PIRBUTEROL ACETATE

PIRBUTEROL ACETATE
(pir-bu'ter-ol)
Maxair
Classifications: beta-adrenergic agonist; bronchodilator;
Therapeutic: bronchodilator

Prototype: Albuterol
Pregnancy Category: C

Availability

0.2 mg aerosol

Action

Exhibits preferential effect on beta2-adrenergic receptors. Stimulation of beta2-adrenoreceptors relaxes bronchospasm and increases ciliary motion. Activates the enzyme that catalyzes the conversion of ATP to cyclic adenosine monophosphate (cAMP). Increased cAMP is associated with relaxation of bronchial smooth muscle and inhibition of the release of histamine and other mediators of hypersensitivity from mast cells.

Therapeutic Effect

Effective bronchodilator and decreases the release of mediators within the mast cell that cause a hypersensitivity reaction.

Uses

Prevention and reversal of bronchospasm associated with asthma.

Contraindications

Hypersensitivity to pirbuterol or any other adrenergic agent such as epinephrine, albuterol, or isoproterenol; pregnancy (category C), lactation, children <12 y.

Cautious Use

Heart disease, irregular heartbeat; QT prolongation, AV block; high blood pressure, history of stroke or seizures; diabetes; Parkinson's disease; thyroid disease; prostate disease; glaucoma.

Route & Dosage

Asthma
Adult/Child (>12 y): Inhaled 2 inhalations (0.4 mg) q6h (max: 12 inhalations/d)

Administration

Inhalation
  • Shake inhaler canister well immediately before using.
  • Direct patient to exhale deeply, loosely close lips around mouthpiece, then inhale slowly and deeply through mouthpiece while pressing top of canister.
  • Store at 15°–30° C (59°–86° F).

Adverse Effects (≥1%)

CNS: Nervousness, headache, dizziness, tremor. CV: Palpitations, tachycardia. GI: Dry mouth, nausea, glossitis, abdominal pain, cramps, anorexia, diarrhea, stomatitis. Other: Cough, tolerance.

Interactions

Drug: Epinephrine and other sympathomimetic bronchodilators may have additive effects. beta blockers may antagonize the effects.

Pharmacokinetics

Onset: 5 min. Peak: 30 min. Duration: 3–4 h. Metabolism: In liver. Elimination: By kidneys. Half-Life: 2–3 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor arterial blood gases and pulmonary functions periodically.
  • Monitor vital signs. Report tachycardia, palpitations, and hypertension or hypotension.

Patient & Family Education

  • Learn proper technique for using the inhaler.
  • Report palpitations, chest pain, nervousness, tremors, or other bothersome adverse effects promptly to physician.
  • Contact physician immediately if symptoms of asthma worsen or you do not respond to the usual dose.
  • Adhere rigidly to dosing directions and contact physician if breathing difficulty persists.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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