Salbutamol

Question 1

Presentation

Answer 1

5 mg in 2.5 ml polyamp

pMDI (100 mcg per actuation)

Question 2

Pharmacology

Answer 2

Synthetic beta adrenergic stimulant with primarily beta 2 effects
- Causes bronchodilatation

Question 3

Metabolism

Answer 3

• by the liver

- excreted by the kidneys

Question 4

Indications

Answer 4

Respiratory distress with suspected bronchospasm

• asthma
• severe allergic reactions
• COPD
• smoke inhalation
• oleoresin capsicum spray exposure

Question 5

Contraindications

Answer 5

NIL of significance in the above indications

Question 6

Precautions

Answer 6

Large doses of salbutamol have been reported to cause intracellular metabolic acidosis

Question 7

Route of administration

Answer 7

• nebulised

- pMDI

Question 8

Side effects

Answer 8

• sinus tachycardia

- muscle tremor (common)

Question 9

Special notes

Answer 9

• nebules/polyamps have a shelf life of one month after the wrapping is opened. The date of opening should be recorded and drug stored < 30 degrees C
• infrequently used - salbutamol IV infusion during interhospital transfer of some women in premature labour - dose must be prescribed and signed by referring medical practitioner

Question 10

Nebulisied effects

Answer 10

onset: 5-15 mins
Peak: n/a
Duration: 15-50 mins

Question 11

Asthma - Adult

Answer 11

Mild/moderate Adult

• 4-12 doses pMDI
• repeat @ 20 mins until symptoms resolve
• 4 breaths for each dose

Severe Adult

• 10 mg nebulised
• repeat 5 mg nebulised @ 5 min until symptoms resolve

Question 12

Asthma - peadiatric

Answer 12

Mild/moderate - >/= 6 yrs

• 4-12 doses pMDI
• repeat @ 20 mins until symptoms resolve
• 4 breaths for each dose

Mild/moderate - 2-5 yrs

• 2 - 6 doses pMDI
• repeat @ 20 mins until symptoms resolve
• 4 breaths for each dose

Severe - medium child

• 2.5 - 5 mg nebulised
• repeat @ 20 min until symptoms resolve

Severe - small child

• 2.5 mg nebulised
• repeat @ 20 min until symptoms resolve

Critical - all children 2-11 yrs

• 10 mg nebulised
• repeat @ 5 min until symptoms resolve

Question 13

Anaphylaxis - Bronchospasm

Answer 13

Mild/moderate Adult

• 4-12 doses pMDI
• repeat @ 20 mins until symptoms resolve
• 4 breaths for each dose

Severe Adult

• 10 mg nebulised
• repeat 5 mg nebulised @ 5 min until symptoms resolve

Mild/moderate - >/= 6 yrs

• 4-12 doses pMDI
• repeat @ 20 mins until symptoms resolve
• 4 breaths for each dose

Mild/moderate - 2-5 yrs

• 2 - 6 doses pMDI
• repeat @ 20 mins until symptoms resolve
• 4 breaths for each dose

Severe - medium child

• 2.5 - 5 mg nebulised
• repeat @ 20 min until symptoms resolve

Severe - small child

• 2.5 mg nebulised
• repeat @ 20 min until symptoms resolve

Critical - all children 2-11 yrs

• 10 mg nebulised
• repeat @ 5 min until symptoms resolve

Question 14

Exacerbation of COPD

Answer 14

Irrespective of severity

• 10 mg nebulised
• single dose only