Albuterol

2. PATHOPHYSIOLOGY OF ASTHMA
• CHRONIC INFLAMMATORY DISORDER IF THE AIRWAYS CHARACTERIZED BY AIRWAY INFLAMMATION AND
HYPERRESPONSIVENESS.
• ASTHMA INVOLVES MANY PATHOPHYSIOLOGIC FACTORS INCLUDING BRONCHIOLAR INFLAMMATION
WITH AIRWAY CONSTRICTION AND RESISTANCE THAT MANIFESTS AS EPISODES OF COUGHING,
SHORTNESS OF BREATH, AND WHEEZING.
• INFLAMMATION OCCURS
• BRONCHOSPASMS, EDEMA, EXCESSIVE MUCUS, AND EPITHELIAL AND MUSCLE DAMAGE CAN LEAD TO
BRONCHOCONSTRICTION WITH BRONCHOSPASM.

3. PATHOPHSYIOLOGY CONTI.
• IT CAN BE DEFINED AS SHARP CONTRACTIONS OF BRONCHIAL SMOOTH MUSCLE, BRONCHOSPASM
CAUSES THE AIRWAYS TO NARROW; EDEMA FROM MICROVASCULAR LEAKAGE CONTRIBUTES TO AIRWAY
NARROWING.
• INCREASED MUCUS SECRETION CAUSES MUCUS PLUGS THAT BLOCK THE ARYWAYS WHICH CAN CAUSE
INJURY TO THE EPITHELIUM.
• LOSS OF THE EPITHELIUM’S BARRIER FUNCTION ALLOWS ALLERGENS TO PENETRATE, CAUSING THE
AIRWAYS TO BECOME HYPERRESPONSIVE .

4. INTENDED DRUG RESPONSE
• THE PHARMACOLOGIC EFFECTS OF THIS DRUG ARE ATTRIBUTABLE TO ACTIVATION OF BETA2-
ADRENERGIC RECEPTORS ON AIRWAY SMOOTH MUSCLE
• THIS DRUG RELAXES THE SMOOTH MUSCLE OF ALL AIRWAYS, FROM THE TRACHEA TO THE TERMINAL
BRONCHIOLES AND ACTS AS A FUNCTIONAL ANTAGONIST TO RELAX THE AIRWAYS.
• THE RELAXATION OF THE AIRWAYS RELIEVES BRONCHOCONSTRICTION, THUS MAKING IT A
BRONCHODILATOR.

5. POTENTIAL INTERACTIONS
• BETA-BLOCKERS MAY DIMINISH THE
BRONCHODILATORY EFFECT
• ATOMOXETINE: MAY ENHANCE THE TACHYCARDIC
EFFECT OF BETA2-AGONISTS AND ENHANCE THE
HYPERTENSIVE EFFECT OF SYMPATHOMIMETICS
• HALOPERIDOL: MAY ENHANCE THE QTC-
PROLONGING EFFECT OF HALOPERIDOL
• LOOP AND THIAZIDE DIURETICS : MAY ENHANCE
THE HYPOKALEMIC EFFECT
• QT-PROLONGING AGENTS: MAY ENHANCE THE
QTC PROLONGING EFFECT OF THE QT-
PROLONGING AGENTS
• MONOAMINE OXIDASE INHIBITORS: MAY
ENHANCE THE ADVERSE/TOXIC EFFECT OF BETA2-
AGONISTS.

6. ADVERSE DRUG REACTIONS
• CNS: EXCITEMENT, NERVOUSNESS, SHAKINESS, HEADACHE, DIZZINESS, INSOMNIA, ANXIETY, ATAXIA,
DEPRESSION, DROWSINESS, RIGORS, MIGRAINE, RESTLESSNESS
• CARDIOVASCULAR: TACHYCARDIA, HYPERTENSION, CHEST PAIN, EDEMA, PALPITATIONS, CHEST
DISCOMFORT, FLUSHING.
• RESPIRATORY: UPPER RESPIRATORY TRACT INFECTION, RHINITIS, BRONCHOSPASMS, SINUSITIS,
COUGH, WHEEZING, NASAL CONGESTIONS, FLU-LIKE SYMPTOMS
• GASTROINTESTINAL: NAUSEA, VOMITING, UNPLEASANT TASTE, GASTROENTERITIS, INCREASED APPETITE

