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Salbutamol

Classification

Bronchodilator

Sympathomimetic

Indications

⚠️ EMR: Requires completion of scope expansion education. Bronchospasm

PCP: Bronchospasm in asthma and chronic obstructive pulmonary disease

ACP: Adjunctive management of hyperkalemia

Contraindications

Known hypersensitivity to salbutamol

Adult dosages

EMR: Bronchospasm

⚠️ EMR: Requires completion of scope expansion education.
5 mg nebulized; repeat doses back to back as necessary
Salbutamol and ipratropium (PCP and above ONLY) can be combined in the same nebulizer for co-administration purposes. Note: ipratropium is a single dose administration, while salbutamol may be repeated.
4 x 100 mcg via metered dose inhaler with spacer; repeat as required
- In patients without influenza-like illness (ILI), nebules are preferred. In patients with ILI or other infectious respiratory conditions, MDI and spacer use is strongly recommended.

ACP: Adjunctive management of hyperkalemia

10-20 mg via nebulizer; may require multiple doses back-to-back to reach total dose
4 x 100 mcg via metered dose inhaler with spacer; repeat as required
- In patients without influenza-like illness (ILI), nebules are preferred. In patients with ILI or other infectious respiratory conditions, MDI and spacer use is strongly recommended.

Pediatric Considerations And Dosing

Follow weight-based dosing

EMR: Bronchospasm

⚠️ EMR: Requires completion of scope expansion education.

Via nebulizer
- Age < 1 year: 2.5 mg
- Age ≥ 1 year: 5 mg
- Salbutamol and ipratropium (PCP and above ONLY) can be combined in the same nebulizer for co-administration purposes. Note: ipratropium is a single dose administration, while salbutamol may be repeated.
Via metered dose inhaler
- < 10 kg: not indicated
- 10-20 kg: 5 x 100 mcg per course; may repeat up to 3 times
- > 20 kg: 10 x 100 mcg per course; may repeat up to 3 times

How Supplied

Metered Dose Inhaler: 100 mcg/spray

Nebules: 2.5 mg in 1 mL for nebulization

Note: MDIs are single patient use only; can be left with patient when transferring care to hospital

Mechanism Of Action

Salbutamol is a selective beta-2 adrenergic agonist that produces bronchodilation and some degree of vasodilation. Some beta-1 effects can be seen, particularly at higher doses.

Pharmacokinetics

Inhaled:

Onset: 5-15 minutes
Peak: 60-90 minutes
Duration: 3-6 hours

Adverse Effects

Restlessness, weakness, vertigo, apprehensiveness
Nausea and vomiting
Tachycardia or other dysrhythmias
Paradoxical worsening of respiratory distress
Cough
Pulmonary edema
Sweating, pallor, flushing
Tremors

Overdose

Discontinue administration if signs of toxicity develop: heart rate > 150/minute (> 200/minute in pediatrics); severe tremors; ventricular arrhythmias.