What is Salbutamol: How to use, Dosage, Side effects

What is Salbutamol: How to use, Dosage, Side effects

What is Salbutamol

 

The active component of Salbutamol is albuterol sulfate, USP, the racemic form of albuterol and a relatively selective beta2-adrenergic bronchodilator.

Salbutamol is a pressurized metered-dose aerosol unit fitted with a counter. Salbutamol is intended for oral inhalation only. Each unit contains a microcrystalline suspension of albuterol sulfate in propellant HFA-134a. It contains no other excipients. 

Chemical name: α1-[(tert-butylamino) methyl]-4-hydroxy-m-xylene-α, α′-diol sulfate

Color: White crystalline

Molecular weight: 576.7

Emperical formula: (C13H21NO3)2•H2SO4

Soluble in: Water, Ethanol

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How to use Salbutamol

Shake the inhaler well immediately before each spray. Follow the instructions below. If you have any questions, ask your doctor or pharmacist.

  1. Remove the cap from the mouthpiece of the actuator:

the strap on the cap will stay attached to the actuator. Inspect the inhaler mouthpiece for the presence of foreign objects before each use, especially if the strap is no longer attached to the actuator or if the cap is not being used to cover the mouthpiece. Make sure the canister is fully and firmly inserted into the actuator. Shake the inhaler well immediately before each spray.

2. Breathe out fully through your mouth:

expelling as much air from your lungs as possible. Place the mouthpiece fully into your mouth, holding the inhaler with the mouthpiece down and closing your lips around it.

3. While breathing in deeply and slowly through your mouth:

Fully depress the top of the metal canister with your index finger. Immediately after the spray is delivered, release your finger from the canister. When you have breathed in fully, remove the inhaler from your mouth and close your mouth.

4. Hold your breath as long as possible

up to 10 seconds, then breathe normally.

5. If your doctor has prescribed additional sprays

wait 1 minute and shake the inhaler again. Repeat steps 2 through 4.

6. Replace the cap on the mouthpiece after each use.

7. Because of the difference in propellants, you may notice a slightly different taste or feel of the spray in your mouth with Salbutamol than you are used to with other albuterol inhalation aerosol products.

8. Never immerse the canister in water to determine the amount of drug left in the canister.

9. Discard the inhaler when the counter reads 000

Dosage of Salbutamol

•For oral inhalation only.

•Treatment or prevention of bronchospasm in adults and children aged 4 years and older: 2 inhalations every 4 to 6 hours. For some patients, 1 inhalation every 4 hours may be sufficient.

•Prevention of exercise-induced bronchospasm in adults and children aged 4 years and older: 2 inhalations 15 to 30 minutes before exercise.

•Priming information: Prime Salbutamol before using for the first time, when the inhaler has not been used for more than 2 weeks, or when the inhaler has been dropped. To prime Salbutamol, release 4 sprays into the air away from the face, shaking well before each spray.

•Cleaning information: At least once a week, wash the actuator with warm water and let it air-dry completely.

Overdosage of Salbutamol

The expected signs and symptoms with overdosage of albuterol are those of excessive beta-adrenergic stimulation and/or occurrence or exaggeration of any of the signs and symptoms of beta-adrenergic stimulation (e.g., seizures, angina, hypertension or hypotension, tachycardia with rates up to 200 beats/min, arrhythmias, nervousness, headache, tremor, muscle cramps, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, insomnia, hyperglycemia, hypokalemia, metabolic acidosis).

As with all inhaled sympathomimetic medicines, cardiac arrest and even death may be associated with an overdose of Salbutamol Inhalation Aerosol. Treatment consists of discontinuation of Salbutamol together with appropriate symptomatic therapy. The judicious use of a cardioselective beta-receptor blocker may be considered, bearing in mind that such medication can produce bronchospasm. There is insufficient evidence to determine if dialysis is beneficial for overdosage of Salbutamol.

Salbutamol

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Side effects of Salbutamol

Like all medicines, Salbutamol can cause side effects, although not everybody gets them.

Stop taking Salbutamol tablets and contact your doctor at once if you experience:

• an allergic reaction such as swelling of the face, lips, throat or tongue, pale or red irregular raised patches with severe itching (hives), difficulty breathing, low blood pressure, collapse

• chest, jaw or shoulder pain (which may be accompanied with shortness of breath, feeling or being sick)

Tell your doctor if you notice any of the following effects or if you notice any not listed:

• increased lactic acid in the body: rapid breathing, being sick, stomach pain.

• low blood potassium: muscle twitching or weakness, an irregular heart beat.

• other: headaches, increased blood sugar levels, slight shaking (usually of the hands), a tense feeling, widening of blood vessels which can cause an increase in heart function and heart rate, an irregular heart beat, muscle spasm, fluid on the lungs. An increase in the amount of acid in the body (ketoacidosis) may occur in diabetics.

Do not take Salbutamol if you:

• are allergic (hypersensitive) to salbutamol or any other ingredients in Salbutamol tablets

• have threatened abortion (potential miscarriage) during the first six months of pregnancy

• are taking beta-blockers such as propranolol

Drug interactions to Salbutamol

Other short-acting sympathomimetic aerosol bronchodilators should not be used concomitantly with albuterol. If additional adrenergic drugs are to be administered by any route, they should be used with caution to avoid deleterious cardiovascular effects.

 Beta-Adrenergic Receptor Blocking Agents

Beta-blockers not only block the pulmonary effect of beta-agonists, such as Salbutanol, but may also produce severe bronchospasm in patients with asthma. Therefore, patients with asthma should not normally be treated with beta-blockers. However, under certain circumstances, there may be no acceptable alternatives to the use of beta-adrenergic blocking agents for these patients; cardioselective beta-blockers could be considered, although they should be administered with caution.

Non–Potassium-Sparing Diuretics

The ECG changes and/or hypokalemia that may result from the administration of non–

potassium-sparing diuretics (such as loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. Although the clinical significance of these effects is not known, caution is advised in the coadministration of Salbutanol with non–potassium-sparing diuretics.

Digoxin

Mean decreases of 16% to 22% in serum digoxin levels were demonstrated after single-dose intravenous and oral administration of albuterol, respectively, to normal volunteers who had received digoxin for 10 days. The clinical relevance of these findings for patients with obstructive airway disease who are receiving inhaled albuterol and digoxin on a chronic basis is unclear. Nevertheless, it would be prudent to carefully evaluate the serum digoxin levels in patients who are currently receiving digoxin and albuterol.

Monoamine Oxidase Inhibitors and Tricyclic Antidepressants

Salbutanol should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants, or within 2 weeks of discontinuation of such agents, because the action of albuterol on the vascular system may be potentiated.

Warnings of Salbutamol

Life-threatening paradoxical bronchospasm may occur. Discontinue Salbutanol immediately and institute alternative therapy.

•Need for more doses of Salbutanol than usual may be a sign of deterioration of asthma and requires reevaluation of treatment.

•Salbutanol is not a substitute for corticosteroids.

•Cardiovascular effects may occur. Use with caution in patients sensitive to sympathomimetic drugs and patients with cardiovascular or convulsive disorders.

•Excessive use may be fatal. Do not exceed recommended dose.

•Immediate hypersensitivity reactions may occur. Discontinue Salbutanol immediately.

•Hypokalemia and changes in blood glucose may occur.

Salbutamol

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