Albuterol
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Trade Name
ProAir HFA, Proventil HFA, Ventolin HFA (inhalers); generic albuterol sulfate
Classification
Beta-2 adrenergic agonist; bronchodilator (short-acting beta-agonist, SABA)
Dosage/Route
- * Dosage:
- – Metered-dose inhaler (MDI): 90 mcg/puff
- – Nebulizer solution: 2.5 mg/3 mL (0.083%), 1.25 mg/3 mL, 0.63 mg/3 mL
- – Tablets: 2 mg, 4 mg (less common)
- * Route: Inhalation (MDI or nebulizer); oral (PO, rare)
Usual Dosage
- * Adults/Children ≥4 (MDI): 1-2 puffs (90-180 mcg) every 4-6 hours PRN
- * Nebulizer: 2.5 mg (0.083%) every 4-6 hours PRN; may increase to q1-4h in acute settings
- * PO (rare): 2-4 mg 3-4 times daily; max 32 mg/day
- * Adjust based on response; rescue use only
Mechanism of Action
Selectively stimulates beta-2 adrenergic receptors in bronchial smooth muscle, causing relaxation and bronchodilation. Increases cyclic AMP, relieving bronchospasm and improving airflow in conditions like asthma or COPD
Side Effects & Adverse Effects
- * Side Effects: Tremors, nervousness, headache, throat irritation
- * Adverse Effects:
- – Tachycardia/palpitations (beta-1 crossover at high doses)
- – Hypokalemia (rare; muscle cramps, arrhythmias)
- – Paradoxical bronchospasm (worsening wheezing)
- – Overuse: Reduced efficacy, risk of severe exacerbation
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor HR, respiratory status (breath sounds, O2 sat) pre/post-use
- – Assess for overuse (if >2 doses/hour or >3 times/week, escalate care)
- – MDI: Shake well, use spacer if prescribed; nebulizer: Mix with saline if diluted
- – Watch for hypokalemia in high doses (check K+ levels)
- * Teachings:
- – Prime inhaler (2-4 puffs into air) if new or unused >2 weeks
- – Inhale slowly/deeply, hold breath 10 sec, wait 1 min between puffs
- – Rinse mouth after to prevent thrush (if with steroids)
- – Report fast heartbeat, worsening breathing
Indication for This Patient
- * Acute bronchospasm (asthma, COPD exacerbation)
- * Exercise-induced bronchospasm (prevention; 2 puffs 15-30 min prior)
- * Rescue therapy for reversible airway obstruction
Time
- * Timing: Every 4-6 hours PRN; acute: q20-30 min up to 3 doses if ordered
- * Onset: 1-5 minutes (inhalation)
- * Peak: 30-60 minutes
- * Duration: 4-6 hours