Generic name: salbutamol
Brand name: Proventil, Vospira ER, Accuneb, Ventodisk, Ventolin
Pregnancy Category: C
Drug Classes: Bronchodilator, Adrenergics
It relaxes the smooth muscles of the bronchioles allowing maximum passage of air. It decreases intracellular calcium which will relax the smooth muscles of the lungs by mobilizing kinase through activation of cyclic-3’5’-adenosine monophosphate (cAMP).
- Quick relief of bronchospasm induced through both exercise and physiological alterations.
- To control and prevent reversible airway obstruction caused by bronchial asthma, chronic obstructive pulmonary diseases such as emphysema and chronic bronchitis as well as other obstructive pulmonary diseases.
- Inhalation: treatment of acute attacks of bronchospasm
- Unlabeled use: Adjunct in treating moderate to severe hyperkalemia in dialysis patients; seems to lower potassium concentrations when inhaled by patients on hemodialysis
Contraindications and cautions:
- Hypersensitivity to salbutamol
- Tachyarrhythmias and tachycardia caused by digitalis intoxication
- Patients with degenerative heart diseases
- Use cautiously with patients who have diabetes as this can aggravate diabetes and ketoacidosis
- Use cautiously in elderly because they are more sensitive to CNS effects
- Tablets – 2, 4 mg
- ER tablets – 4, 8 mg
- Syrup – 2 mg/5mL
- Aerosol – 90 mcg/actuation
- Solution for inhalation – 0.021%, 0.042%, 0.083%, 0.5%
- Oral – 2 or 4 mg (1-2 tsp syrup) three to four times a day
- ER tablets – 4-8 mg every 12 hours
- Inhalation – 1 or 2 inhalation/s every 4-6 hours (1 aerosol dispenser = 90 mcg)
- Prevention of exercise-induced bronchospasms – 2 inhalations 15 minutes prior to exercise
- Oral – 2 mg three or four times a day
- Inhalation – 10-15 kg, use 1.25 mg twice or thrice a day by nebulisation; more than 15 kg, use 2.5 mg twice or thrice by nebulisation
- Oral route: onset – 30 minutes; peak – 2-2.5 hours; duration – 4-8 hours
- Inhalation route: onset – 5 minutes; peak – 1.5-2 hrs; duration – 3-8 hours
Half-life: 2-4 hours
Distribution: Crosses placenta, enters breastmilk
Side Effects and Adverse Reactions:
- CNS: Restlessness, apprehension, anxiety, fear, CNS stimulation, vertigo, headache, weakness, tremors, drowsiness
- CV: Cardiac arrhythmias, palpitations, tachycardia
- Dermatologic: Sweating, pallor, flushing
- GI: Nausea, vomiting, heartburn, unusual or bad taste in the mouth
- Respiratory: Respiratory difficulties, pulmonary edema, coughing, bronchospasm, paradoxical airway resistance with repeated, excessive use of inhalation preparations
- Check and verify with doctor’s order and Kardex.
- Observe rights in medication administration such as giving the right drug to the right patient using the right route and at the right time.
- Monitor ECG, serum electrolytes and thyroid function test results.
- Administer accurately because adverse reactions and tolerance might occur.
- Raise side rails up because client might be restless and drowsy because of this drug.
- Keep room well-lit and see to it that client has a person with him closely in case of vertigo.
- Assess pulse for rhythm.
- Provide oral care or let patient gurgle after inhalation to get rid of the unpleasant aftertaste of the inhalation.
- Auscultate lungs for presence of adventitious breath sounds that may signal pulmonary edema, airway resistance or bronchospasm.
- Inspect client’s nail bed and oral mucosa for pallor.
- Place client in position of comfort to facilitate optimum rest and sleep.
Client and Family Teaching:
- Advise patient to seek assistance in performing activities of daily living because the risk of feeling weak as well as having vertigo, drowsiness, and headache is possible.
- Educate client about avoiding stimulus that might precipitate vertigo such as too much light and too much noise both in forms of talking and loud music and television.
- Instruct client to rise slowly from bed or when changing positions from lying to sitting to standing.
- Advise client to have small frequent feedings to avoid increasing risk of vomiting and heartburn.
- Emphasize with the family and the client the importance of wiping off sweat to avoid easy breakdown of skin integrity.
- Instruct client to report palpitations and increasing difficulty of breathing.
- Encourage family to provide opportunity for the client to express his or her feelings as apprehension and anxiety are common side effects of the drug.
- Instruct client to increase oral fluid intake to facilitate drug excretion.
- Instruct client to avoid spicy and oily foods to prevent risk of developing heartburn.
- Emphasize with the client the importance of gurgling after inhalation to prevent dry mouth.