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Salbutamol Drug Study

Generic Name: Albuterol Brand Name: Salbutamol, Proventil, Ventolin, Accuneb, airet, Novo-Salbutamol, Proventil HFA, Gen-salbutamol, Ventodisk, Ventolin HFA, Volmax, VoSpira ER Classification: Bronchodilator (therapeutic); adrenergics (pharmacologic) Indications 1. To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder (COPD) 2. Quick relief for bronchospasm 3. For the prevention of exercise-induced bronchospasm 4. Long-term control agent for patients with chronic or persistent bronchospasm Mechanism of Action It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles. The relief from nasal congestion and bronchospasm is made possible by the following mechanism that takes place when Salbutamol is administered. 1. First, it binds to the beta2-adrenergic receptors in the airway of the smooth muscle which then leads to the activation of the adenyl cyclase and increased levels of cyclic- 35-adenosine monophosphate (cAMP). 2. When cAMP increases, kinases are activated. 3. Kinases inhibit the phosphorylation of myosin and decrease intracellular calcium. 4. Decreased in intracellular calcium will result to the relaxation of the smooth muscle airways. Contraindications 1. Hypersensitivity to adrenergic amines 2. Hypersensitivity to fluorocarbons Precaution 1. Cardiac disease including coronary insufficiency, a history of stroke, coronary artery diseaseand cardiac arrhythmias 2. Hypertension 3. Hyperthyroidism 4. Diabetes 5. Glaucoma 6. Geriatric patients older individuals are at higher risk for adverse reactions and may require lower dosage 7. Pregnancy especially near term 8. Lactation 9. Children less than 2 years of age because safety of its use has not been established 10. Excess inhaler use which may lead to tolerance and paradoxical bronchospasm Side Effects and Adverse Reactions 1. Nervousness 2. Restlessness 3. Tremor 4. Headache 5. Insomnia 6. Chest pain 7. Palpitations 8. Angina 9. Arrhythmias 10. Hypertension 11. Nausea and vomiting 12. Hyperglycemia 13. Hypokalemia Route and Dosage PO (Adults and Children more than 12 years): 2-4 mg 3-4 times a day or 4-8 mg of extended dose tablets twice a day. PO (Geriatric Patients): initial dose should not exceed 2 mg 3-4 times a day and may be increased carefully up to 32 mg/day PO (Children 6-12 years old): 2 mg 3-4 times a day or 4 mg as extended-release tablets twice a day; may be carefully increased as needed but not to exceed 24 mg/day PO (Children 2-6 years old): 0.1 mg/kg 3 times a day Inhalation (Adults and children more than 4 years of age): 2 inhalations every 4-6 hours Inhalation (Children 2-12 years old): 0.1-0.15 mg/kg/dose 3-4 times a day Manufacturer Distributor Contents Indications Zuellig Salbutamol

Ventolin
GlaxoSmithKline

Treatment & prevention of bronchial asthma, bronchitis, emphysema w/ associated reversible airway obstruction. Click to view Ventolin detailed prescribing infomation Tab Adult 2 tab tid-qid. If adequate bronchodilation is not obtained, dose may be gradually increased to 4 tab tidqid. Childn >12 yr 1-2 tab, 6-12 yr 1 tab, 2-6 yr 1/2-1 tab. All doses to be taken tid-qid. Syr Adult 10 mL. If adequate bronchodilation is not obtained, each single dose may be gradually increased to 20 mL. Childn >12 yr5-10 mL, 6-12 yr 5 mL, 2-6 yr 2.5-5 mL. All doses to be taken tidqid. MDI Acute bronchospasm Adult 1-2 inhalations as single dose. Prevention of allergen or exercise-induced bronchospasm Adult 2 inhalations before exertion. Childn 1 inhalation. May be increased to 2 inhalations if required. Chronic therapy Adult & childnUp to 2 inhalations qid. Rotacap For inhalation w/ a Rotahaler. Relief of acute bronchospasm Adult 1-2 rotacap as single dose. Childn 1 rotacap as a single dose. Before exertion to prevent exercise-induced bronchospasm Adult 2 rotacap. Childn 1 rotacap. Chronic therapy Adult 2 rotacap tid-qid. Childn 1 rotacap tidqid. Nebule Severe bronchospasm & status asthmaticus Adult & childn Initially 1 nebule but may be increased to 2 nebules & may be repeated up to qid by nebulizer. If prolonged delivery time (>10 min) is desirable, dilute w/ normal saline for inj. Click to view Ventolin detailed prescribing infomation View Ventolin overdosage for action to be taken in the event of an overdose. Should be taken on an empty stomach (Take 1 hr before or 2 hr after meals.).

