From the Guidelines
Salbutamol is a short-acting beta-2 adrenergic receptor agonist medication primarily used to treat asthma and chronic obstructive pulmonary disease (COPD), with a standard adult dose of 2.5-5 mg via nebulizer or 1-2 puffs (100-200 micrograms) via inhaler every 4-6 hours as needed for symptom relief, as recommended by the most recent guidelines 1.
Key Points
- Salbutamol works by relaxing the smooth muscles in the airways, which helps to open them up and make breathing easier.
- The medication begins working within minutes and effects last for 4-6 hours.
- Common side effects include tremors, headache, increased heart rate, and nervousness.
- Patients should rinse their mouth after using the inhaler to prevent oral thrush and use a spacer device if coordination is difficult.
- Salbutamol should not replace controller medications for chronic conditions but serves as a rescue medication for acute symptoms.
- Overuse (more than 2 canisters per month) indicates poor disease control and warrants medical review.
Administration
- For acute asthma attacks, up to 4-8 puffs may be used, but medical attention should be sought if relief isn't achieved.
- Nebulized treatment with 2.5-5 mg of salbutamol or 5-10 mg of terbutaline can be used for acute exacerbations of COPD, with the option to add anticholinergic treatment such as 500 mg ipratropium bromide for additional benefit 1.
Important Considerations
- Increasing use of SABA treatment or the use of SABA >2 days a week for symptom relief (not prevention of EIB) generally indicates inadequate asthma control and the need for initiating or intensifying anti-inflammatory therapy 1.
- Regularly scheduled, daily, chronic use of SABA is not recommended.
From the FDA Drug Label
Albuterol sulfate inhalation aerosol is indicated in adults and children 4 years of age and older for the treatment or prevention of bronchospasm with reversible obstructive airway disease and for the prevention of exercise-induced bronchospasm. The use of Salbutamol (Albuterol) is for the treatment or prevention of bronchospasm with reversible obstructive airway disease and for the prevention of exercise-induced bronchospasm in adults and children 4 years of age and older 2.
- Key uses:
- Treatment of bronchospasm
- Prevention of bronchospasm
- Prevention of exercise-induced bronchospasm Note that the safety and effectiveness of Salbutamol (Albuterol) have not been established in pediatric patients below the age of 4 years 2.
From the Research
Use of Salbutamol (Albuterol)
- Salbutamol is used as a reliever of asthma symptoms, particularly in the management of acute asthma attacks 3, 4, 5.
- It is a short-acting beta-2-agonist (SABA) that provides bronchodilation by relaxing bronchial smooth muscle contraction 5.
- Salbutamol can be administered through various routes, including inhalation, orally, intravenously, intramuscularly, and subcutaneously, each with different pharmacokinetic parameters and efficacy 5.
- In cases of severe persistent asthma, salbutamol may be used in combination with an inhaled corticosteroid, such as beclometasone, or possibly an oral corticosteroid 4.
- Combination therapy of salbutamol with ipratropium bromide has been shown to provide greater bronchodilatation than salbutamol alone in acute severe asthma 6, 7.
Administration and Efficacy
- The efficacy of salbutamol varies depending on the route of administration and the individual patient's response 5.
- Studies have demonstrated that combination therapy with salbutamol and ipratropium bromide can improve peak expiratory flow rates and reduce hospital admission rates in patients with acute bronchospasm 6, 7.
- However, the direction of outcome measures may favor combination therapy, but not always statistically significant 7.