7. ADVERSE DRUG REACTIONS
• NEUROMUSCULAR & SKELETAL: MUSCLE CRAMPS, MUSCULOSKELETAL PAIN BACK PAIN, LEG CRAMPS
• INFECTION: COLD SYMPTOMS, INFECTION, FEVER
• HEMATOLOGIC & ONCOLOGIC: DECREASED HEMATOCRIT, DECREASED HEMOGLOBIN, DECREASED WHITE
BLOOD CELL COUNT
• GENITOURINARY: URINARY TRACT INFECTION

8. PHARMACOKINETICS
• ONSET OF ACTION
1. NEBULIZATION/ORAL INHALATION: 0.5 TO 2
HOURS
2. INHALATION POWDER: 30 MINUTES
• DURATION: NEBULIZATION/ORAL INHALATION: 2
TO 6 HOURS
• PROTEIN BINDING: 10%
• METABOLISM: HEPATIC TO AN INACTIVE SULFATE
• HALF-LIFE ELIMINATION
1. INHALATION: 3.8 TO 5 HOURS
2. ORAL: 3.7 TO 5 HOURS
• EXCRETION: URINE (30% AS UNCHANGED DRUG);
FECES (<20%)

9. DRUG BINDING ISSUES
• BETA –BLOCKERS-BETA BLOCKERS DIMINISH THE BRONCHODILATORY EFFECT OF BETA2-AGONISTS
• BETA BLOCKERS BLOCK THE EFFECTS OF ALBUTEROL
• BETA-BLOCKERS CAN CAUSE SERIOUS BRONCHOSPASMS AND CAUSE ASTHMA SYMPTOMS TO WORSEN

10. IMPROVING COMMUNICATION
• COMMUNICATING WITH THE FAMIILY ABOUT THE POTENTIAL SIDE EFFECTS BEFORE INITIATING THE
MEDICATION.
• ITS COULD BE HELPFUL TO COMMUNICATE THE PLAN OF CARE TO ALL MEMBERS OF THE HEALTHCARE
TEAM WITH MANAGEMENT OF ASTHMA.
• EDUCATING STAFF ON POTENTIAL SIDE EFFECTS TO ALBUTEROL SO THAT ALL MEMBERS CAN BE ALERT FOR
POTENTIAL SIDE EFFECTS.
• UTILIZE TECHNOLOGY TO IMPROVE COMMUNICATION.

11. APPLICATION TO PRACTICE SETTING
• ASSESS LUNG SOUNDS, OBTAIN PATIENT’S BLOOD PRESSURE AND HR BEFORE AND DURING THE
ADMINISTRATION OF ALBUTEROL.
• KEEP IN MIND THAT IF A PATIENT HAS, HYPERTENSION, HYPOTHYROIDISM OR A SEIZURE DISORDER ALBUTEROL
SHOULD BE USED WITH CAUTION.
• EXPLAIN TO PATIENTS AND FAMILY MEMBERS THAT THE PATIENT MAY HAVE A JITTERY FEELING, FEELING
ANXIOUS, AND HAVE HEART PALPITATIONS.
• PEDIATRICS HAVE A HIGHER INCIDENCE OF SHAKINESS, EXCITEMENT AND NERVOUSNESS SO DISTRACTION
MAY BE BENEFICIAL IN THIS SETTING.

12. REFERENCES
• BARNES, P.J. (1996), PATHOPHYSIOLOGY OF ASTHMA. BRITISH JOURNAL OF CLINICAL PHARMACOLOGY,
42, 3-10.
• ARCANGELO, V.P. & PETERSON, A. M. (2013). PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE: A
PRACTICAL APPROACH. PHILADELPHIA, PA: WOLTERS KLUWER.
• DALWADI, VIJAY (2018, NOVEMBER) PERSONAL INTERVIEW
• LEXICOMP ONLINE (N.D.). RETRIEVED FROM HTTP:
//ONLINE.LEXI.COM/LCO/ACTION/DOC/RETRIEVE/DOCID/GENOM_F/122084