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Name of Drug Generic (Brand

)

Classificati on

Available Forms

Mechanism of Action

Specific Indication

Side Effects/Adverse Effects

Contraindication s

Nursing Implications

Albuterol (AccuNeb, Airomir, NovoSalmol (CAN), Proventil, Proventil HFA, Proventil Repetabs, Salbutamol (CAN), Ventolin, Ventodisk (CAN), Ventolin HFA, Ventolin Rotocaps, Volmax, Ventolin Obstetric Injection, VoSpire ER) Pregnancy Category C

Autonomic NS Agent, Beta2 -selective adrenergic agonist (Sympathomimetic), Bronchodilat or, Antiasthmatic.

Tablets: 2, 4 mg; Extended -release Tablets: 4mg, 8mg; Syrup: 2mg/5mL Capsules for Inhalatio n: 200mcg; Sol. for Inhalatio n: 0.83%, 0.5%, 0.63mg/m L, 1.25mg/3 mL

Binds to beta2adrenergic receptors in airway smooth muscle, leading to activation of adenylcyclase & increased levels of cyclic-3', 5'adenosine monophosphate (cAMP). Increases in cAMP activate kinases, w/c inhibit the phosphorylation of myosin & decrease intracellular calcium. Decreased intracellular calcium relaxes smooth muscle airways. Relaxation of airway smooth muscle w/ subsequent bronchodilation

Relief & prevention of bronchospasm in patients w/ reversible obstructive airway disease (chronic asthma, bronchitis) Inhalation: Treatment of acute attacks of bronchospasm Prevention of exerciseinduced bronchospasm Unlabeled use: Adjunct in treating serious hyperkalemia in dialysis patients; seems to lower potassium conc’ns when inhaled by patients on hemodialysis.

CNS: Restlessness, apprehension, anxiety, fear, CNS stimulation, tremor, hyperkinesia, insomnia, drowsiness, irritability, weakness, vertigo, headache, nervousness, convulsions, hallucinations. CV: Cardiac arrhythmias, reflex tachy/bradycardia, palpitation, PVCs (rare), anginal pain, HPN, hypotension. Derm: Sweating, pallor, flushing. GI: N&V, heartburn, unusual or bad taste in mouth
GU: Increased incidence of leiomyomas of uterus when given in higher than human doses in preclinical studies. Respi: Respi difficulties, pulmonary edema, cough, bronchospasm, paradoxical airway resistance w/ repeated, excessive use of inhalation preparations.

Contraindicated w/ hypersensitivity to albuterol; tachyarrhythmias, tachycardia caused by digitalis intoxication; general anesthesia w/ halogenated hydrocarbons/ cyclopropane (sensitize the myocardium to catecholamines); unstable vasomotor system disorders; HPN; coronary insufficiency, CAD; Hx of CVA; COPD pts w/ DHD. Use cautiously w/ DM (large IV doses can aggravate diabetes & ketoacidosis); hyperthyroidism; Hx of seizure disorders; psychoneurotic individuals; labor & delivery (oral use has delayed 2nd stage of labor; parenteral use can accelerate fetal heart beat & cause hypoglycemia, hypokalemia, pulmonary edema in the mother & hypoglycemia in the neonate); lactation the elderly (more sensitive to CNS effects).

BEFORE:  Assess lung sounds, pulse, & BP before administration & during peak of medication. Note amt, color, & character of sputum produced.  Monitor pulmonary function tests before initiating therapy & periodically throughout course to determine effectiveness of medication. DURING:  Observe for paradoxical bronchospasm (wheezing). If condition occurs, withhold medication and notify physician or other health care professional immediately.  Instruct mother to take missed dose as soon as remembered, spacing remaining doses at regular intervals. Do not double doses or increase the frequency of doses. AFTER:  Inform the mother not to smoke near the child & to avoid respiratory irritants.  Advise the mother to rinse the child’s mouth w/ water after each inhalation dose to minimize dry mouth.