Accuneb, Novosalmol , Pro-Air HFA, Proventil, Proventil HFA, Ventolin, Ventolin HFA, VoSpire ER
Classifications: bronchodilator (respiratory smooth muscle relaxant); beta-adrenergic agonist;
Therapeutic:bronchodilator (respiratory smooth muscle relaxant)
Pregnancy Category: C
2 mg, 4 mg tablets; 4 mg, 8 mg, extended-release tablets; 2 mg/5 mL syrup; 200 mcg capsules for inhalation; 0.083%, 0.5% solution for inhalation
Moderately selective beta2-adrenergic agonist with comparatively long action. Acts prominently on beta2 receptors (particularly smooth muscles of trachea, bronchi, uterus, and vascular supply to skeletal muscles). Inhibits
histamine release by mast cells. Produces bronchodilation by relaxing smooth muscles of bronchial tree.
Bronchodilation decreases airway resistance, facilitates mucous drainage, and increases vital capacity.
To relieve bronchospasm associated with acute or chronic asthma, bronchitis, or other reversible obstructive airway diseases.
Also used to prevent exercise-induced bronchospasm.
Adjunct in treatment of refractory heart failure and to stimulate intracellular transport of potassium in hyperkalemic familial
Albuterol or levalbuterol hypersensitivity; congenital long QT syndrome; pregnancy (category C). Use of oral syrup in children
Cardiovascular disease, renal impairment, hypertension, hyperthyroidism, diabetes mellitus, elderly, history of seizures;
hypersensitivity to sympathomimetic amines or to fluorocarbon propellant used in inhalation aerosols.
Route & Dosage
Adult: PO 24 mg 34 times/d, 48 mg sustained release 2 times/d Inhaled 12 inhalations q46h
Child: PO 26 y, 0.10.2 mg/kg t.i.d. (max: 4 mg/dose); 612 y, 2 mg 34 times/d Inhaled 612 y, 12 inhalations q46h
- Do not crush extended release tablets. Scored tablets may be broken in half.
- Note: An initial dose of 2 mg t.i.d. or q.i.d. is recommended for older adult patients.
- Store tablets and syrup between 2°25° C (36°77° F) in tight, light-resistant container.
- Administer albuterol 2030 min before concomitant beclomethasone (Vanceril) inhalation treatments to allow deeper penetration
of beclomethasone into lungs, unless otherwise directed by physician.
- Store canisters between 15°30° C (59°86° F) away from heat and direct sunlight.
Adverse Effects (≥1%) Body as a Whole:
Hypersensitivity reaction. CNS: Tremor,
anxiety, nervousness, restlessness, convulsions, weakness, headache, hallucinations. CV:
Palpitation, hypertension, hypotension, bradycardia, reflex tachycardia. Special Senses:
Blurred vision, dilated pupils. GI:
Nausea, vomiting. Other:
Muscle cramps, hoarseness.
Diagnostic Test Interference
Transient small increases in plasma glucose may occur.
other sympathomimetic bronchodilators
, possible additive effects; mao inhibitors
, tricyclic antidepressants
potentiate action on vascular system; beta-adrenergic blockers
antagonize the effects of both drugs.
Inhaled: 515 min; PO 30 min. Peak:
Inhaled: 0.52 h; PO 2.5 h. Duration:
Inhaled: 36 h; PO 46 h (812 h with sustained release). Metabolism:
In liver by CYP3A4; may cross the placenta. Elimination:
76% of dose eliminated in urine in 3 d. Half-Life:
Assessment & Drug Effects
- Monitor therapeutic effectiveness which is indicated by significant subjective improvement in pulmonary function within
6090 min after drug administration.
- Monitor for: S&S of fine tremor in fingers, which may interfere with precision handwork; CNS stimulation, particularly in
children 26 y, (hyperactivity, excitement, nervousness, insomnia), tachycardia, GI symptoms. Report promptly to physician.
- Lab tests: Periodic ABGs, pulmonary functions, and pulse oximetry.
- Consult physician about giving last albuterol dose several hours before bedtime, if drug-induced insomnia is a problem.
Patient & Family Education
- Review directions for correct use of medication and inhaler (see ADMINISTRATION).
- Avoid contact of inhalation drug with eyes.
- Do not increase number or frequency of inhalations without advice of physician.
- Notify physician if albuterol fails to provide relief because this can signify worsening of pulmonary function and a reevaluation
of condition/therapy may be indicated.
- Note: Albuterol can cause dizziness or vertigo; take necessary precautions.
- Do not use OTC drugs without physician approval. Many medications (e.g., cold remedies) contain drugs that may intensify