salbutamol

CLINICAL USE

Beta2-adrenoceptor agonist:Reversible airways disease

DOSE IN NORMAL RENAL FUNCTION

Oral: 2–4 mg 3–4 times daily SC/IM: 500 micrograms, repeated 4 hourly if necessaryIV: 250 micrograms slow bolus, repeated if requiredInfusion: start with 5 micrograms/minute, adjust according to response, usually 3–20 micrograms/minuteAerosol: 100–200 micrograms (1–2 puffs) 4 times dailyPowder: 200–400 micrograms 4 times dailyNebulisation: 2.5–5 mg 4 times daily, or more frequently

PHARMACOKINETICS

Molecular weight :239.3

%Protein binding :10

%Excreted unchanged in urine : 51–64

Volume of distribution (L/kg) :2–2.5

half-life – normal/ESRD (hrs) :4–6/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in normal renal function

HD :Unknown dialysability. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsIncreased risk of hypokalaemia when diuretics, theophylline or large doses of corticosteroids are given with high doses of salbutamolAntihypertensives: acute hypotension with

IV infusion

of salbutamol and methyldopa

ADMINISTRATION

Reconstition

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Route

IV, SC, IM, oral, inhaled, nebulised

Rate of Administration

IV slow bolus;

IV infusion

3–20 micrograms/minute

Comments

Infusion: dilute 10 mL (10 mg) to 500 mL with sodium chloride 0.9% or glucose 5% (20 micrograms/mL)Via syringe pump: dilute 10 mL (10 mg) to 50 mL with sodium chloride 0.9% or glucose 5% (200 micrograms/mL)

OTHER INFORMATION

Monitor ECG/BP/pulse Nebulised salbutamol may be prescribed for hypokalaemic effect in acute hyperkalaemia (unlicensed).

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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