Salbutamol Drug StudyGeneric Name: Albuterol

Brand Name: Salbutamol, Proventil, Ventolin, Accuneb, airet, Novo-Salbutamol, Proventil HFA, Gen-salbutamol, Ventodisk, Ventolin HFA, Volmax, VoSpira ERClassification: Bronchodilator (therapeutic); adrenergics (pharmacologic)

Indications1. To control and prevent reversible airway obstruction caused by asthma or

chronic obstructive pulmonary disorder (COPD)2. Quick relief for bronchospasm3. For the prevention of exercise-induced bronchospasm4. Long-term control agent for patients with chronic or persistent

bronchospasm

Mechanism of ActionIt relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles. The relief from nasal congestion and bronchospasm is made possible by the following mechanism that takes place when Salbutamol is administered.

1. First, it binds to the beta2-adrenergic receptors in the airway of the smooth muscle which then leads to the activation of the adenyl cyclase and increased levels of cyclic- 3’5’-adenosine monophosphate (cAMP).

2. When cAMP increases, kinases are activated.3. Kinases inhibit the phosphorylation of myosin and decrease intracellular

calcium.4. Decreased in intracellular calcium will result to the relaxation of the smooth

muscle airways.

Contraindications1. Hypersensitivity to adrenergic amines2. Hypersensitivity to fluorocarbons

Precaution1. Cardiac disease including coronary insufficiency, a history of

stroke, coronary artery diseaseand cardiac arrhythmias2. Hypertension3. Hyperthyroidism4. Diabetes5. Glaucoma6. Geriatric patients – older individuals are at higher risk for adverse reactions

and may require lower dosage7. Pregnancy especially near term8. Lactation9. Children less than 2 years of age because safety of its use has not been

established10. Excess inhaler use which may lead to tolerance and paradoxical

bronchospasm

Side Effects and Adverse Reactions1. Nervousness2. Restlessness3. Tremor4. Headache5. Insomnia6. Chest pain7. Palpitations8. Angina9. Arrhythmias10. Hypertension11. Nausea and vomiting12. Hyperglycemia13. Hypokalemia

Route and DosagePO (Adults and Children more than 12 years): 2-4 mg 3-4 times a day or 4-8 mg of extended dose tablets twice a day.PO (Geriatric Patients): initial dose should not exceed 2 mg 3-4 times a day and may be increased carefully up to 32 mg/dayPO (Children 6-12 years old): 2 mg 3-4 times a day or 4 mg as extended-release tablets twice a day; may be carefully increased as needed but not to exceed 24 mg/dayPO (Children 2-6 years old): 0.1 mg/kg 3 times a dayInhalation (Adults and children more than 4 years of age): 2 inhalations every 4-6 hoursInhalation (Children 2-12 years old): 0.1-0.15 mg/kg/dose 3-4 times a day

Ventolin

Manufacturer GlaxoSmithKline

Distributor Zuellig

Contents Salbutamol

Indications Treatment & prevention of bronchial asthma, bronchitis, emphysema w/ associated reversible airway obstruction.Click to view Ventolin detailed prescribing infomation

Dosage Tab Adult 2 tab tid-qid. If adequate bronchodilation is not obtained, dose may be gradually increased to 4 tab tid-qid. Childn >12 yr 1-2 tab, 6-12 yr 1 tab, 2-6 yr 1/2-1 tab. All doses to be taken tid-qid. Syr Adult 10 mL. If adequate bronchodilation is not obtained, each single dose may be gradually increased to 20 mL. Childn >12 yr5-10 mL, 6-12 yr 5 mL, 2-6 yr 2.5-5 mL. All doses to be taken tid-qid. MDI Acute bronchospasm Adult 1-2 inhalations as single dose. Prevention of allergen or exercise-induced bronchospasm Adult 2 inhalations before exertion. Childn 1 inhalation. May be increased to 2 inhalations if required. Chronic therapy Adult & childnUp to 2 inhalations qid. Rotacap For inhalation w/ a Rotahaler. Relief of acute bronchospasm Adult 1-2 rotacap as single dose. Childn 1 rotacap as a single dose. Before exertion to prevent exercise-induced bronchospasm Adult 2 rotacap. Childn 1 rotacap. Chronic therapy Adult 2 rotacap tid-qid. Childn 1 rotacap tid-qid. Nebule Severe bronchospasm & status asthmaticus Adult & childn Initially 1 nebule but may be increased to 2 nebules & may be repeated up to qid by nebulizer. If prolonged delivery time (>10 min) is desirable, dilute w/ normal saline for inj.Click to view Ventolin detailed prescribing infomation

Overdosage View Ventolin overdosage for action to be taken in the event of an overdose.

Administration Should be taken on an empty stomach (Take 1 hr before or 2 hr after meals.).

