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--- respiratory:beta2_agonists:albuterol [2026/02/15 14:58] – created andrew2393cns
+++ respiratory:beta2_agonists:albuterol [2026/02/15 15:07] (current) – [Related] andrew2393cns
@@ Line 1: / Line 1: @@
 ====== Albuterol (ProAir®, Ventolin®, Proventil®) ======
-{{tag>respiratory beta2_agonist saba bronchodilator}}
+<WRAP right 340px>
+<WRAP infobox>
-<WRAP right 300px>
+^ Albuterol | {{:respiratory:beta2_agonists:albuterol-teaser.png?200|}} |
-^ Class | Short-Acting β2 Agonist (SABA) |
+| Brand Names | ProAir®, Ventolin®, Proventil® |
-^ Use | Rescue inhaler |
+| Drug Class | [[respiratory:beta2_agonists:saba|Short-Acting β2 Agonist (SABA)]] |
-^ Onset | ~3–5 minutes |
+| Primary Indication | Acute bronchospasm |
-^ Duration | 4–6 hours |
+| Receptor Target | β2 adrenergic receptor |
-^ Route | Inhaled (MDI, DPI, Neb) |
+| Mechanism | ↑ cAMP → Bronchodilation |
+| Onset | ~3–5 minutes |
+| Duration | 4–6 hours |
+| Route | Inhaled (MDI, DPI, Neb) |
+| Potassium Effect | ↓ Serum K⁺ (cellular shift) |
+| FDA Approval | 1981 |
 </WRAP>
+</WRAP>
+===== Overview =====
+Albuterol is the first-line rescue bronchodilator for acute bronchospasm in asthma and COPD.
+It provides rapid airway smooth muscle relaxation but does **not treat airway inflammation**, making it a symptom reliever rather than a controller medication.
-Albuterol is the **first-line rescue bronchodilator** for acute bronchospasm in asthma and COPD.
+Frequent use indicates poorly controlled disease and need for anti-inflammatory therapy such as [[respiratory:inhaled_corticosteroids:start|Inhaled Corticosteroids]].
-It rapidly relaxes airway smooth muscle but **does NOT treat inflammation**.
+<WRAP clear></WRAP>
 ----
@@ Line 19: / Line 31: @@
 ===== Mechanism of Action =====
-β2 receptor stimulation → ↑ cAMP → bronchial smooth muscle relaxation
+**Receptor Activated**
+  * β2 adrenergic receptor
-Additional effects:
+**Cellular Effects**
-  * ↓ mast cell mediator release
+  * ↑ cAMP
+  * Smooth muscle relaxation
+  * ↓ mediator release from mast cells
   * ↑ mucociliary clearance
-  * Drives potassium into cells (↓ serum K⁺)
+**Systemic Effect**
+  * Drives potassium intracellularly
+Net effect:
+  * Rapid bronchodilation and relief of airflow obstruction
 ----
@@ Line 33: / Line 53: @@
   * Exercise-induced bronchospasm prevention
   * COPD rescue therapy
-  * Hyperkalemia (temporary potassium shift)
+  * Temporary treatment of hyperkalemia
+Often used with:
+  * [[respiratory:inhaled_corticosteroids:start|Inhaled Corticosteroids]]
+  * [[respiratory:antimuscarinics:start|Antimuscarinics]]
 ----
-===== Dosing (Typical Adult) =====
+<WRAP contra>
+===== Contraindications =====
-**MDI:** 1–2 puffs every 4–6 hours PRN
+Absolute:
-**Nebulizer:** 2.5 mg every 4–6 hours PRN
+  * Hypersensitivity to albuterol
-**Exercise prevention:** 2 puffs 15 minutes before activity
-Frequent use (>2 days/week) → indicates uncontrolled asthma
+Relative / Caution:
+  * Tachyarrhythmias
+  * Ischemic heart disease
+  * Hyperthyroidism
+</WRAP>
 ----
-===== Adverse Effects =====
+<WRAP details>
+===== Dosing =====
-^ Effect ^ Why It Happens ^
+Metered-Dose Inhaler:
-| Tremor | β2 stimulation in skeletal muscle |
+  * 1–2 puffs every 4–6 hours PRN
-| Tachycardia | β1 spillover & reflex response |
-| Palpitations | Adrenergic stimulation |
-| Hypokalemia | Intracellular potassium shift |
-| Anxiety | CNS adrenergic activation |
-Dose dependent.
