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Albuterol

Albuterol sulfate
Proventil, Ventolin

Pregnancy Category C

Drug classes

Sympathomimetic drug
Beta-2 selective adrenergic agonist
Bronchodilator
Antiasthmatic drug

Mechanism of action

In low doses, acts relatively selectively at alpha2-adrenergic receptors to cause bronchodilation and vasodilation; at higher doses, alpha2-selectivity is lost, and the drug acts at alpha1 receptors to cause typical sympathomimetic cardiac effects.

Indications

  1. Relief of bronchospasm in patients with reversible obstructive airway disease

  2. Prevention of exercise-induced bronchospasm

  3. Unlabeled use: adjunct in treating serious hyperkalemia in dialysis patients; seems to lower potassium concentrations when inhaled by patients on hemodialysis

Contraindications

  1. Hypersensitivity to albuterol;
  2. Tachyarrhythmias
  3. General anesthesia with halogenated hydrocarbons or cyclopropane (these sensitize
    the myocardium to catecholamines)
  4. Unstable vasomotor system disorders
  5. Hypertension; coronary insufficiency, coronary artery disease; history of
    stroke
  6. COPD patients who have developed degenerative heart disease

Use caution in the presence of diabetes mellitus (large IV doses can aggravate diabetes and ketoacidosis); hyperthyroidism; history of seizure disorders; psychoneurotic individuals; labor and delivery (oral use has delayed second stage of labor; parenteral use of ?-adrenergic
agonists can accelerate fetal heart beat and cause hypoglycemia, hypokalemia, pulmonary edema in the mother and hypoglycemia in the neonate); lactation.

Adverse effects

  • CNS: Restlessness, apprehension, anxiety, fear, CNS stimulation, hyperkinesia, insomnia, tremor, drowsiness, irritability, weakness, vertigo, headache
  • GI: Nausea, vomiting, heartburn, unusual or bad taste
  • CV: Cardiac arrhythmias, tachycardia, palpitations, PVCs (rare), anginal pain
  • Respiratory: Respiratory difficulties, pulmonary edema, coughing, bronchospasm, paradoxical airway resistance with repeated, excessive use of inhalation preparations
  • GU: Increased incidence of leiomyomas of uterus when given in higher than human doses in preclinical studies
  • Dermatologic: Sweating, pallor, flushing
     

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