Class: Selective β2-Agonist
Dosage Forms. Metered Dose Inhaler (MDI): 90 (base) mcg/actuation; Tablet: 2 mg, 4 mg; Extended-Release Tablet: 4 mg, 8 mg; Syrup: 2 mg/5 mL
Common FDA Label Indication, Dosing, and Titration.
1. Asthma (acute exacerbation): Adults, 4-8 inhalations every 20 min up to 4 h, then every 1-4 h prn; Children, 4-8 inhalations every 20 min for 3 doses, then every 1-4 h prn (use mask for children <4 y of age)
2. Asthma (bronchospasm): Adults and Children, MDI, 1-2 inhalations every 4-6 h prn; Adults and Children 12 y and older, oral, 2-4 mg immediate-release tablet po tid or qid or 4-8 mg extended-release tablet po q12h; Children 6-11 y, 2 mg immediate release tablet po tid or qid or 4 mg extended-release tablet po q12h; Children 2-6 y of age, 0.1 mg/kg oral syrup po tid
3. Exercise-induced asthma, prevention: Adults, 2 inhalations 15-30 min prior to exercise; Children 4 y and older, 2 inhalations 15-30 min prior to exercise
Off-Label Uses.
1. Chronic obstructive pulmonary disease: 2 inhalations every 4-6 h prn
MOA. Albuterol is a selective β2-adrenergic agonist that produces bronchodilation, vasodilation, uterine relaxation, skeletal muscle stimulation, peripheral vasodilation, and tachycardia.
Drug Characteristics: Albuterol
Medication Safety Issues: Albuterol
Drug Interactions: Albuterol
Adverse Reactions: Albuterol
Efficacy Monitoring Parameters. Inhalation technique, resolution of asthma symptoms, and pulmonary function tests.
Toxicity Monitoring Parameters. Use alternative therapy or seek emergency treatment if paradoxical bronchospams occur.
Key Patient Counseling Points. Instruct patient on inhaler technique. Wash the mouthpiece and air dry thoroughly at least once a week (may cease to deliver medication if mouthpiece becomes blocked). Do not crush extended-release tablets. Part of the extended-release tablet may pass into stool. Contact prescriber if more albuterol is needed to control symptoms than usual as this may indicate asthma deterioration.
Clinical Pearls. The National Heart, Lung and Blood Institute asthma guidelines recommend short-acting beta-agonists (SABA) as the drug of choice for treating acute asthma symptoms and exacerbations. Do not use SABA as a component of chronic therapy without an anti-inflammatory agent.