Albuterol Inhaler Dosing for 13-Year-Old Male Weighing 72.4 kg
For a 13-year-old male weighing 72.4 kg, the recommended dose of albuterol via metered-dose inhaler (MDI) is 4-8 puffs (90 mcg/puff) every 20 minutes for 3 doses, then every 1-4 hours as needed. 1
MDI Administration Guidelines
- A spacer/holding chamber must be used when administering metered-dose inhaler treatments to ensure optimal delivery 1
- Each actuation of the albuterol MDI delivers 90 mcg per puff 1
- For acute exacerbations, 4-8 puffs should be administered every 20 minutes for 3 doses, then every 1-4 hours as needed 1
- The MDI with spacer is as effective as nebulized therapy for mild-to-moderate exacerbations when proper technique is used 1
- The actuator of the MDI should be periodically cleaned as medication may plug the orifice 1
Alternative Nebulizer Option
If nebulizer treatment is preferred or necessary:
- For a 13-year-old weighing 72.4 kg, administer 2.5-5 mg of albuterol nebulizer solution every 20 minutes for 3 doses, then 2.5-10 mg every 1-4 hours as needed 1
- For continuous nebulization in severe cases, use 0.5 mg/kg/hour up to 10-15 mg/hour (approximately 10-15 mg/hour for this patient) 1
- Dilute the solution in a minimum of 3 mL of saline for adequate nebulization 1
- Oxygen is the preferred gas source for nebulization 1
Monitoring and Safety Considerations
- Monitor for potential adverse effects including tachycardia, skeletal muscle tremor, hypokalemia, hyperglycemia, and headache 2
- Administration can be repeated and dose adjusted until desired clinical effect is achieved, unless the patient develops symptomatic tachycardia 1
- For severe exacerbations, consider adding ipratropium bromide to albuterol treatment for the first few hours 1
- Increasing use or lack of expected effect indicates diminishing asthma control and may require adjustment of maintenance therapy 2
Special Considerations for Adolescents
- At 13 years of age and 72.4 kg, this patient should receive the adult dosing regimen rather than pediatric dosing 1
- For MDI administration, proper technique is crucial - instruct the patient to exhale completely, place the mouthpiece in mouth, inhale slowly and deeply while activating the inhaler, and hold breath for 5-10 seconds 1
- If symptoms persist despite appropriate dosing, consider evaluation for other factors affecting response to therapy 2