Drug Index

Salbutamol

 
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Mechanism :

Salbutamol is a beta2-adrenergic agonist. The pharmacologic effects of beta2-adrenoceptor agonist drugs are at least in part attributable to stimulation of intracellular adenyl cyclase, the enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3,5 -adenosine monophosphate (cyclic AMP). Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.


Indication :

• Relief of severe bronchospasm

• Hyperkalemia (Use as nebuliser)


Contraindications :

Patients with a history of hypersensitivity to any of its components.


Dosing :

Oral:

Use in children >2 years. 0.3-0.4 mg/kg/day PO in 3 divided doses; Maximum: 4 mg/dose.

Aerosol inhaler:

Upto 100-200 mcg single dose on demand.

Nebuliser:

>12 years: 2.5 mg as a single dose. This may be increased to 5 mg. Treatment may be repeated up to four times a day.

4 to 11 years: 2.5 mg to 5 mg up to four times a day.

<4 years: 1.25-2.5 mg 6 hourly.

Clinical efficacy of nebulised salbutamol in infants under 18 months is uncertain. As transient hypoxia may occur, supplemental oxygen therapy should be considered. Salbutamol nebuliser solution should be used undiluted. However, if a prolonged delivery time is indicated (More than 10 minutes) then dilution with sterile normal saline may be required.

Injectable:

Use in children >12 years of age.

Subcutaneous route: 500 mcg (8 mcg/kg) and repeated every four hours as required.

Intramuscular route: 500 mcg (8 mcg/kg) and repeated every four hours as required.

IV: 250 mcg (4 mcg/kg) injected slowly. If necessary the dose may be repeated.


Adverse Effect :

Dose related: hypokalemia, tremor, nervousness, mild tachycardia (most frequently seen with systemic therapy).


Interaction :

Corticosteroids: Increase the risk of hypokalemia, if high dose corticosteroids are given with high doses of salbutamol.
Diuretics: Increase the risk of hypokalemia if acetazolamide, loop diuretics, and thiazides are given with high doses of salbutamol.
Theophylline: Increases the risk of hypokalemia if given with high doses of salbutamol.
Beta-blockers: May partially or totally inhibit the effects of salbutamol.


07/14/2019 06:55:18 Salbutamol
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