bronchodilator saba

Albuterol

ProAir / Proventil / Ventolin / AccuNeb

Route: inhaled (MDI) · inhaled (SVN) · IV (not FDA-approved in US)
Onset: 5–15 minutes
Duration: 4–6 hours

Mechanism of action

Selective beta-2 adrenergic agonist. Activates adenylyl cyclase → increases cAMP → smooth muscle relaxation and bronchodilation. Also stabilizes mast cells.

Dosing

Adult: MDI: 2 puffs (90 mcg/puff) q4–6h PRN; acute: up to 4–8 puffs. SVN: 2.5 mg in 3 mL NS q4–6h; acute/continuous: 10–15 mg/hr
Pediatric: SVN: 0.15 mg/kg (min 2.5 mg) q20 min × 3 for acute exacerbation, then q1–4h PRN

Continuous nebulization: 10–15 mg/hr for severe exacerbations

Indications

Acute bronchospasm (asthma, COPD exacerbation)
Exercise-induced bronchospasm (prophylaxis)
Hyperkalemia (adjunct — drives K+ intracellularly)
Bronchospasm during mechanical ventilation

Contraindications

Hypersensitivity to albuterol
Tachyarrhythmias (use with caution)

Side effects

Tachycardia
Tremor (skeletal muscle)
Hypokalemia (with high/repeated doses)
Nervousness/anxiety
Headache
Paradoxical bronchospasm (rare)
Hyperglycemia

Monitoring parameters

Heart rate and rhythm
SpO2
Serum potassium (with frequent dosing)
Blood glucose (diabetic patients)
Respiratory rate and breath sounds
Peak flow / spirometry response

Drug interactions

Beta-blockers (antagonize bronchodilation)
MAOIs and TCAs (potentiate cardiovascular effects)
Diuretics (additive hypokalemia)
Digoxin (hypokalemia increases toxicity risk)

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