Albuterol (Inhalation)

Overview

Albuterol belongs to a group of medications called beta-agonists and is also known as salbutamol. This medicine is a short-term bronchodilator. It works by dilating the bronchi, so the lung muscles in the airways can relax and allow more air to get into the lungs. Relief is often observed in a few hours or days. The patient may stop using Albuterol once the symptoms are alleviated. This drug should not be used long term. It is not available over-the-counter and needs to be prescribed by a doctor.

Albuterol treats asthma and COPD symptoms. It comes in inhalation form. It can be available as a nebulizer solution, inhalation suspension or powder. Albuterol using the Inhalation route comes in various drug brand names in the US including Accuneb, ProAir HFA, Proair Respiclick, Proventil, Proventil HFA, ReliOn Ventolin HFA, Ventolin, Ventolin HFA.

Albuterol inhaler is taken by itself or along with steroids therapy to treat asthma and COPD, depending on the patient's case. Some asthma cases are mild, while others experience more severe bouts of asthma.

Conditions Treated with Albuterol:

• bronchospasm
• COPD
• Muscle paralysis
• Asthma

Type of Medicine:

• Beta-agonists

Side Effects

Patients may experience side effects when they use Albuterol. If the side effect's symptoms are serious or take a long time to go away, call the doctor right away. Some of the known side effects of the medicine include:

• Shaking of body that cannot be controlled
• Anxiety
• Headache
• Nauseous
• Throwing up
• Coughing
• Irritation in the throat
• Aches in back, bone or muscle

Call the doctor right away if the patient experiences serious side effects. Watch out for these severe side effects due to Albuterol:

• Rapid beating of heart or tachycardia
• Irregular heartbeat or arrhythmia
• Pain in chest
• Rashes
• Hives
• Itchiness
• Inflammation of the face, lips, eyes, tongue, throat, hands, ankles, and feet
• Having difficulty breathing
• Inability to swallow
• Hoarseness of voice

There could be other symptoms that a patient may observe after using Albuterol. Inform the doctor right away if problems or unusual symptoms arise.

If a patient cannot tolerate the side effects of Albuterol, the doctor can do the following things:

Changing the drug route

Side effects are minimized if it is taken using an inhaler, instead of taking syrup or a pill. It also matters what the patient uses to inhale the drug. If the patient utilizes a nebulizer, the side effects could lower if he or she uses a metered dose inhaler instead. If the patient still has symptoms, he or she can add a spacer to the inhaler to further minimize the side effects. The doctor can change the method of taking Albuterol to fit the patient's especially if he or she is taking another drug that may interact with Albuterol.

Changing the treatment plan

Side effects may occur depending on the amount dosage a patient takes. Albuterol can treat asthma symptoms, but it is intended for short-term asthma treatment. If a patient takes albuterol frequently, the doctor may need to reassess the treatment plan to determine if it is necessary to use it as much. Using albuterol more than three times a week or using a canister each month may require better ways to manage asthma. Also, the doctor can find ways to minimize albuterol intake, thus reducing its side effects.

Modifying the prescription

The doctor can also change the prescription by giving another short-acting bronchodilator, such as levalbuterol, to replace Albuterol to reduce the side effects. A change in prescription might help the patient experience lesser side effects.

Dosage

The dose a doctor prescribes to a patient is often based on several factors, such as:

• the disorder that needs to be treated such as COPD or asthma
• other existing medical conditions of the patient
• other medications a patient take
• medical history particularly allergies
• the patient's response to the drug
• the patient's age
• weight
• gender
• height

Aerosol Inhaler

• This is used to treat acute bronchospasm or prevention of exercise-induced asthmatic symptoms
• The standard dosage for children 12 years and above and adults is 2 inhalations in every 4 to 6 hours
• Some patients may have mild asthma and may only need 1inhalation for every 4 hours. Using Albuterol more frequently or at a larger dosage is not recommended.
• To use Albuterol for maintenance purposes or to prevent bronchospasm, using 2 inhalations for 4 times every day should be enough.
• If a patient uses the same dosage and it does not alleviate the symptoms, then it is time to reevaluate the treatment plan. This could be a sign that the asthma is getting worse and the patient needs another treatment plan to prevent a severe asthma attack. The doctor may add an anti-inflammatory drug to the prescription such as corticosteroids to be taken along with Albuterol inhaler.
• Prevention of Exercise-Induced Bronchospasm
• The standard dose for children 12 years and above as well as adults is two inhalations, at least 15 minutes before doing the exercise regimen.

