EMmedonline

 SALBUTAMOL

• Salbutamol is a selective β-2 adrenoceptor agonist. At therapeutic doses it acts on the β-2 adrenoreceptors of pulmonary bronchial muscle with little or no action on the β-1 adrenoreceptors of cardiac muscle.

• Salbutamol stimulates the production of intracellular cyclic AMP, enhancing the binding of intracellular calcium to the cell membrane and endoplasmic reticulum, resulting in bronchodilation. Also enhances mucociliary clearance.

• Activation of the β-2 adreno-receptors opens ATPase channels and drives potassium from the extracellular to the intracellular space. Thus decreases extracellular pottasium and increases intracellular potassium, so decreasing the chance of arrhythmias

• Bronchodilation usually starts within 3-5 minutes with peak at 15-20 minutes. The duration of effect is approximately 4 hours.

MDI

• Acute bronchospasm : 100 or 200 mcg (1-2 puff) 3-4 times daily.

• Acute severe asthma : For asthma attacks 4-8 puffs q2-4h, may administer q20min x 3 with medical supervision .

• TRADE NAME : Ventrolin 100mcg/puff

NEBULISATION

• 2.5 – 5mg may repeat upto 4 times a day.

• Endotracheal: 0.02 mg/kg/dose 4 hourly as nebulised solution. May be repeated 2 hourly.

1. Via face mask: 0.05-0.15 mg/kg/dose 4 hourly as nebulised solution. May be repeated 2 hourly.

1. For hyperkalaemia: 4 micrograms/kg IV over 10 minutes ^.

TRADE NAME : Salbair Resp. 2.5mg/2.5 ml

SIDE EFFECTS OF INHALANTS : tachycardia, skeletal muscle tremor, headache, and irritability. At very high dose hyperglycemia, hypokalemia.

TAB

• Adult : 2-4 mg tid (max 8gm/day)

• Childrens : 100mcg/kg

Notes:

• The Driving Gas in acute asthma should be oxygen otherwise air.

• The Gas Flow Rate should be 8 litres per minute.

• The Delivery Time should be 10 minutes and any remaining solution should then be discarded .

• Drugs should be diluted with normal saline to a min. volume of 4ml and a maximum of 10 ml.