Albuterol Sulfate (18 brand names, 8 dosage forms, 2 routes)
Available dosage forms: AEROSOL, METERED, SOLUTION, TABLET, SYRUP, TABLET, EXTENDED RELEASE, POWDER, METERED, CAPSULE, SPRAY, METERED.
Routes of administration: INHALATION, ORAL.
Brand Names
- ACCUNEB
- AIRSUPRA
- ALBUTEROL SULFATE
- ALBUTEROL SULFATE AND IPRATROPIUM BROMIDE
- ALBUTEROL SULFATE; IPRATROPIUM BROMIDE
- COMBIVENT
- COMBIVENT RESPIMAT
- DUONEB
- PROAIR DIGIHALER
- PROAIR HFA
- PROAIR RESPICLICK
- PROVENTIL
- PROVENTIL-HFA
- VENTOLIN
- VENTOLIN HFA
- VENTOLIN ROTACAPS
- VOLMAX
- VOSPIRE ER
Contraindications
VENTOLIN HFA is contraindicated in patients with a history of hypersensitivity to any of the ingredients [see Warnings and Precautions ( 5.6), Description ( 11)] .
Adverse Reactions
The following clinically significant adverse reactions are described elsewhere in the labeling: Paradoxical bronchospasm [see Warnings and Precautions ( 5.1)] Cardiovascular effects [see Warnings and Precautions ( 5.4)] Hypersensitivity reactions, including anaphylaxis [see Warnings and Precautions ( 5.6)] Hypokalemia [see Warnings and Precautions ( 5.8)]
Drug Interactions
Other short-acting sympathomimetic aerosol bronchodilators should not be used concomitantly with albuterol. If additional adrenergic drugs are to be administered by any route, they should be used with caution to avoid deleterious cardiovascular effects.
Mechanism of Action
In vitro studies and in vivo pharmacologic studies have demonstrated that albuterol has a preferential effect on beta 2-adrenergic receptors compared with isoproterenol. Although beta 2-adrenoceptors are the predominant adrenergic receptors in bronchial smooth muscle and beta 1-adrenoceptors are the predominant receptors in the heart, there are also beta 2-adrenoceptors in the human heart comprising 10% to 50% of the total beta-adrenoceptors. The precise function of these receptors has not been established, but their presence raises the possibility that even selective beta 2-agonists may have cardiac effects. Activation of beta 2-adrenergic receptors on airway smooth muscle leads to the activation of adenyl cyclase and to an increase in the intracellular concentration of cyclic-3′,5′-adenosine monophosphate (cyclic AMP). This increase of cyclic AMP leads to the activation of protein kinase A, which inhibits the phosphorylation of myosin and lowers intracellular ionic calcium concentrations, resulting in relaxation. Albuterol relaxes the smooth muscles of all airways, from the trachea to the terminal bronchioles. Albuterol acts as a functional antagonist to relax the airway irrespective of the spasmogen involved, thus protecting against all bronchoconstrictor challenges. Increased cyclic AMP concentrations are also associated with the inhibition of release of mediators from mast cells in the airway. Albuterol has been shown in most controlled clinical trials to have more effect on the respiratory tract, in the form of bronchial smooth muscle relaxation, than isoproterenol at comparable doses while producing fewer cardiovascular effects. Controlled clinical studies and other clinical experience have shown that inhaled albuterol, like other beta-adrenergic agonist drugs, can produce a significant cardiovascular effect in some patients, as measured by pulse rate, blood pressure, symptoms, and/or electrocardiographic changes [see Warnings and Precautions (5.4)].
Overdosage
The expected signs and symptoms with overdosage of albuterol are those of excessive beta-adrenergic stimulation and/or occurrence or exaggeration of any of the signs and symptoms of beta-adrenergic stimulation (e.g., seizures, angina, hypertension or hypotension, tachycardia with rates up to 200 beats/min, arrhythmias, nervousness, headache, tremor, muscle cramps, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, insomnia, hyperglycemia, hypokalemia, metabolic acidosis). As with all inhaled sympathomimetic medicines, cardiac arrest and even death may be associated with an overdose of VENTOLIN HFA. Treatment consists of discontinuation of VENTOLIN HFA together with appropriate symptomatic therapy. The judicious use of a cardioselective beta-receptor blocker may be considered, bearing in mind that such medication can produce bronchospasm. There is insufficient evidence to determine if dialysis is beneficial for overdosage of VENTOLIN HFA.