Solution Used for Nebulization

• The standard starting dose for children 2 to 12 years old is 1.25 mg or 0.63 mg of AccuNeb (albuterol brand name used for nebulization) for 3 or 4 times per day.
• 1.25 mg or 0.63 mg of albuterol is equal to one vial (3 mL of 1.25 mg or 0.63 mg inhalation solution). Use nebulizer for 5 to 15 minutes.
• Children 6 to 12 years old with more serious asthma symptoms, weighing more than 88 lbs or 40 kg, or children 11 to 12 years of age may need an initial dosage of 1.25 mg of AccuNeb to attain a better response.

Albuterol inhalation, often known in brand drug name Proair HFA, Proventil HFA, Ventolin HFA, is prescribed for children 4 years old and above, as well as adults. Albuterol powder utilized for oral inhalation often known for its drug brand name Proair Respiclick is prescribed for children 12 years old and above. Albuterol solution that is used for oral inhalation is prescribed for both adults and children 2 years old and above.

Albuterol may come as a liquid solution that is inhaled by mouth with the use of a jet nebulizer. This turns the solution into a mist so that it can be inhaled.

When the albuterol inhalation is for prevention purposes of exercise-induced bronchospasm, use the medication 15 to 30 minutes before doing the exercises. Use the Albuterol for nebulizer three or four times daily, as needed.

Always follow the doctor's prescription. If the instruction is not clear, ask the doctor or pharmacist for clarification. Albuterol can prevent and control asthma, but it won't heal the condition permanently. The patient should use it as frequently as per doctor's orders.

Depending on the size of the can, the albuterol inhaler provides a maximum of 60 or 200 inhalations. The albuterol powder makes at most 200 inhalations. After using the albuterol up to its maximum inhalations, the aerosol needs to be disposed, as it may not provide the right dosage of medicine required by the patient. Discard the inhaler after using it for 13 months, after it expires or after reaching the maximum number of inhalations, whichever occurs first.

The inhaler may come with a built-in counter to determine the inhalations. Do not wait until you run out to call for a refill. If there is no counter, the number of inhalations can be determined by the number of times it is used in a day, multiplied by the number of days.

If a patient forgets a dose, get them to take their prescribed dose as soon as possible. But if it is time to use albuterol again, then skip the missed dose. Do not double the dose to make up for a missed one, as this may cause an overdose.

Keep an eye out for symptoms of overdosage, including:

• Pounding heartbeat
• Pain in chest
• Seizures
• Anxiety
• Body shaking uncontrollably
• Pain in head
• Dryness in mouth
• Getting dizzy
• Nauseous
• Extreme lethargy
• Low energy
• Having trouble staying asleep or falling asleep

If a patient overdoses and loses consciousness, call 911. If not, call the poison control center at number 1-800-222-1222.

Drug Interactions

To prevent adverse drug interactions, a patient should inform the doctor of any medications he or she is currently taking. Be thorough in the disclosure. Tell the doctor about the supplements, vitamins, prescription drugs, illegal drugs, and over-the-counter medications, dietary and herbal medications you're using.

It is especially important to disclose this due to the possible counter-interactions effects of these drugs:

• Using other short-acting sympathomimetic aerosol bronchodilators along with Albuterol would have serious adverse effects to the patient as this could compound the effects on the cardiovascular system. Albuterol is a beta-agonist that causes certain effects to the cardiovascular. Using it together with another bronchodilator may cause the patient to experience an increase in blood pressure, changes in heartbeat, and rapid pulse. It could lead to severe symptoms and cause fatal effects to the cardiovascular system. Sympathomimetic medications are often utilized in surgery or in hospital. Patients taking these medications should use an alternative therapy to alleviate bronchospasm symptoms.
• Digoxin should be used with caution together with Albuterol. Clinical trials had shown that using Albuterol could lower serum digoxin levels by 16% to 22%. This could lower the effectiveness on patients who take Digoxin on a daily basis. If a patient needs to take both digoxin and albuterol, doctors must monitor the serum digoxin levels in patients.
• Epinephrine used together with albuterol can lead to more side effects in the cardiovascular system, such as faster heart rate or higher blood pressure. If a patient has issues with high blood pressure, heart ailments or arrhythmia, the doctor may prescribe other medications that do not interact with epinephrine.
• Beta blockers can counteract the pulmonary effects of Albuterol. It blocks the effects of Albuterol in the patient's lungs and will counteract the dilating effects of a bronchodilator. This could lead to serious bronchospasm in patients with asthma, consequently, worsening the asthma rather than controlling it. In usual circumstances, asthmatic patients should not take beta-blockers, but in cases where there are no other alternatives such as prevention of myocardial infarction, it may be necessary to use beta-blockers for asthma patients as a last resort. Beta-blockers should be used with caution.
• Diuretics can cause changes in the ECG and lower the potassium levels (also called hypokalemia) in the bloodstream. Beta-agonists like albuterol can worsen the effect of diuretics. Therefore, it is important to use caution when the patient uses both albuterol and diuretics.
• Patients should be cautious about using other inhalers to relax the airways, and medicines to treat colds.
• Tricyclic Antidepressants or monoamine oxidase (MAO) inhibitors should be used with utmost caution during the treatment of albuterol or two weeks after the use of MAO because it can increase the effects of albuterol on the vascular system.