Dosage

Overdosage Administration

Contraindications Threatened abortion during 1st or 2nd trimesters of pregnancy. Toxemia of pregnancy, antepartum haemorrhage, placenta praevia. Click to view Ventolin detailed prescribing infomation Special Precautions Thyrotoxicosis. Inhaled salbutamol prep are not appropriate for managing premature labour. Acute severe asthma. Monitor serum K levels. Pulmonary edema. Monitor fluid balance, cardioresp function & ECG. Pregnancy & lactation. Click to view Ventolin detailed prescribing infomation Fine tremor of skeletal muscle, feelings of tension, peripheral vasodilation, a compensatory small increase in heart rate, headache, transient muscle cramps, hypersensitivity reactions, potentially serious hypokalaemia, hyperactivity in childn. Paradoxical bronchospasm, mouth & throat irritation (inhalers). Tachycardia. Palpitation. View ADR Monitoring Website Nonselective -blockers. Hypokalemia potentiated by xanthine derivatives, steroids, diuretics & by hypoxia. MAOIs. View more drug interactions with Ventolin

Adverse Drug Reactions

Drug Interactions

Combivent
Manufacturer Distributor Contents Indications Boehringer Ingelheim Metro Drug Ipratropium Br 500 mcg, salbutamol 2.5 mg Management of reversible bronchospasm associated w/ obstructive airway diseases in patients who require more than a single bronchodilator. Adult & childn >12 yr 1 vial 6-8 hrly. Childn 2-12 yr 3 drops/kg/dose (max: 2500 mcg of salbutamol) 6-8 hrly. Dosage Manufacturer Distributor Contents UAP United Lab

Duavent

Per 2.5 mL pulmoneb Ipratropium Br 500 mcg, salbutamol sulfate 2.5 mg. Per actuation Ipratropium Br 21 mcg, salbutamol sulfate 120 mcg Management of reversible bronchospasm associated w/ obstructive airway diseases eg bronchial asthma,COPD. Click to view Duavent detailed prescribing infomation Pulmoneb Adult, adolescent >12 yr & elderly Treatment of acute attacks 1-2 pulmoneb. Maintenance: 1 pulmoneb 6-8 hrly. Childn 2-12 yr 3 drops/kg/dose. Max: 2.5 mg of salbutamol 6-8 hrly. MDI Adult & childn >12 yr2 actuations 6 hrly. Max: 12 actuations in 24 hr. Click to view Duavent detailed prescribing infomation View Duavent overdosage for action to be taken in the event of an overdose.

Indications

Dosage

Contraindications Hypertrophic obstructive cardiomyopathy or tachyarrhythmia. Special Precautions Insufficiently controlled DM, recent MI, severe organic heart or vascular disorders, hyperthyroidism, pheochromocytoma, risk of narrow-angle glaucoma, prostatic hypertrophy or bladder-neck obstruction; cystic fibrosis. Pregnancy & lactation. Fine tremor of skeletal muscle; palpitations; headache, dizziness, nervousness; dryness of mouth, throat irritation; urinary retention. View ADR Monitoring Website Other -adrenergics, anticholinergics, xanthine derivatives, glucocorticosteroids, diuretics; digoxin, -blockers; MAOIs, TCAs, halogenated hydrocarbon anesth. View more drug interactions with Combivent

Overdosage

Adverse Drug Reactions

Drug Interactions

Contraindications Hypertrophic obstructive cardiomyopathy or tachyarrhythmia. Hypersensitivity to soya lecithin or related food products (for MDI). Click to view Duavent detailed prescribing infomation Warnings For additional cautionary notes to warn of the potential risk of using the medicine... click to view Duavent detailed prescribing infomation Narrow-angle glaucoma, prostatic hypertrophy or bladderneck obstruction. Convulsive disorders, hyperthyroidism, DM. Patients unusually responsive to sympathomimetic amines. Hepatic or renal disease. Pregnancy & lactation. Paradoxical bronchospasm (for MDI only). Click to view Duavent detailed prescribing infomation Headache, pain, influenza, chest pain; nausea. Bronchitis, dyspnea, coughing, pneumonia, bronchospasm, pharyngitis, sinusitis, rhinitis. View ADR Monitoring Website Antagonism w/ -blockers. MAOIs or tricyclic antidepressants may potentiate the effect of salbutamol on CVS. Potential additive effects w/ anticholinergic agents. -adrenergic agents & diuretics. View more drug interactions with Duavent

Special Precautions

AGE Newborns 1 year 5-8 years 10 years Teen Adult Older adult

PULSE 130 (80-180) 120 (80-140) 100 (75-120) 70 (50-90) 75 (50-90) 80 (60-100) 70 (60-100)

RESPIRATIONS 35 (30-80) 30 (20-40) 20 (15-25) 19 (15-25) 18 (15-20) 16 (12-20) 16 (15-20)

Adverse Drug Reactions

Drug Interactions

Age Group Newborn Infants (1 year or less) Toddlers (1 - 3 years) Pre-schooler (3 - 6 years) School aged children (7 - 12 years) Adolescent (12 - 17 years) Adults (Above 18 years) Elders (Above 70 years)

Temperature (in Fahrenheit)

97.7 F - 99.5 F 97.0 F - 99.0 F 97.5 F - 98.6 F 97.5 F - 98.6 F 97.5 F - 98.6 F

97.5 F - 98.6 F 97.6 F - 99 F 96.8 F - 97.5 F