.
Aerosol inhalation--1 or 2 inhalations q 4 to 6 hours. More frequent administration or more inhalations isn't recommended.
Capsules for inhalation--200 mcg inhaled q 4 to 6 hours using a Rotahaler inhalation device. Some patients may need 400 mcg q 4 to 6 hours.
Adults and children ages 12 and older: Solution for inhalation--2.5 mg t.i.d. or q.i.d. by nebulizer. To prepare solution, use 0.5 ml of the 0.5% solution diluted with 2.5 ml of normal saline. Or, use 3 ml of the 0.083% solution.
Children ages 2 to 12: Solution for inhalation--initially, 0.1 to 0.15 mg/kg by nebulizer, with subsequent dosing titrated to response. Don't exceed 2.5 mg t.i.d. or q.i.d. by nebulization.
Adults and children ages 14 and older:
Syrup--2 to 4 mg (1 to 2 tsp) P.O. t.i.d. or q.i.d. Maximum dose is 8 mg q.i.d.
Children ages 6 to 14: Syrup--2 mg
(1 tsp) P.O. t.i.d. or q.i.d. Maximum dose is 24 mg daily given in divided doses.
Children ages 2 to 6: Syrup--initially, 0.1 mg/kg P.O. t.i.d. Starting dose shouldn't exceed 2 mg (1 tsp) t.i.d. Maximum dose is 4 mg (2 tsp) t.i.d.
Adults and children ages 12 and older: Oral tablets--2 to 4 mg P.O. t.i.d. or q.i.d. Maximum dose is 8 mg q.i.d. Extended-release tablets--4 to 8 mg P.O. q 12 hours. Maximum dose is 16 mg b.i.d.
Children ages 6 to 11: Oral tablets--2 mg P.O. t.i.d. or q.i.d. Maximum dose is 6 mg q.i.d. Extended-release tablets--4 mg P.O. q 12 hours. Maximum dose is 12 mg b.i.d.
Elderly: 2 mg P.O. t.i.d. or q.i.d. as oral tablets or syrup. Maximum dose is 8 mg t.i.d. or q.i.d.
Adjust-a-dose: For those sensitive to beta stimulators: 2 mg P.O. t.i.d. or q.i.d. as oral tablets or syrup. Maximum dose is 8 mg t.i.d. or q.i.d.
Prevention of exercise-induced bronchospasm--
Adults and children ages 4 and older: 2 aerosol inhalations 15 to 30 minutes before exercise; or 200 mcg (capsule for inhalation) inhaled using a Rotahaler inhalation device 15 minutes before exercise.
Prevention of premature labor--
Adults: initially, 10 mcg/minute by continuous I.V. infusion (via an infusion pump). Dosage should be increased at 10-minute intervals until desired response is achieved.

Adverse reactions
CNS: tremor, nervousness, dizziness, insomnia, headache, hyperactivity, weakness, CNS stimulation, malaise.
CV: tachycardia, palpitations, hypertension.
EENT: dry and irritated nose and throat (with inhaled form), nasal congestion, epistaxis, hoarseness.
GI: heartburn, nausea, vomiting, anorexia, bad taste in mouth, increased appetite.
Metabolic: hypokalemia.
Musculoskeletal: muscle cramps.
Respiratory: bronchospasm, cough, wheezing, dyspnea, bronchitis, increased sputum.
Other: hypersensitivity reactions.

Interactions
Drug-drug. CNS stimulants: increased CNS stimulation. Avoid concomitant use.
Digoxin: digoxin serum levels may be decreased. Monitor closely.
MAO inhibitors, tricyclic antidepressants: increased adverse CV effects. Monitor patient closely.
Propranolol, other beta blockers: mutual antagonism. Monitor patient carefully.

Effects on diagnostic tests
Albuterol may decrease sensitivity of spirometry used for diagnosis of asthma.

Contraindications
Contraindicated in patients with hypersensitivity to drug or its ingredients.

Nursing considerations

I.V. administration

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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