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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS FOR SYSTEMIC USE › Selective beta-2-adrenoreceptor agonists
salbutamol
R03CC02
Forms & Strengths
- Metered-dose inhaler (MDI): 100 mcg/actuation
- Nebulizer solution: 2.5 mg/2.5 mL, 5 mg/mL
- Oral syrup: 2 mg/5 mL
- Oral tablet: 2 mg, 4 mg
- Solution for injection: 0.5 mg/mL
Adult Dosing
- Bronchospasm (MDI): 1 to 2 puffs (100-200 mcg) every 4 to 6 hours as needed
- Bronchospasm (Nebulizer): 2.5 mg up to 3 to 4 times daily
- Acute severe asthma: 2.5-5 mg via nebulizer every 20 minutes as needed for the first hour
- Prevention of exercise-induced bronchospasm: 2 puffs 15-30 minutes before exercise
Pediatric Dosing
- Bronchospasm (MDI, children >= 4 years): 1 to 2 puffs every 4 to 6 hours as needed
- Bronchospasm (Nebulizer, children >= 2 years): 2.5 mg up to 3 to 4 times daily
- Bronchospasm (Nebulizer, children < 2 years): 0.15 mg/kg (minimum 1.25 mg) up to 3 to 4 times daily
- Prevention of exercise-induced bronchospasm (children >= 4 years): 2 puffs 15-30 minutes before exercise
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
- Stimulation of intracellular adenylate cyclase increases cyclic AMP
- Activates protein kinase A, leading to inhibition of myosin phosphorylation and relaxation of smooth muscle
- Inhibits release of immediate-type hypersensitivity mediators from mast cells
Contraindications
- Hypersensitivity to salbutamol (albuterol) or any component of the formulation
- History of life-threatening hypersensitivity reaction to aerosol propellant
Adverse Reactions
- Tremor
- Palpitations
- Tachycardia
- Nervousness or excitation
- Headache
- Hypokalemia (with high doses)
- Paradoxical bronchospasm (rare)
Drug Interactions
- Beta-blockers (non-selective): May antagonize the bronchodilatory effect and induce severe bronchospasm
- Loop or thiazide diuretics: May potentiate hypokalemia and ECG changes
- MAO inhibitors or tricyclic antidepressants: May potentiate cardiovascular adverse effects
- Other sympathomimetic agents: Additive cardiovascular toxicity
Curated Content: Needs Vetting Before Put to Clinical Use