Salbutamol
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salbutamol albuterol bronchodilator
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Salbutamol (Albuterol)
Class
Short-Acting Beta-2 Adrenergic Agonist (SABA)
Mechanism of Action
Beta-2 receptors ko selectively stimulate karta hai bronchial smooth muscle mein → cAMP badh jaata hai → smooth muscle relax hoti hai → bronchodilation
Pharmacokinetics
| Parameter | Detail |
|---|---|
| Onset (inhaled) | 3-5 minutes |
| Peak effect | 30-120 minutes |
| Duration | 2-5 hours |
| Route | Inhaled (MDI/nebulizer), IV, oral |
Indications
- Acute asthma (first-line bronchodilator)
- COPD exacerbations
- Hyperkalemia (transcellular K+ shift - K+ ko cells ke andar push karta hai)
- Premature labor (tocolysis - less common now)
- Exercise-induced bronchospasm
Doses (Pediatric - Acute Asthma)
| Route | Weight | Dose |
|---|---|---|
| MDI (100 mcg/puff) | 1-3 yrs | 4 puffs |
| MDI | 4-6 yrs | 6 puffs |
| MDI | ≥7 yrs | 8 puffs |
| Nebulizer | <10 kg | 1.25 mg |
| Nebulizer | 10-20 kg | 2.5 mg |
| Nebulizer | >20 kg | 5 mg |
Adult nebulizer dose: 2.5-5 mg in 3 mL NS, q20 min x3 in acute severe asthma
Adverse Effects
- Tachycardia (beta-1 spillover)
- Tremor (skeletal muscle beta-2 stimulation)
- Hypokalemia (K+ cellular shift - same mechanism as hyperkalemia treatment)
- Palpitations
- Headache
- Paradoxical bronchospasm (rare)
Important Points
- Levosalbutamol (R-enantiomer) - NOT more effective or safer than salbutamol, aur zyada expensive hai
- Severe exacerbations mein ipratropium ke saath combine karo
- SABA overuse → poor asthma control ka marker hai
- Preferred delivery: MDI + spacer (nebulizer ke barabar effective, faster)
Drug Interactions / Cautions
- Beta-blockers se antagonism
- MAOIs / TCAs - cardiovascular effects badh sakte hain
- Caution in hypertension, ischemic heart disease, thyrotoxicosis
- Pregnancy: Category C (tocolytic effect)
- Tintinalli's Emergency Medicine
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