Salbutamol

Salbutamol selectively stimulates beta-2 adrenergic receptors in the bronchial smooth muscle, leading to activation of adenyl cyclase and increased intracellular cyclic-3',5'-adenosine monophosphate (cAMP). This increase in cAMP causes relaxation of bronchial smooth muscle, resulting in bronchodilation and improved airflow. It also inhibits the release of mediators from mast cells in the airway.

Adult

**Metered Dose Inhaler (MDI):** 100-200 mcg (1-2 puffs) every 4-6 hours as needed. For acute bronchospasm, 2 puffs. For exercise-induced bronchospasm, 2 puffs 15-30 minutes before exercise. **Nebulization:** 2.5-5 mg (in 2-4 mL normal saline) every 4-6 hours PRN, administered over 5-15 minutes.…

Pediatric

**MDI (>4 years):** 100-200 mcg (1-2 puffs) every 4-6 hours as needed. **Nebulization (<2 years):** 0.1-0.15 mg/kg (minimum 1.25 mg) up to 4 times a day. **Nebulization (2-12 years):** 2.5 mg up to 4 times a day.

Renal adjustment

No specific dose adjustment generally required, as a significant portion is excreted unchanged renally.

Hepatic adjustment

No specific dose adjustment generally required as hepatic metabolism mainly involves sulfation to an inactive metabolite.

Geriatric

No specific dose adjustment required, but use with caution in elderly patients with pre-existing cardiovascular disease or other comorbidities due to increased risk of cardiac side effects.

Max dose

**MDI:** Up to 8-12 puffs in 24 hours (800-1200 mcg). Higher doses should be used under medical supervision. **Nebulization:** Up to 40 mg in 24 hours, but typically no more than 20 mg/day for routine use.

• Hypersensitivity to salbutamol or any component of the formulation
• Tachyarrhythmias
• Severe cardiac disease (relative contraindication, use with caution)