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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS, INHALANTS › Selective beta-2-adrenoreceptor agonists
salbutamol
R03AC02
Forms & Strengths
- Inhaler (MDI): 100 mcg/actuation
- Nebulizer solution: 2.5 mg/2.5 mL, 5 mg/mL
- Oral syrup: 2 mg/5 mL
- Oral tablets: 2 mg, 4 mg
- Solution for injection: 0.5 mg/mL
Adult Dosing
- Bronchospasm (MDI): 100 to 200 mcg (1-2 puffs) every 4 to 6 hours as needed
- Acute bronchospasm (MDI/Nebulizer): 2.5 mg to 5 mg nebulized every 20 minutes for 3 doses, then as needed
- Prevention of exercise-induced bronchospasm: 200 mcg (2 puffs) 15 to 30 minutes before exercise
- Oral: 2 to 4 mg 3 to 4 times daily
Pediatric Dosing
- Bronchospasm (MDI, age >= 4 years): 100 to 200 mcg every 4 to 6 hours as needed
- Acute bronchospasm (Nebulizer, age >= 2 years): 0.15 mg/kg (minimum 2.5 mg) up to 5 mg every 20 minutes for 3 doses
- Prevention of exercise-induced bronchospasm (age >= 4 years): 200 mcg 15 to 30 minutes before exercise
- Oral syrup (age 2-6 years): 0.1 mg/kg up to 2 mg 3 times daily
Indications
- Treatment and prevention of bronchospasm in reversible obstructive airway disease
- Prevention of exercise-induced bronchospasm
- Management of acute severe asthma exacerbations
Mechanism of Action
- Selective beta-2 adrenergic receptor agonist in bronchial smooth muscle
- Stimulates intracellular adenyl cyclase, increasing cyclic AMP
- Results in relaxation of bronchial smooth muscle and inhibition of immediate hypersensitivity mediator release
Contraindications
- Hypersensitivity to salbutamol or any component of the formulation
- History of paradoxical bronchospasm with specific vehicle components (rare)
Adverse Reactions
- Common: Tremor, nervousness, headache, tachycardia, palpitations
- Metabolic: Hypokalemia, hyperglycemia (at high doses)
- Respiratory: Paradoxical bronchospasm, throat irritation, cough
- Cardiovascular: Arrhythmias, chest pain, hypertension or hypotension
Drug Interactions
- Non-selective beta-blockers (e.g., propranolol) antagonize bronchodilatory effects and may provoke severe bronchospasm
- Loop or thiazide diuretics may potentiate hypokalemia
- MAO inhibitors and tricyclic antidepressants potentiate vascular effects
- Other sympathomimetic agents lead to additive cardiovascular toxicity
Curated Content: Needs Vetting Before Put to Clinical Use