Salbutamol Flashcards
What are the presentations?
Salbutamol nebules: 5mg in 2.5mL
Metered Dose Inhaler (MDI): 100mcg per puff
What is it and what does it do?
Short acting Beta 2 stimulant that causes relaxation of bronchial smooth muscle (bronchodilation).
What is the onset?
Initial effect 2-5 minutes maximum by 10 minutes
What are the indications? (7)
Bronchospasm and respiratory distress associated with wheeze:
Acute Bronchial Asthma
Bronchitis
Smoke inhalation
Severe allergic / anaphylactic reactions
Acute Pulmonary Oedema of non-cardiac origin
Salt Water Aspiration Syndrome (SCUBA divers)
Chronic Obstructive Pulmonary Disease (COPD)
What are the contraindications?
Known hypersensitivity to Salbutamol
Cardiogenic Pulmonary Oedema
Age <12 months
What are the precautions?
A spacer / MDI is the preferred route for Salbutamol administration where the patient presents with influenza like illness.
The use of a Multi Dose Inhaler (MDI) and spacer is equally as effective as nebulisation, in all asthma situations, where the patient is still able to adequately inhale.
Use of a nebuliser is recommended where the patient loses this ability.
Ambulance Transport Officers (ATO) are only authorised to use Salbutamol MDI in a known asthmatic patient with respiratory distress.
If hypoxic, nebulise Salbutamol in preference to MDI, to address both hypoxia and bronchospasm. The nebulised route also makes it possible to administer Ipratropium Bromide simultaneously.
What are the doses by nebuliser and MDI?
MDI / Space chamber as per Clinical Skill
Press once firmly on the MDI to discharge 1 puff into the spacer
Instruct the patient to take 4 breaths in and out
Repeat 1 puff at a time until 4 puffs have been taken
Repeat every 4 minutes as clinically required
Nebulised as per Clinical Skill
Use one to two nebules (5mg in 2.5ml) with 6-8L/min oxygen
Give salbutamol via continuous nebulisation in life threatening asthma
Repeat as clinically required
What are the side effects?
Muscle tremor
Tachycardia
