AIM | Medications

Medications

Medication Type	Quick Relief
Brand Names	Accuneb, Proventil®, Proventil HFA, Proventil Repetabs®, Ventolin®, Ventolin HFA® Proair HFA, VoSpire ER
Generic Names	Albuterol
Description	This medication causes muscles around the airways to relax, opening them for easier breathing. It comes in tablet, oral tablet extended release, oral syrup, inhaled aerosol spray and nebulized mist treatment.
Dosage	Adults Dosing: Asthma: nebulized solution, 2.5 to 5mg every 20 min for 3 doses, then 2.5 to 10 mg every 1 to 4 hr as needed, or 10 to 15mg/hr by continuous nebulizer. Asthma: (acute asthma exacerbation) metered-dosed inhaler, 4 to 8 oral inhalations every 20 min up to 4 hr, then every 1 to 4 hr as needed. Exercise-induced asthma; Prophylaxis: metered-dose inhaler, 2 oral inhalations 15 to 30 min prior to exercise. Tablets: Asthma: syrup and tablets, 2 mg or 4 mg by mouth 3 or 4 times daily; MAX 32 mg per day in divided doses. Asthma: extended-release tablets, 4 mg or 8 mg by mouth every 12 hr; MAX 32 mg per day in divided doses. Pediatric Dosing: Asthma: (acute asthma exacerbation; NHLBI asthma guidelines) metered-dose inhaler, 4 to 8 oral inhalations every 20 min for 3 doses, then every 1 to 4 hr as needed; add mask for children less than 4 years of age Asthma: (acute asthma exacerbation; NHLBI asthma guidelines) nebulized solution, 0.15 mg/kg (minimum dose 2.5 mg) every 20 min for 3 doses then 0.15 to 0.3 mg/kg up to 10 mg every 1-4 hr as needed, or 0.5 mg/kg/hr by continuous nebulization. Asthma: syrup and tablets; 6 to 12 years of age, 2 mg by mouth 3 or 4 times daily; MAX 24 mg per day in divided doses. Asthma: syrup; 2 to 6 years of age, 0.1 mg/kg by mouth 3 times daily; MAX starting dosage 2 mg 3 times daily; MAX 12 mg per day in divided doses. Asthma: extended-release tablets; 6 yr to 12 yr, 4 mg by mouth every 12 hr; max 24 mg per day in divided doses. Exercise-induced asthma; Prophylaxis: metered-dose inhaler; 4 yr and older, 2 oral inhalations 15 to 30 min prior to exercise. Geriatric Dosing: Begin therapy with Ventolin(R) syrup or Ventolin(R) tablets at 2 mg by mouth 3 or 4 times daily; may gradually increase to a maximum of 8 mg 4 times a day (maximum total daily dose 32 mg).
Precautions	Patients should use caution when using this medication if they have cardiovascular disease (including high blood pressure), diabetes, hyperthyroidism, or do not respond well to this class of medication. -Use while on beta blockers may cause block pulmonary effects leading to severe bronchospasm; cardioselective beta blockers (i.e., atenolol, metoprolol) should be considered as an alternative, and use with caution -Use while on MAOIs or within 2 weeks of discontinuation of MAOI, proceed with extreme caution due to potential of increased action of albuterol on the vascular system -Preexisting convulsive disorders, use with caution -If used while on digoxin, proceed with caution due to occurrences of reduced serum digoxin levels -Immediate hypersensitivity is rare, but can occur and manifest as symptoms of itchiness, swelling of the throat or mouth, rash, bronchospasm, anaphylaxis, and oropharyngeal edema; potential of albuterol being contraindicated should be considered if immediate hypersensitivity occurs -May cause low potassium level, considered transient not requiring supplementation, but potentially lead to other cardiovascular effects -Preexisting ketoacidosis, use with caution -Use while on non-sparing potassium diuretics may lead to low potassium, or other cardiovascular side effects, use with caution -Paradoxical bronchospasm has been reported, often occurs with first use of new canister, can be life threatening, if occurs, discontinue immediately and use alternative treatment
Side Effects	Shakiness, nervousness, headache, increased heart rate, nausea, vomiting, hyperactivity, trouble sleeping, cough, increased appetite, increase risk of respiratory infections.
Proper Use	See instructions on how to use nebulizer and inhaler for proper delivery of medication. Wait at least one minute between puffs for best results.
Common Interactions	Epinephrine, monoamine oxidase inhibitors (MAOIs: isocarboxazid, phenelzine, tranylcypromine), tricyclic antidepressants (TCAs: amitriptyline, clomipramine, doxepin, imipramine, trimipramine), propranolol and other β-blockers (atenolol, esmolol, betaxolol, penbutolol, carteolol, bisoprolol, pindolol, metoprolol, timolol, sotalol, acebutolol, nadolol)
Proper Storage	Keep clean and dry.