Proventil® HFA; Ventolin®; Ventolin®
Bronchodilator in reversible airway obstruction due to asthma or
Clinical effects on the fetus: Crosses the placenta. Tocolytic effects, fetal
tachycardia, fetal hypoglycemia secondary to maternal hyperglycemia with oral or
intravenous routes reported. Available evidence suggests safe use during
Breast-feeding/lactation: No data on crossing into breast milk or clinical
effects on the infant
Hypersensitivity to albuterol, adrenergic amines or any
Use with caution in patients with hyperthyroidism, diabetes mellitus, or
sensitivity to sympathomimetic amines; cardiovascular disorders including
coronary insufficiency or hypertension; excessive use may result in tolerance
Because of its minimal effect on beta1-receptors and its
relatively long duration of action, albuterol is a rational choice in the
elderly when a beta agonist is indicated. All patients should utilize a spacer
device when using a metered dose inhaler. Oral use should be avoided in the
elderly due to adverse effects.
Cardiovascular: Tachycardia, palpitations, pounding heartbeat
Gastrointestinal: GI upset, nausea
1% to 10%:
Cardiovascular: Flushing of face, hypertension or hypotension
Central nervous system: Nervousness, CNS stimulation, hyperactivity,
insomnia, dizziness, lightheadedness, drowsiness, headache
Gastrointestinal: Xerostomia, heartburn, vomiting, unusual taste
Neuromuscular & skeletal: Muscle cramping, tremor, weakness
Miscellaneous: Diaphoresis (increased)
<1%: Chest pain, unusual pallor, loss of appetite, paradoxical
Symptoms of overdose include hypertension, tachycardia, angina, hypokalemia
Hypokalemia and tachyarrhythmias: Prudent use of a cardioselective
beta-adrenergic blocker (eg, atenolol or metoprolol); keep in mind the potential
for induction of bronchoconstriction in an asthmatic. Dialysis has not been
shown to be of value in the treatment of an overdose with this agent.
Decreased effect: Beta-adrenergic blockers (eg, propranolol)
Increased therapeutic effect: Inhaled ipratropium may increase duration of
bronchodilation, nifedipine may increase FEV-1
Increased toxicity: Cardiovascular effects are potentiated in patients also
receiving MAO inhibitors, tricyclic antidepressants, sympathomimetic agents (eg,
amphetamine, dopamine, dobutamine), inhaled anesthetics (eg, enflurane)
Albuterol nebulizer solution is compatible with cromolyn or ipratropium
Relaxes bronchial smooth muscle by action on beta2-receptors with
little effect on heart rate
Peak effect: Oral: 2-3 hours; Nebulization/oral inhalation: Within 0.5-2
Duration of action: Oral: 4-6 hours; Nebulization/oral inhalation: 3-4 hours
Metabolism: By the liver to an inactive sulfate, with 28% appearing in the
urine as unchanged drug
Half-life: Inhalation: 3.8 hours; Oral: 3.7-5 hours
Elimination: 30% appears in urine as unchanged drug
2-6 years: 0.1-0.2 mg/kg/dose 3 times/day; maximum dose not to exceed 12
mg/day (divided doses)
6-12 years: 2 mg/dose 3-4 times/day; maximum dose not to exceed 24 mg/day
Children >12 years and Adults: 2-4 mg/dose 3-4 times/day; maximum dose not
to exceed 32 mg/day (divided doses)
Elderly: 2 mg 3-4 times/day; maximum: 8 mg 4 times/day
Inhalation MDI: 90 mcg/spray:
Children <12 years: 1-2 inhalations 4 times/day using a tube spacer
Children greater than or equal to 12 years and Adults: 1-2 inhalations every
4-6 hours; maximum: 12 inhalations/day
Exercise-induced bronchospasm: 2 inhalations 15 minutes before exercising
Inhalation: Nebulization: 0.01-0.05 mL/kg of 0.5% solution every 4-6 hours;
intensive care patients may require more frequent administration; minimum dose:
0.1 mL; maximum dose: 1 mL diluted in 1-2 mL normal saline; continuous nebulized
albuterol at 0.3 mg/kg/hour has been used safely in the treatment of severe
status asthmaticus in children; continuous nebulized doses of 3 mg/kg/hour
± 2.2 mg/kg/hour in children whose mean age was 20.7
months resulted in no cardiac toxicity; the optimal dosage for continuous
nebulization remains to be determined.
Hemodialysis: Not removed
Peritoneal dialysis: Significant drug removal is unlikely based on
Limit caffeine intake; should be administered with water 1 hour before or 2
hours after meals
Heart rate, CNS stimulation, asthma symptoms, arterial or capillary blood
gases (if patients condition warrants)
|Mental Health: Effects
on Mental Status|
May produce CNS stimulation resulting in anxiety, tremor, and
Effects on Psychiatric
Effect of propranolol may be reduced; cardiovascular effects (tachycardia,
palpitations) may be increased with MAOIs, TCAs, and
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
No effects or complications reported
Use exactly as directed. Do not use more often than recommended. Maintain
adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid
intake). You may experience nervousness, dizziness, or fatigue (use caution when
driving or engaging in hazardous activities until response to drug is known);
dry mouth, unpleasant taste, stomach upset (frequent small meals, frequent mouth
care, chewing gum, or sucking lozenges may help); or difficulty urinating
(always void before treatment). Report unresolved GI upset, dizziness or
fatigue, vision changes, chest pain or palpitations, persistent inability to
void, nervousness or insomnia, muscle cramping or tremor, or unusual cough.
Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend
to be pregnant. Consult prescriber if breast-feeding.
Self-administered nebulizer: Wash hands before and after treatment. Wash and
dry nebulizer after each treatment. Twist open the top of one unit dose vial and
squeeze contents into nebulizer reservoir. Connect nebulizer reservoir to the
mouthpiece or face-mask. Connect nebulizer to compressor. Sit in comfortable,
upright position. Place mouthpiece in your mouth or put on face mask and turn on
compressor. If face-mask is used, avoid leakage around the mask to avoid mist
getting into eyes which may cause vision problems. Breath calmly and deeply
until no more mist is formed in nebulizer (about 5 minutes). At this point
treatment is finished.
Before using, the inhaler must be shaken well; assess lung sounds, pulse, and
blood pressure before administration and during peak of medication; observe
patient for wheezing after administration, if this occurs, call
Aerosol: 90 mcg/dose (17 g) [200 doses]
Proventil®, Ventolin®: 90
mcg/dose (17 g) [200 doses]
Aerosol, chlorofluorocarbon free (Proventil® HFA): 90
mcg/dose (17 g)
Capsule for oral inhalation (Ventolin®
Rotacaps®): 200 mcg [to be used with
Rotahaler® inhalation device]
Solution, inhalation: 0.083% (3 mL); 0.5% (20 mL)
Proventil®: 0.083% (3 mL); 0.5% (20 mL)
Ventolin®: 0.5% (20 mL)
Syrup, as sulfate: 2 mg/5 mL (480 mL)
Proventil®, Ventolin®: 2 mg/5 mL
Tablet, as sulfate: 2 mg, 4 mg
Proventil®, Ventolin®: 2 mg, 4 mg
Tablet, extended release:
Proventil® Repetabs®: 4 mg
Volmax®: 4 mg, 8 mg
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"Nebulized Albuterol in Acute Childhood Asthma: Comparison of Two Doses,"
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