Alternate Name(s):
Ventolin
Classification:
Beta-Agonist, Bronchodilator
Original Date:
March 1996
Revised Date:
June 2018
Indications:
- Bronchospasm in infants with brochopulmonary dysplasia (BPD)
- Adjunctive therapy for Neonatal Hyperkalemia
Administration:
- For Bronchospasm in infants with BPD:
- Inhalation solution via nebulizer: dilute with 2 - 3 mL of 0.9%NaCl
- Metered-dose inhaler (MDI): use with aerochamber
- For Neonatal Hyperkalemia:
- Inhalation solution via nebulizer
- IV intermittent infusion
Dosage:
- For Bronchospasm in infants with BPD:
- Nebulization: 1.25 mg - 2.5 mg/dose q8h prn. Dilute to 3 mL with 0.9%NaCl
- Inhalation: 1 - 2 puffs (100 - 200 micrograms) Q4-6H prn
- For Neonatal Hyperkalemia:
- Nebulization (possible if conventionally/Jet ventilated, not possible for HFOV)
- 0.4 mg in 2 mL of 0.9%NaCl every 2 hours to a maximum of 12 doses
- IV Intermittent Infusion:
- 4 micrograms/kg iv over 20 minutes q4h
- Nebulization (possible if conventionally/Jet ventilated, not possible for HFOV)
Side Effects:
- CNS: twitching, tremors, abnormal motor activity
- CVS: tachycardia, palpitations
- Endocrine and metabolic: hyperglycemia, lactic acidosis
Parameters to Monitor:
- HR
- Serum glucose
- Serum potassium
Reconstitution and Stability:
- Salbutamol 1 mg/mL (NOT available at TOH)
- Take 0.2 mL (200 mcg = 0.2 mg) and add to 9.8 mL D5W or 0.9% NaCl
- Final concentration: 20 mcg/mL
Compatibility:
- Solutions compatible: D5W, 0.9% NaCl
- Y-site compatible: hydromorphone, morphine
References:
- American Society of Health-System Pharmacists (ASHP). Handbook on Injectable Drugs 19th Edition. Bethesda: ASHP 2017
- Mhanna MJ, Patel JS, Patel S, et al, "The Effects of Racemic Albuterol Versus Levalbuterol in Very Low Birth Weight Infants," Pediatr Pulmonol, 2009, 44(8):778-83
- Vemgal P, Ohlsson Interventions for non-oliguric hyperkalaemia in preterm neonates. A. Cochrane Database Syst Rev. 2012 May 16;5:CD005257.
- Yaseen H Darwich M. Salbutamol Versus Cation-Exchange resin (Kayexalate) for the Treatment of Nonoliguric Hyperkalemia in Preterm Infants. Am J Perinatol. 2008 Mar;25(3):193-7.