Salbutamol (Inhaler)

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Salbutamol Inhaler (Ventolin, ProAir) belongs to a group of medicines called short-acting ß2 agonists bronchodilators.

Salbutamol acts directly on the muscles in the walls of the airways in the lung causing the muscles to relax. This widens or opens up your airways making it easier to breathe.

Salbutamol is used by patients with asthma as it helps to relieve the symptoms of asthma such as wheezing, shortness of breath, tightness in the chest and cough. Salbutamol is also used to prevent symptoms of asthma which are brought on by exercise or allergens such as house dust mite, pollen, cigarette smoke, cat and dog fur, etc.

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Salbutamol.jpg

[edit] MECHANISM OF ACTION

Salbutamol is a short-acting Beta2 adrenergic receptor agonist with a fast onset of action (5 minutes). Beta2 receptors are the predominant adrenergic receptors in bronchial smooth muscle. The binding of Salbutamol to Beta2 adrenergic receptors in bronchial smooth muscle, activates the intracellular adenylate cyclase, an enzyme which catalyzes the conversion of adenosine triphosphate (ATP) to cyclic adenosine monophosphate (cAMP). The increase of cAMP determines:

  • Bronchodilation; Increased intracellular cyclic AMP (cAMP) increases the activation of cAMP-dependent protein kinase A, which inhibits the phosphorylation of myosin and lowers intracellular calcium levels within the muscle. Lower levels of calcium cause relaxation of the smooth muscle and therefore bronchodilatation.
  • Inhibition of the release of mast cell mediators
  • Increased mucociliary clearance

[edit] INDICATIONS

Salbutamol is used to treat breathing problems in people with asthma and similar conditions. This includes relieving and preventing exercise-induced bronchospasm and bronchospasm brought on by other “triggers” like house dust, pollen, cats, dogs and cigarette smoke.

[edit] DOSAGE

  • Salbutamol 100 micrograms:
    • Asthma: Adults and children 4 years of age and older, Two puffs every 4 to 6 hours to relieve asthma, for some patients, 1 inhalation every 4 hours may be sufficient.
    • To prevent exercise-induced bronchospasm and bronchospasm brought on by other “triggers”, Two puffs 10-15 minutes before exercise or exposure to a “trigger”.

Shake inhaler well before using it, wait at least one full minute between inhalations.

[edit] CONTRAINDICATIONS

  • Hypersensitivity to Salbutamol

[edit] WARNINGS AND PRECAUTIONS

  • Use with caution in patients with underlying cardiovascular disorders.(Monitor heart rate)
  • Use with caution in patients with convulsive disorders, hyperthyroidism, or diabetes mellitus
  • Paradoxical bronchospasm may occur and should be treated immediately with alternative therapy
  • Need for more doses of Salbutamol (Inhaler) than usual may be a sign of deterioration of asthma and requires reevaluation of treatment

[edit] INTERACTIONS

  • Beta blockers: Beta blockers (medications used to slow down the heart beat), especially nonselective ones may block bronchodilatory effects of beta-agonists and produce severe bronchospasm. Patients with asthma should not normally be treated with beta blockers.
  • Nonpotassium-sparing diuretics: As with other beta-agonists, Salbutamol (Inhaler) may produce significant hypokalemia in some patients. Co-administration of nonpotassium-sparing diuretics (such as loop diuretics or thiazide diuretics) which cause hypokalemia as a side effect, may worsen hypokalemia . Consider monitoring potassium levels

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category C (US), Salbutamol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
  • In nursing mothers, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother

[edit] SIDE EFFECTS

Adverse effects include: Headache, throat irritation, bronchitis, upper respiratory inflammation, cough, musculoskeletal pain, hypokalemia, dry mouth, palpitations, chest pain, rapid heart rate, tremor, or nervousness.

Serious adverse effects: Paradoxical bronchospasm and arrhythmia

[edit] RELATED LINKS

Asthma and chronic obstructive pulmonary disease (COPD)

[edit] BIBLIOGRAPHY

Ventolin HFA PRESCRIBING INFORMATION

[edit] REFERENCES

Asthma / Chronic obstructive pulmonary disease (COPD)
Adrenergics, inhalants Short acting β2-agonists Fenoterol (Berotec)   Levosalbutamol (Xopenex)   Salbutamol (Ventolin)   Terbutaline (Bricanyl)
Long acting β2-agonists (LABA) Arformoterol (Brovana)   Clenbuterol (Spiropent)   Formoterol (Foradil)   Salmeterol (Serevent)
Ultra long acting β2-agonists Indacaterol   Olodaterol   Vilanterol
Inhaled corticosteroids Beclomethasone (Inhaler)   Budesonide (Inhaler)   Ciclesonide (Inhaler)   Flunisolide (Inhalation suspension)   Fluticasone (Inhaler)   Mometasone (Inhaler)
Anticholinergics (Muscarinic antagonists) Aclidinium bromide   Glycopyrronium bromide   Ipratropium bromide   Oxitropium bromide (Inhalation suspension)   Tiotropium bromide
Mast cell stabilizers Cromoglicate   Nedocromil
Monoclonal anti-IgE antibody Omalizumab
Xanthine derivatives Aminophylline   Bamifylline   Doxofylline   Dyphylline   Theophylline
Eicosanoid inhibition Leukotriene antagonists Montelukast   Pranlukast   Zafirlukast
Thromboxane receptor antagonists Ramatroban   Seratrodast
Non-xanthine PDE4 inhibitors Ibudilast   Roflumilast
Combination products Corticosteroid + Long acting Beta2 agonist Beclomethasone/Formoterol (Inhaler)   Fluticasone/Salmeterol (Inhaler)   Fluticasone/Vilanterol   Mometasone/Formoterol
Corticosteroid + Short acting Beta2 agonist Beclomethasone/Salbutamol   Salbutamol/Flunisolide (Inhalation suspension)   Salbutamol/Flunisolide (Inhaler)
Short acting Beta2 agonist + Muscarinic antagonist Fenoterol/Ipratropium bromide (Inhaler)   Levosalbutamol/Ipratropium   Salbutamol/Ipratropium bromide