Salbutamol
Classification
Bronchodilator
Sympathomimetic
Indications
PCP: Bronchospasm
ACP: Adjunctive management of hyperkalemia
Contraindications
- Known hypersensitivity to salbutamol
- Hemodynamically significant tachycardia
Adult dosages
PCP: Bronchospasm
- 5 mg nebulized. Repeat doses back to back as necessary.
- NB: nebulized medication therapy not authorized during Covid.
- 4 x 100 mcg via metered dose inhaler. Repeat as required.
ACP: Adjunctive management of hyperkalemia
- 10-20 mg via nebulizer. May require multiple doses back-to-back to reach total dose.
- NB: nebulized medication therapy not authorized during Covid.
Pediatric Considerations And Dosing
PCP: Bronchospasm
- Via nebulizer
- Age < 1 year: 2.5 mg
- Age > 1 year: 5 mg
- NB: nebulized medication therapy not authorized during Covid
- Via metered dose inhaler:
- < 10 kg: not indicated
- < 20 kg: 5 x 100 mcg per round. May repeat up to 3 times.
- > 20 kg: 10 x 100 mcg per round. May repeat up to 3 times.
Mechanism Of Action
Salbutamol is a selective beta-2 adrenergic agonist that produces bronchodilation and some degree of vasodilation. Some beta-1 effects can be seen, particularly at higher doses.
Pharmocokinetics
Inhaled:
- Onset: 5 minutes
- Peak: 1.5-2 hours
- Half-life: 3.8 hours
- Duration: 3-8 hours
Adverse Effects
- Restlessness, weakness, vertigo, apprehensiveness
- Nausea and vomiting
- Tachycardia or other dysrhythmias
- Paradoxical worsening of respiratory distress
- Cough
- Pulmonary edema
- Sweating, pallor, flushing
- Tremors
Overdose
Discontinue administration if signs of toxicity are developing: heart rates > 150/minute in adults (> 200/minute in children), or if severe tremors, or ventricular arrhythmias develop.