+Nebulizer:
+  * 2.5 mg every 4–6 hours PRN
+Exercise prevention:
+  * 2 puffs 15 minutes prior to activity
+Frequent use (>2 days/week):
+  * Indicates uncontrolled asthma
+</WRAP>
 ----
-===== Contraindications & Cautions =====
+<WRAP details>
+===== Pharmacokinetics =====
-  * Severe tachyarrhythmias
+Onset:
-  * Hyperthyroidism
+  * 3–5 minutes
-  * Caution in ischemic heart disease
-Not a steroid — safe in pregnancy and pediatrics.
+Peak:
+  * ~30 minutes
+Duration:
+  * 4–6 hours
+Elimination:
+  * Hepatic metabolism and renal excretion
+</WRAP>
 ----
-===== Clinical Pearls =====
+<WRAP details>
+===== Adverse Effects =====
+Adrenergic:
+  * Tremor
+  * Tachycardia
+  * Palpitations
+  * Anxiety
+Metabolic:
+  * Hypokalemia
+  * Hyperglycemia (mild)
+Other:
+  * Headache
+Dose dependent — more common with frequent use.
-<WRAP round tip 90%>
-Using albuterol frequently does NOT mean the patient needs more albuterol
-It means they need anti-inflammatory therapy (ICS)
 </WRAP>
-  * First drug given in asthma exacerbation
+----
-  * Spacer improves lung deposition significantly
-  * Nebulizer does NOT deliver more drug — only easier for severe distress
+<WRAP details>
-  * Causes temporary improvement in hyperkalemia
+===== Drug Interactions =====
+Beta-blockers:
+  * Reduced bronchodilator effect
+MAO inhibitors / stimulants:
+  * Increased tachycardia
+Diuretics:
+  * Increased hypokalemia risk
+</WRAP>
 ----
+<WRAP monitoring>
 ===== Monitoring =====
-  * Symptom frequency
+  * Rescue inhaler use frequency
-  * Rescue inhaler use per week
+  * Symptom control
-  * Heart rate in high-dose therapy
+  * Heart rate (high doses)
   * Potassium (continuous nebs)
+</WRAP>
+----
+<WRAP pearls>
+===== Clinical Pearls =====
+  * First drug used in asthma exacerbation
+  * Frequent use = need controller therapy
+  * Spacer significantly improves lung delivery
+  * Nebulizer easier to inhale — not stronger
+  * Useful temporary treatment for hyperkalemia
+</WRAP>
+----
+===== Comparison Within Class =====
+Compared to [[respiratory:beta2_agonists:levalbuterol|Levalbuterol]]:
+  * Less selective β2 activity
+  * More tremor/tachycardia
+  * Lower cost
+Compared to [[respiratory:beta2_agonists:formoterol|Formoterol]]:
+  * Shorter duration
+  * Used for rescue rather than maintenance
 ----
-===== Related Drugs =====
+===== Related =====
-  * [[respiratory:beta2_agonists:levalbuterol|Levalbuterol]]
+  * [[respiratory:beta2_agonists|β2 Agonists]]
-  * [[respiratory:beta2_agonists:formoterol|Formoterol]]
+  * [[respiratory:inhaled_corticosteroids:start|Inhaled Corticosteroids]]
-  * [[respiratory:inhaled_corticosteroids|Inhaled Corticosteroids]]
+  * [[respiratory:asthma|Asthma]]
+  * [[respiratory:copd|COPD]]