Albuterol is a short-acting beta-2 adrenergic agonist (SABA) bronchodilator commonly prescribed for treating and preventing bronchospasm in patients with reversible obstructive airway disease. It’s one of the most frequently used medications for asthma and COPD management in emergency and outpatient settings.
Generic names: Albuterol, Salbutamol (outside the US)
Brand names: Ventolin HFA, ProAir HFA, Proventil HFA, AccuNeb, VoSpire ER
Pharmacologic class: Beta-2 adrenergic agonist
Therapeutic class: Bronchodilator
Mechanism of action: Albuterol selectively stimulates beta-2 adrenergic receptors in bronchial smooth muscle, causing relaxation and bronchodilation. This action helps open airways and improve breathing in patients with respiratory conditions.
Indications for use:
- Prevention and treatment of bronchospasm in patients with reversible obstructive airway disease
- Prevention of exercise-induced bronchospasm
- Acute asthma exacerbations
- COPD symptom management
- Hyperkalemia (in some cases)
Precautions and contraindications:
- Hypersensitivity to albuterol
- Caution in patients with cardiovascular disorders
- Patients with diabetes (may affect blood glucose)
- Patients with thyroid disorders
- Seizure disorders
- Pregnancy category C
Drug Interactions
- Beta-blockers can reduce the effectiveness
- MAO inhibitors and tricyclic antidepressants may potentiate cardiovascular effects
- Diuretics may enhance hypokalemia
- Other sympathomimetic agents may increase adverse effects
- Digoxin may increase the risk of arrhythmias
Adverse Effects
- Tremors
- Tachycardia, palpitations
- Anxiety, nervousness
- Headache
- Throat irritation, cough
- Muscle cramps
- Hypokalemia
- Hyperglycemia
- Paradoxical bronchospasm (rare)
- QT prolongation (with high doses)
Administration Considerations
Available preparations:
- Metered-dose inhaler (MDI)
- Nebulizer solution
- Extended-release tablets
- Immediate-release tablets
- Oral syrup
Dosages:
- MDI: 1-2 puffs (90 mcg/puff) every 4-6 hours as needed
- Nebulizer: 2.5-5 mg every 4-8 hours as needed
- Tablets: 2-4 mg three to four times daily
- Maximum daily dose varies by preparation and patient condition
Nursing Considerations for Albuterol
Related Nursing Diagnoses
- Ineffective breathing pattern
- Risk for activity intolerance
- Anxiety related to dyspnea
- Knowledge deficit regarding medication administration
- Risk for complications related to medication side effects
Nursing Assessment
Assess respiratory status:
- Breath sounds
- Respiratory rate and effort
- Peak flow measurements
- Oxygen saturation
- Signs of respiratory distress
Evaluate cardiovascular status:
- Heart rate and rhythm
- Blood pressure
- Signs of palpitations
Monitor for side effects:
- Tremors
- Anxiety
- Tachycardia
- Muscle cramps
- Assess the patient’s inhaler technique and knowledge
- Monitor potassium levels in patients receiving frequent doses
Nursing Interventions
Ensure proper administration technique:
- Teach correct MDI use with spacer if needed
- Properly set up nebulizer treatments
- Monitor response to therapy
- Monitor vital signs before and after administration
- Assess peak flow measurements when appropriate
- Document medication effectiveness and side effects
- Provide appropriate positioning during administration
- Monitor oxygen saturation during treatments
Patient Teaching Associated with Albuterol
Proper MDI technique:
- Shake the inhaler well before use
- Exhale completely
- Create a proper seal around the mouthpiece
- Press the canister while inhaling slowly
- Hold your breath for 10 seconds
- Wait 1-2 minutes between puffs
Spacer device use when prescribed:
- Proper assembly and cleaning
- Correct breathing technique
- Regular maintenance
Nebulizer care and use:
- Proper setup and cleaning
- Medication measurement
- Treatment timing
- Equipment maintenance
Signs and symptoms to report:
- Increased shortness of breath
- Chest pain
- Rapid heart rate
- Severe tremors
- Paradoxical bronchospasm
Lifestyle modifications:
- Avoiding triggers
- Exercise precautions
- When to use pre-exercise
Medication storage:
- Room temperature for inhalers
- Protect from extreme temperatures
- Replace by the expiration date
- Count remaining doses
Note: This is not an all-inclusive list of possible drug interactions, adverse effects, precautions, nursing considerations, or patient instructions. Please consult with a pharmacist for complete information.
References
- Johnson DB, Merrell BJ, Bounds CG. Albuterol. [Updated 2024 Jan 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482272/
- Nakawah, M. O., Hawkins, C., & Barbandi, F. (2023). Asthma, Management and Practice Parameters. In StatPearls. StatPearls Publishing.
- Rau, J. L. (2021). The Inhalation of Drugs: Advantages and Problems. Respiratory Care, 66(1), 156-169.
- Global Initiative for Asthma. (2023). Global Strategy for Asthma Management and Prevention. Retrieved from www.ginasthma.org