Full disclosure of all medications used is important, so the doctor can determine the correct dosage for albuterol. Also, the doctor may prescribe other medications if Albuterol is deemed to affect him or her adversely. Some patients may require constant monitoring due to their conditions, such as those with heart ailments or pregnant women.

Some patients reported getting dizzy after using Albuterol. It might be a good idea to refrain from driving or operating large machines while taking Albuterol medication.

Warnings

Patients should always carry Albuterol with them. Always refill the prescription before it runs out. Albuterol is usually taken along with other drugs such as corticosteroids, long-acting beta-agonists and bronchodilators to treat asthma. Use these medications as per the doctor's prescription. Increasing the dosage of the medications may be needed to prevent asthma attacks.

Do not take more than what is prescribed by the doctor. Follow the dosage in the prescription. Taking a smaller dosage may not treat the condition. Taking more than what is allowed can cause an overdose, which could be fatal. If a patient takes more than necessary, he or she should get emergency medical help or call the Poison hotline tel. #1-800-222-1222. Also, do not take Albuterol longer than what has been prescribed.

Just like any drug, it is important to determine first if the patient is allergic to albuterol or any of the ingredients used in the medicine. If a patient is allergic to milk powder, refrain from using the inhalation powder. If unsure of what the ingredients are, ask the pharmacist for the list.

Also, to determine if Albuterol is safe to use, the patient should inform the doctor if he or she has other conditions such as:

• Heart ailments or high blood pressure
• Arrhythmia
• Experiences seizures, particularly epilepsy
• Diabetes
• Hyperthyroidism
• Low potassium levels in the blood

Some patients may experience paradoxical bronchospasm wherein the patient's asthma worsens after taking Albuterol inhaler. This often occurs within the first use of an aerosol. This is life-threatening. If this happens, the patient should stop using the medication right away. The doctor can prescribe an alternative therapy that will produce better results such as steroids therapy.

Albuterol, like other beta-agonists, can have effects on the cardiovascular system such as rapid heartbeat, increase in blood pressure, and increase pulse rate. This is why, Albuterol is prescribed with caution on people with cardiovascular ailments like heart diseases, arrhythmia or high blood pressure. If the patient experiences cardiovascular symptoms, Albuterol may be stopped and replaced with another medication.

Pregnant women should use Albuterol with caution. This drug falls into Category C of the FDA's classification of pregnancy medications. No studies have been conducted on humans, so it cannot be ascertain if the medicine can harm the fetus. However, clinical studies done on animals show no effects on the fetus. If the patient plans to get pregnant, it is important to inform the doctor too before taking Albuterol.

Using albuterol during labor and delivery could potentially interfere with the uterine contractions. If the patient needs albuterol to relieve asthma or bronchospasm during labor, it should only be administered if the benefits far outweigh the possible risks.

The use of Albuterol during preterm labor is highly discouraged. There have been reported serious adverse effects brought about by the administration of Albuterol for preterm labor such as pulmonary edema on the mother.

Women who are nursing their babies should also take necessary precaution when taking this drug. Albuterol may pass into breast milk and cause harm to the baby. It is unsure what the effect of Albuterol is to nursing babies.

Children under 4 years old are not allowed to use Albuterol inhalation. It could not be established if it is safe or effective to use Albuterol for patients below 4 years old.

A patient should disclose to the doctor what other medications he or she is taking. The patient should also tell the doctor if he or she is taking vitamins or herbal supplements to prevent any contraindication or interaction. The doctor might need to watch for any side effects or change the drug dosage, if needed.

