AlbuterolNursing considerations

Side effects by what to assess

Sources: [1][2][3][4][5][6][7]

Blood glucose

Why

Hyperglycemia in diabetes or overdose

When

In diabetes

Normal

Fasting 70 to 99 mg/dL.

Sources: [1][2][3]

Blood pressure

Why

Blood pressure changes

When

In patients with hypertension or heart disease

Act on

Significant changes may require stopping

Normal

Below 120/80 mm Hg.

Sources: [1][2]

Heart rate

Why

Tachycardia and palpitations

When

With symptoms, and in patients with heart disease

Act on

Significant changes may require stopping

Normal

60 to 100 beats per minute in adults at rest.

Sources: [1][2]

Potassium

Why

Hypokalemia, worse with loop or thiazide diuretics

When

With high doses or diuretics

Act on

Usually transient; supplementation rarely needed

Normal

3.7 to 5.2 mEq/L.

Sources: [1][2][3]

High-alert status

Inhaled albuterol is not on the ISMP acute care high-alert list. IV adrenergic agonists are.

Sources: [1]

Narrow therapeutic index

The label does not describe a narrow therapeutic index or direct dosing by measured blood levels of the drug.

Sources: [1]

Boxed warning

None on the current label.

Sources: [1]

Antidote or reversal

No specific antidote. Overdose causes excess beta stimulation: tachycardia up to 200 beats/min, arrhythmias, seizures, hypokalemia, and hyperglycemia. Stop the drug and treat symptoms. A cardioselective beta blocker may be considered cautiously because it can trigger bronchospasm.

Sources: [1]

Patient teaching

• Each dose should last about 4 to 6 hours; do not use more often or take more puffs without talking to the prescriber
• Get medical help right away if it works less well, symptoms worsen, or you need it more often
• Stop and seek help if breathing gets worse right after a dose
• Palpitations, chest pain, fast heartbeat, shakiness, and nervousness are common
• Take other inhalers and asthma medicines only as directed

Sources: [1]

Sound-alike and look-alike names

None listed in the ISMP list of confused drug names.

Sources: [1]

Adult dose

Bronchospasm

2 inhalations every 4 to 6 hours; for some, 1 inhalation every 4 hours is enough. Do not exceed this frequency or number.

Exercise-induced bronchospasm prevention

2 inhalations 15 to 30 minutes before exercise.

Sources: [1][2]

Renal adjustment

The label gives no renal dose adjustment. Older adults should start at the low end because of more frequent organ impairment.

Sources: [1][2]

Hepatic adjustment

The label gives no hepatic dose adjustment.

Sources: [1]

Mechanism

A short-acting beta-2 agonist. Stimulating beta-2 receptors on airway smooth muscle raises cyclic AMP and relaxes the bronchi. Some beta-2 receptors sit in the heart (10% to 50% of cardiac beta receptors), so heart effects are still possible.

Sources: [1]