Albuterol

General

• Type: Beta-2 agonist
• Dosage Forms: aerosol inhaler, liquid nebulized form, PO
• Common Trade Names: ProAir HFA, Proventil, Ventolin HFA, ReliOn Ventolin HFA, Accuneb

Adult Dosing

• Mild Asthma/COPD - 90mcg/inh via inhalation aerosol q4hrs PRN wheezing
• Mod/Severe Asthma/COPD exacerbation - 5mg Nebulized q15mins
• Hyperkalemia (not-FDA approved) - 15-20mg Nebulized

Pediatric Dosing

• Mild asthma exacerbation - 1-2 puffs of 90mcg/inh via inhaled aerosol q4hrs PRN wheezing
• Mod/Severe asthma exacerbation - 2.5mg nebulized q20mins
• Wheezing - 2.5mg nebulized q20mins

Special Populations

• Pregnancy Rating: C
• Lactation Risk Categories: Probably safe
• Renal Dosing
  • Adult: no adjustment
  • Pediatric: no adjustment
• Hepatic Dosing
  • Adult: not defined
  • Pediatric: not defined

Contraindications

• Allergy to class/drug
• caution if ischemic heart disease
• caution if hypertension
• caution if arrhythmias
• caution if hypokalemia
• caution if diabetes mellitus
• caution if seizure disorder
• caution if hyperthyroidism
• caution if pheochromocytoma
• caution if pregnancy
• caution if elderly patients

Adverse Reactions

Serious

• Hypersensitivity reaction
• Bronchospasm (paradoxical)
• Arrhythmias
• Elevated blood pressure
• Angina
• Hypokalemia
• Lactic acidosis
  • Due to enhancing glycogenolysis and gluconeogenesis

Common

• Tremor
• Anxiety
• Tachycardia
• Palpitations
• Headache
• Dizziness
• Nausea
• Muscle cramps
• Insomnia

Pharmacology

• Half-life: 2.7-6h
• Metabolism: liver, CYP450
• Excretion: urine primarily, feces
• Mechanism of Action: stimulates beta-2 adrenergic receptors, relaxing airway smooth muscle