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Action/Kinetics:
Markedly stimulates beta-2 receptors, resulting in relaxation of smooth muscles of the bronchial tree, as well as peripheral vasodilation. Minimal effects on beta-1 receptors. Similar to isoproterenol but with a longer duration of action and fewer side effects.
Onset, aerosol, hand bulb nebulizer or IPPB: 5-30 min;
duration: 1-6 or more hr after repeated doses.
PO: Onset, 15-30 min;
peak effect: 1 hr.
Duration: 4 hr. Marked first-pass effect after PO use. Metabolized in the liver and excreted through the kidney.
Uses:
Bronchodilator in asthma, bronchitis, emphysema, and other conditions associated with reversible bronchospasms. Treatment of acute asthmatic attacks in children over 6 years of age (use only 5% solution for inhalation).
Additional Contraindications:
PO in children less than 6 years old.
Special Concerns:
Dosage of syrup or tablets not determined in children less than 6 years of age.
Additional Side Effects:
GI: Diarrhea, bad taste or taste changes.
Respiratory: Worsening of asthma, nasal congestion, hoarseness.
Miscellaneous: Hypersensitivity reactions, rash, fatigue, backache, skin reactions.
Drug Interactions:
Possible potentiation of adrenergic effects if used before or after other sympathomimetic bronchodilators.
How Supplied:
Metered dose inhaler (Aerosol): 0.65 mg/inh;
Solution for Inhalation: 0.4%, 0.6%, 5%;
Syrup: 10 mg/5 mL;
Tablet: 10 mg, 20 mg
Dosage
?Syrup, Tablets
Bronchodilation.
Adults and children over 27.2 kg or 9 years: 20 mg t.i.d.-q.i.d.;
children under 27.2 kg or 6-9 years of age: 10 mg t.i.d.-q.i.d.;
children less than 6 years of age: 1.3-2.6 mg/kg/day of the syrup has been studied.
?Inhalation using Hand Bulb Nebulizer
Bronchodilation.
Usual dose is 10 inhalations (range: 5-15 inhalations) of undiluted 5% solution.
?Nebulizer
Bronchodilation.
0.1 mL (0.1-0.2 mL) diluted in saline to 3 mL.
?IPPB
Bronchodilation.
0.3 mL (range: 0.2-0.3 mL) of 5% solution diluted to 2.5 mL saline or other diluent. Give the unit-dose vial as follows:
Adults: 1 vial/nebulization treatment. Each 0.4% vial is equal to 0.2 mL of the 5% solution diluted to 2.5 mL with normal saline. Each 0.5% vial is equal to 0.3 mL of the 5% solution diluted to 2.5 mL with normal saline.
?MDI
Bronchodilation.
2-3 inhalations (1.30-2.25 mg) q 3-4 hr. Do not exceed a total daily dose of 12 inhalations (9 mg).