Contraindications

Threatened abortion during 1st or 2nd trimesters of pregnancy. Toxemia of pregnancy, antepartum haemorrhage, placenta praevia.Click to view Ventolin detailed prescribing infomation

Special Precautions

Thyrotoxicosis. Inhaled salbutamol prep are not appropriate for managing premature labour. Acute severe asthma. Monitor serum K levels. Pulmonary edema. Monitor fluid balance, cardioresp function & ECG. Pregnancy & lactation.Click to view Ventolin detailed prescribing infomation

Adverse Drug Reactions

Fine tremor of skeletal muscle, feelings of tension, peripheral vasodilation, a compensatory small increase in heart rate, headache, transient muscle cramps, hypersensitivity reactions, potentially serious hypokalaemia, hyperactivity in childn. Paradoxical bronchospasm, mouth & throat irritation (inhalers). Tachycardia. Palpitation.View ADR Monitoring Website

Drug Interactions Nonselective β-blockers. Hypokalemia potentiated by xanthine derivatives, steroids, diuretics & by hypoxia. MAOIs.View more drug interactions with Ventolin

Combivent

Manufacturer Boehringer Ingelheim

Distributor Metro Drug

Contents Ipratropium Br 500 mcg, salbutamol 2.5 mg

Indications Management of reversible bronchospasm associated w/ obstructive airway diseases in patients who require more than a single bronchodilator.

Dosage Adult & childn >12 yr 1 vial 6-8 hrly. Childn 2-12 yr 3 drops/kg/dose (max: 2500 mcg of salbutamol) 6-8 hrly.

Contraindications

Hypertrophic obstructive cardiomyopathy or tachyarrhythmia.

Special Precautions

Insufficiently controlled DM, recent MI, severe organic heart or vascular disorders, hyperthyroidism, pheochromocytoma, risk of narrow-angle glaucoma, prostatic hypertrophy or bladder-neck obstruction; cystic fibrosis. Pregnancy & lactation.

Adverse Drug Reactions

Fine tremor of skeletal muscle; palpitations; headache, dizziness, nervousness; dryness of mouth, throat irritation; urinary retention.View ADR Monitoring Website

Drug Interactions Other β-adrenergics, anticholinergics, xanthine derivatives, glucocorticosteroids, diuretics; digoxin, β-blockers; MAOIs, TCAs, halogenated hydrocarbon anesth.View more drug interactions with Combivent

AGE PULSE RESPIRATIONS

Newborns 130 (80-180) 35 (30-80)

1 year 120 (80-140) 30 (20-40)

5-8 years 100 (75-120) 20 (15-25)

10 years 70 (50-90) 19 (15-25)

Teen 75 (50-90) 18 (15-20)

Adult 80 (60-100) 16 (12-20)

Older adult 70 (60-100) 16 (15-20)

Age Group Temperature (in ° Fahrenheit)

Newborn 97.7° F - 99.5° FInfants (1 year or less)

97.0° F - 99.0° F

Toddlers (1 - 3 years)

97.5° F - 98.6° F

Pre-schooler (3 - 6 years)

97.5° F - 98.6° F

School aged children (7 - 12 years)

97.5° F - 98.6° F

Adolescent (12 - 17 years)

97.5° F - 98.6° F

Adults (Above 18 years)

97.6° F - 99 ° F

Elders (Above 70 years)

96.8° F - 97.5° F

Duavent

Manufacturer UAP

Distributor United Lab

Contents Per 2.5 mL pulmoneb Ipratropium Br 500 mcg, salbutamol sulfate 2.5 mg. Per actuation Ipratropium Br 21 mcg, salbutamol sulfate 120 mcg

Indications Management of reversible bronchospasm associated w/ obstructive airway diseases eg bronchial asthma,COPD.Click to view Duavent detailed prescribing infomation

Dosage Pulmoneb Adult, adolescent >12 yr & elderly Treatment of acute attacks 1-2 pulmoneb. Maintenance: 1 pulmoneb 6-8 hrly. Childn 2-12 yr 3 drops/kg/dose. Max: 2.5 mg of salbutamol 6-8 hrly. MDI Adult & childn >12 yr2 actuations 6 hrly. Max: 12 actuations in 24 hr.Click to view Duavent detailed prescribing infomation

Overdosage View Duavent overdosage for action to be taken in the event of an overdose.

Contraindications

Hypertrophic obstructive cardiomyopathy or tachyarrhythmia. Hypersensitivity to soya lecithin or related food products (for MDI).Click to view Duavent detailed prescribing infomation

Warnings For additional cautionary notes to warn of the potential risk of using the medicine... click to view Duavent detailed prescribing infomation

Special Precautions

Narrow-angle glaucoma, prostatic hypertrophy or bladder-neck obstruction. Convulsive disorders, hyperthyroidism, DM. Patients unusually responsive to sympathomimetic amines. Hepatic or renal disease. Pregnancy & lactation. Paradoxical bronchospasm (for MDI only).Click to view Duavent detailed prescribing infomation

Adverse Drug Reactions

Headache, pain, influenza, chest pain; nausea. Bronchitis, dyspnea, coughing, pneumonia, bronchospasm, pharyngitis, sinusitis, rhinitis.View ADR Monitoring Website

Drug Interactions Antagonism w/ β-blockers. MAOIs or tricyclic antidepressants may potentiate the effect of salbutamol on CVS. Potential additive effects w/ anticholinergic agents. β-adrenergic agents & diuretics.View more drug interactions with Duavent