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

Relief of bronchospasm in patients with reversible obstructive airway disease
Prevention of exercise-induced bronchospasm
Unlabeled use: adjunct in treating serious hyperkalemia in dialysis patients; seems to lower potassium concentrations when inhaled by patients on hemodialysis

Contraindications

Hypersensitivity to albuterol;
Tachyarrhythmias
General anesthesia with halogenated hydrocarbons or cyclopropane (these sensitize
the myocardium to catecholamines)
Unstable vasomotor system disorders
Hypertension; coronary insufficiency, coronary artery disease; history of
stroke
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 �2-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