Albuterol: Comprehensive Guide
Drug Name
Generic Name
Albuterol
Brand Name(s)
Pakistan: Ventolin, Proventil
India: Asthalin, Ventorlin
US: ProAir, Ventolin, Proventil
UK: Ventolin
Pharmacological Class
Class
Bronchodilator
Subclass
Short-Acting Beta-2 Agonist (SABA)
Mechanism of Action
Albuterol works by stimulating beta-2 adrenergic receptors in the bronchial smooth muscle, leading to relaxation and bronchodilation. This helps to relieve bronchospasm and improve airflow in conditions such as asthma and chronic obstructive pulmonary disease (COPD).
Indications
Primary Indications
- Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
Off-label Uses
- Hyperkalemia (adjunctive treatment)
- Exercise-induced bronchospasm prophylaxis
Dosage and Administration
Standard Dosage
For adults and children over 4 years old, the typical dosage is 2.5 mg to 5 mg via nebulizer or 90 mcg per puff using an inhaler, taken every 4 to 6 hours as needed.
Route of Administration
Inhalation (via nebulizer or metered-dose inhaler)
Special Populations
Pediatric: Adjust dose according to age and weight.
Geriatric: Start at lower end of dosing range due to increased sensitivity.
Pharmacokinetics
Absorption
Albuterol is rapidly absorbed following inhalation.
Distribution
Widely distributed throughout the body with minimal protein binding.
Metabolism
Metabolized in the liver to inactive compounds.
Excretion
Excreted primarily in urine as unchanged drug and metabolites.
Half-life
Approximately 5-6 hours.
Contraindications
Albuterol is contraindicated in patients with a history of hypersensitivity to albuterol or any of its components. It should be used with caution in patients with cardiovascular disorders, hyperthyroidism, or diabetes mellitus.
Warnings and Precautions
Excessive use of albuterol can result in paradoxical bronchospasm and may lead to significant cardiovascular effects such as increased heart rate, blood pressure changes, and arrhythmias. Patients should be advised to use the medication as prescribed and report any unusual symptoms to their healthcare provider.
Side Effects
Common Side Effects
- Tremor
- Headache
- Palpitations
- Nervousness
- Dizziness
- Sore throat
Serious Side Effects
- Paradoxical bronchospasm
- Chest pain
- Severe allergic reactions
- Arrhythmias
- Hypokalemia
Drug Interactions
Major Interactions
- Beta-blockers (may decrease effectiveness of albuterol)
- MAO inhibitors (may increase cardiovascular effects)
Moderate Interactions
- Diuretics (may enhance hypokalemic effect)
- Digoxin (may decrease serum digoxin levels)
Minor Interactions
- Tricyclic antidepressants (may increase cardiovascular effects)
Pregnancy and Lactation
Pregnancy Category
Category C: Risk cannot be ruled out. Albuterol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Breastfeeding Considerations
Albuterol is excreted in breast milk. Caution should be exercised when administered to a nursing woman, considering the benefits of breastfeeding and the potential risks to the infant.
Patient Counseling Information
Key Points for Patients
- Inform patients about the correct use of inhalers or nebulizers.
- Advise patients to report any increase in frequency or severity of asthma symptoms.
- Discuss the potential side effects and interactions with other medications.
- Emphasize the importance of adhering to prescribed dosage and usage instructions.