When using albuterol inhalation, make sure it will not get into the patient's eyes. Do not use the inhaler near a flame. This can cause an explosion if the inhaler gets too close to high heat. Familiarize with the instructions on how to use an inhaler or nebulizer. If the patient is not sure how to do it, the doctor, pharmacist or respiratory therapist should provide instructions.

Just like any aerosol, the patient needs to prime Albuterol inhaler especially if used for the first time or has not been used for more than 2 weeks. To prime it, spray 4 times away from the face before using it.

Sometimes taking the albuterol inhalation might cause breathing difficulty and wheezing. Inform the doctor immediately, if that is the case. Stop using albuterol inhalation unless the doctor says so.

Storage

Albuterol should be stored in a safe place, away from children's reach. Do not remove the medicine from its container. Keep the container close tightly at all times. Vials of nebulizer solution that are not used should be kept in the foil pouch they came in.

Always store the nebulizer solution vials at room temperature at 55 F to 77 F (15 C to 25 C) or place them in the refrigerator. Do not expose them to too much heat or moisture above 120 F as the container may burst. Refrain from storing in the bathroom where the temperatures may rise.

The inhaler should also be stored at room temperature. Do not store them in moist and excessively hot places such as the bathroom. Do not bore a hole in the aerosol canister. Do not throw it in a fire to discard it, as this may cause an explosion.

Medications that expired or not needed anymore should be discarded cautiously so pets and children cannot ingest them. Refrain from flushing these medicines in the toilet too. The best way to get rid of these medications is using a medicine take-back program. To be able to know the details about local take-back programs, contact the pharmacist or the garbage and recycling offices. If there are no take-back programs locally, visit the website of FDA's Safe Disposal of Medicines.

Always take precautionary measures to prevent the aerosol inhaler and other medicines to fall into the hands of young children. Put them in places that are out of children's reach. These medications can cause poisoning and could be fatal if not stored or disposed properly. Always put medicines in a safe place and lock the safety caps tightly.

Summary

Albuterol is an effective short-acting bronchodilator that is effective in reducing and treating symptoms of bronchospasm or the narrowing of airways in patients particularly those with asthma and COPD patients. It helps by relaxing the airways, allowing air to get into the lungs. The patient can breathe better and easier, as a result. It treats bronchospasm on people with reversible obstructive airway condition.

Albuterol can be used to either relieve bronchospasm symptoms or prevent exercise-induced bronchospasm. It cannot cure the condition but can temporarily alleviate the symptoms. To prevent bronchospasm during exercise, it is usually taken at least 15 minutes before starting the regimen.

Albuterol treats asthma symptoms particularly shortness of breath and wheezing by opening the airways. It provides short-term and fast relief to airway obstructions. It works within hours. Sometimes, the medication may take days to take effect. This drug is not intended to be used long term. The medication can be used alone or with other drugs such as anti-inflammatory like corticosteroids. This depends on the case of the patient.

Other uses of Albuterol include using inhaled albuterol to treat or recover from muscle paralysis. Some patients experience sudden paralysis or inability to move. When this happens, inhaled albuterol could help. However, it is not advisable to self-administer the drug. Always seek medical advice or help from a doctor. Also, find out possible risks that might be associated with using this medication to treat paralysis.

Albuterol belongs to a group of drugs called beta-agonists. Being a beta-agonist it has effects on the cardiovascular functions of the patient. This is why it is recommended to use the medication with caution in patients with cardiovascular diseases such as arrhythmia, high blood pressure, tachycardia and heart ailment.

Albuterol may interact with certain medications. It could also worsen certain illnesses particularly cardiovascular disorders, if taken along with certain medications. This is why it is important for the patient to disclose to the doctor what conditions he or she may have and what medications he or she is taking. This is to ensure that the medication can be administered safely and effectively. It can also prevent serious side effects from occurring.

Albuterol may cause some mild to severe side effects to the patient. The most common side effects include nervousness, uncontrollable shaking of the body and rapid heartbeat. To avoid possible side effects, the doctor should come up with the best treatment plan that is suitable to the patient's case.

Albuterol can alleviate asthma symptoms effectively. The drug often relieves asthma in hours or days. If the symptoms, do not go away, this could mean that the asthma is getting worse. The patient needs to be reassessed by the doctor and the treatment plan needs to be reevaluated. Anti-inflammatory drugs such as corticosteroids may be added to the treatment plan together with albuterol to control asthma.

Albuterol is administered by inhaling it. The patient should follow the doctor's instructions and prescription when using it. The dosage should not be increased or decreased without the doctor's knowledge. Also, it should not be used frequently or longer than what is prescribed. Overdosage may cause fatal effects.