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Generic Name:Albuterol

Brandname:Accuneb, Novosalmol , Proventil,Proventil HFA,Proventil Repetabs, Salbutamol, Ventolin, Ventolin Rotocaps, Volmax
Classifications:  autonomic nervous system agent; beta-adrenergic agonist (sympathomimetic); bronchodilator (respiratory smooth muscle relaxant)
Prototype:  Albuterol
Pregnancy Category:  C

Availability:
2 mg, 4 mg tablets;  4 mg, 8 mg extended release tablets;  2 mg/5 mL syrup;  200 mcg capsules for inhalation;  0.083%, 0.5% solution for inhalation.

Actions:  
Synthetic sympathomimetic amine and moderately selective beta2-adrenergic agonist with comparatively long action. Acts more prominently on beta2 receptors (particularly smooth muscles of bronchi, uterus, and vascular supply to skeletal muscles) than on beta1 (heart) receptors. Minimal or no effect on alpha-adrenergic receptors. Inhibits histamine release by mast cells.

Therapeutic effects:
Produces bronchodilation, regardless of administration route, by relaxing smooth muscles of bronchial tree. This decreases airway resistance, facilitates mucus drainage, and increases vital capacity.

Uses:
To relieve bronchospasm associated with acute or chronic asthma, bronchitis, or other reversible obstructive airway diseases. Also used to prevent exercise-induced bronchospasm.

Route & Dosage  
Bronchospasm
adult:   PO  2–4 mg 3–4 times/d, 4–8 mg sustained release 2 times/d Inhaled 1–2 inhalations q4–6h
child:   PO  2–6 y, 0.1–0.2 mg/kg t.i.d. (max: 4 mg/dose); 6–12 y, 2 mg 3–4 times/d; Inhaled6–12 y, 1–2 inhalations q4–6h

Administration

Oral
  • Do not crush extended release tablets. Scored tablets may be broken in half.
  • Note: An initial dose of 2 mg t.i.d. or q.i.d. is recommended for older adult patients.
  • Store tablets and syrup between 2°–25° C (36°–77° F) in tight, lightresistant container.
Inhalation  
  • Administer albuterol 20–30 min before concomitant beclomethasone (Vanceril) inhalation treatments to allow deeper penetration of beclomethasone into lungs, unless otherwise directed by physician.
  • Store canisters between 15°–30° C (59°–86° F) away from heat and direct sunlight.

Adverse effects

BodyWhole: Hypersensitivity reaction.
CNS: Tremor, anxiety, nervousness, restlessness , convulsions , weakness , headache, hallucinations. CV: Palpitation, hypertension, hypotension, bradycardia, reflex tachycardia.
SpecSenses:Blurred vision, dilated pupils.
GI: Nausea, vomiting.
other: Muscle cramps, hoarseness.
Diagnostic Test Interference Transient small increases in plasma glucose may occur.
interaction
drug:  With epinephrine, other sympathomimetic bronchodilators, possible additive effects; mao inhibitors, tricyclic antidepressants potentiate action on vascular system; beta-adrenergic blockers antagonize the effects of both drugs.

Nursing implications
  • Assessment & Drug Effects
  • Monitor therapeutic effectiveness which is indicated by significant subjective improvement in pulmonary function within 60–90 min after drug administration.
  • Monitor for: S&S of fine tremor in fingers, which may interfere with precision handwork; CNS stimulation, particularly in children 2–6 y,
  • Lab tests: Periodic ABGs, pulmonary functions, and pulse oximetry.
  • Consult physician about giving last albuterol dose several hours before bedtime, if drug-induced insomnia is a problem.

Patient & Family Education

  • Review directions for correct use of medication and inhaler.
  • Avoid contact of inhalation drug with eyes.
  • Do not increase number or frequency of inhalations without advice of physician.
  • Notify physician if albuterol fails to provide relief because this can signify worsening of pulmonary function and a reevaluation of condition/therapy may be indicated.
  • Note: Albuterol can cause dizziness or vertigo, take necessary precautions.
  • Do not use OTC drugs without physician approval. Many medications (e.g., cold remedies) contain drugs that may intensify albuterol action.
  • Do not breast feed while taking this drug without consulting physician
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