What is the recommended dose and administration of albuterol (salbutamol) 2.5 mg/3ml for an 8 kg child?

From the Guidelines

For an 8 kg child, the recommended dose of albuterol (salbutamol) 2.5 mg/3ml solution is 0.15 mg/kg per nebulization, which equals 1.2 mg (or approximately 1.5 ml of the 2.5 mg/3ml solution), administered via nebulizer every 20 minutes for 3 doses then as needed, as indicated by the guidelines 1.

Administration Details

• The solution should be placed in the nebulizer chamber and administered with oxygen or compressed air until the medication is completely nebulized, typically taking 5-10 minutes.
• Monitor the child for tachycardia, tremors, or irritability, which are common side effects.
• The dose may be repeated as needed, with a minimum dose of 2.5 mg, according to the guidelines 1.

Key Considerations

• Always ensure proper fit of the nebulizer mask and keep the child as calm as possible during administration to maximize medication delivery to the lungs.
• Albuterol works as a beta-2 adrenergic agonist, causing bronchodilation by relaxing smooth muscles in the airways, which helps improve airflow in conditions like asthma or bronchiolitis.

Dosage Calculation

• The recommended dose of 0.15 mg/kg is based on the child's weight, which in this case is 8 kg, resulting in a dose of 1.2 mg per nebulization.
• This dose can be administered every 20 minutes for 3 doses, then as needed, with a maximum dose of 10 mg every 1-4 hours as needed, or 0.5 mg/kg/hour by continuous nebulization, as indicated by the guidelines 1.

From the Research

Administration of Albuterol for an 8 kg Child

To administer albuterol 2.5 mg/3ml to an 8 kg child, we need to consider the recommended dose and administration guidelines.

• The dose of albuterol is typically based on the child's weight, with a common dose being 0.15 mg/kg per dose 2.
• For an 8 kg child, the dose would be 0.15 mg/kg x 8 kg = 1.2 mg per dose.
• Since the available concentration is 2.5 mg/3ml, the volume of albuterol that should be administered can be calculated as (1.2 mg / 2.5 mg) x 3 ml = 1.44 ml per dose.
• However, it's essential to note that the studies provided do not directly address the administration of albuterol 2.5 mg/3ml to an 8 kg child.
• A study from 1998 mentions that children received a nebulized solution of albuterol (2.5 or 5 mg per dose, depending on body weight) every 20 minutes for three doses and then as needed 3.
• Another study from 2021 discusses the association of various weight-based doses of continuous albuterol on hospital length of stay, but does not provide specific guidance for an 8 kg child 4.

Considerations and Precautions

When administering albuterol to a child, it's crucial to consider the potential side effects and precautions:

• Hypokalemia (low potassium levels) is a possible side effect of albuterol overdose, as reported in a case series from 1994 5.
• The American Academy of Pediatrics and other medical organizations provide guidelines for the management of asthma and the use of albuterol in children, but these guidelines may not specifically address the administration of albuterol 2.5 mg/3ml to an 8 kg child.
• It's essential to consult with a healthcare professional to determine the best course of treatment and administration guidelines for an 8 kg child requiring albuterol therapy.