What is the oral dose of Salbutamol (albuterol) for a 31 kg patient, given a concentration of 2 mg/5 ml?

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Oral Salbutamol (Albuterol) Dosing for a 31 kg Child

For a 31 kg child, the appropriate oral dose of salbutamol (albuterol) is 4.65 mg (11.6 ml of 2 mg/5 ml solution) four times daily.

Dosing Calculation

  • The American Academy of Pediatrics recommends a weight-based dosing approach for oral salbutamol in children 1
  • The standard pediatric oral dose is 0.15 mg/kg per dose 1
  • For a 31 kg child: 0.15 mg/kg × 31 kg = 4.65 mg per dose 1
  • Using the 2 mg/5 ml concentration: 4.65 mg × (5 ml/2 mg) = 11.6 ml per dose 1

Administration Schedule

  • Administer four times daily for maintenance therapy 2
  • Peak effect of syrup formulation occurs at approximately 4 hours and lasts for 6 hours 2
  • The syrup formulation provides better bioavailability compared to tablet form 2

Clinical Considerations

  • Oral salbutamol should be used for maintenance therapy rather than acute exacerbations 3
  • For acute exacerbations, inhaled salbutamol via nebulizer or metered-dose inhaler is preferred due to faster onset of action and fewer systemic side effects 3
  • The oral bioavailability of salbutamol is approximately 10-20%, which explains the higher dosing requirement compared to inhaled formulations 4

Monitoring and Side Effects

  • Monitor for common side effects including:

    • Tachycardia and palpitations 4
    • Skeletal muscle tremor 4
    • Hypokalemia 4
    • Hyperglycemia 4
    • Nervousness or restlessness 4
  • Side effects are more common with oral administration compared to inhaled routes due to higher systemic absorption 4

Important Considerations

  • If the child is experiencing an acute exacerbation, consider switching to nebulized therapy at 0.15 mg/kg (minimum 2.5 mg) every 20 minutes for up to 3 doses 1
  • For children with persistent asthma requiring regular bronchodilator therapy, controller medications should be considered rather than relying solely on oral salbutamol 3
  • Regular use of salbutamol exceeding twice weekly for symptom control indicates poor asthma control and need for controller medication adjustment 5

References

Guideline

Albuterol Nebulizer Dosing Guidelines for Pediatric Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Levalbuterol Dosage and Administration Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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