Drug Guide

Generic Name

Albuterol Sulfate

Brand Names Proventil, Ventolin, Ventolin Rotacaps, Volmax, Proventil-hfa, Accuneb, Ventolin Hfa, Proair Hfa, Vospire Er, Proair Respiclick, Proair Digihaler

Classification

Therapeutic: Bronchodilator

Pharmacological: SABA (Short-Acting Beta-Agonist)

FDA Approved Indications

Relief of bronchospasm in reversible airway obstruction in asthma and COPD.
Prevention of exercise-induced bronchospasm.

Mechanism of Action

Albuterol is a selective beta-2 adrenergic agonist that stimulates beta-2 receptors on airway smooth muscle, leading to bronchial smooth muscle relaxation and bronchodilation.

Dosage and Administration

Adult: Inhalation via metered-dose inhaler (MDI) 2 inhalations every 4 to 6 hours as needed. For nebulizer, typically 2.5 mg every 20 minutes for up to 3 doses, then as needed.

Pediatric: Inhalation via MDI or nebulizer, dose adjusted by age and weight. Usually 2 inhalations every 4 to 6 hours as needed.

Geriatric: Use with caution; start at lower end of dose range due to possible increased sensitivity and comorbidities.

Renal Impairment: Use caution; no specific dose adjustment known.

Hepatic Impairment: No specific data; use with caution.

Pharmacokinetics

Absorption: Rapid and well-absorbed after inhalation.

Distribution: Widely distributed; crosses placenta but minimal amounts enter breast milk.

Metabolism: Primarily hepatic via conjugation.

Excretion: Excreted mainly in urine as conjugated metabolites.

Half Life: 3 to 4 hours.

Contraindications

Hypersensitivity to albuterol or other beta-agonists.

Precautions

Use with caution in patients with tachyarrhythmias, hypertension, or history of cardiac disease. Should be used cautiously during pregnancy and lactation.

Adverse Reactions - Common

Tremor (Common)
Nervousness (Common)
Headache (Common)
Increased heart rate (tachycardia) (Common)
Palpitations (Common)

Adverse Reactions - Serious

Serious arrhythmias (Uncommon)
Hypersensitivity reactions including bronchospasm, rash, or urticaria (Rare)

Drug-Drug Interactions

Other beta-agonists, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, beta-blockers (may diminish effect or cause adverse effects)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, lung sounds, heart rate, and blood pressure before and during therapy.

Diagnoses:

Impaired airway clearance
Ineffective breathing pattern

Implementation: Administer via inhaler or nebulizer as prescribed. Educate patient on correct inhaler technique.

Evaluation: Assess symptom relief, peak expiratory flow rate, and adverse effects.

Patient/Family Teaching

Instruct on correct use of inhaler or nebulizer.
Advise to report chest pain, tremors, or rapid heartbeat.
Educate that use as a rescue inhaler is common for immediate relief.

Special Considerations

Black Box Warnings:

None currently for albuterol.

Genetic Factors: Genetic variations can affect beta-adrenergic responsiveness.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Severe tachycardia, hypokalemia, agitation, tremors, hypertension, hypoglycemia.

Treatment: Discontinue albuterol; provide supportive care; ensure cardiac and respiratory stabilization. Manage hypokalemia with potassium replacement if needed.

Storage and Handling

Storage: Store at room temperature away from moisture, heat, and direct sunlight.

Stability: Stable under recommended storage conditions for the duration of the shelf life.