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GROUP MEMBERS
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VIDA KWOFIE
MONIQUE VENEY
LYLIANE MBAH
NATASHA LOMAX
REGGIE DEGRAF
Introduction: Name and
Classification of Medication
 Generic
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(nonproprietary) drug name:
albuterol
 Trade/Brand
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Proventil, Ventolin, ProAir
 Drug
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name:
Classification:
Bronchodilator, Beta-adrenergic agonist
Routes of Administration
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PO
 2mg,
4mg tablets; 4mg, 8mg extended release
tablets; 2mg/5ml syrup
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Inhalation
 200mcg
capsules; 0.083%, 0.5% inhalation
solution; 90mcg actuation
PHARMACODYNAMICS
 Bronchialdilation
– relaxes smooth muscles
in the respiratory tract
 Selective
agonist
 Inhibits
short-acting beta2 adrenergic
histamine release
INDICATION
 Asthma
 COPD
 Bronchitis
 Bronchospasm
CONTRAINDICATION
 Allergy
or hypersensitivity to albuterol or
levalbuterol or any of their components
 Congenital
 Oral
long QT syndrome
syrup use in children < 2y.o.
PRECAUTION
 Administer
w/ caution in patients w/
cardiovascular diseases, diabetes mellitus,
hyperthyroidism, seizure disorders, elderly
 Increased sympathomimetic effects when taking
other sympathomimetic drugs
 Enhanced toxicity in patients taking
methylxanthines
 Therapeutic effectiveness should be monitored
closely as well as
 May cause hyper-excitability and insomnia
REVIEW OF THE LITERATURE
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Albuterol can induce exacerbation of hypokalemic
periodic paralysis
(HPP) (Tucker & Villanueva, 2013).
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HPP is a rare event, which can also be due to other drugs or
factors
(Brosch, Sant, & Galomb, 2011).
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Literatures suggest that there is controversy on the cause of
elevated serum lactate levels in patients with acute asthma
exacerbation (Lewis et al., 2014). Some studies attribute the
elevated serum lactate level to increase work of breathing,
while others attribute it to albuterol (Lewis et al., 2014). In
one study, it was concluded that hyperlactemia was likely
caused by albuterol than the disease severity (Lewis et al.,
2014).
REVIEW OF THE LITERATURE
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Lactic acidosis can occur as a result of inadequate
oxygenation during an acute severe asthma episode
(Ganaie & Hughes, 2011).
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The treatment for albuterol intoxication is mostly
supportive and symptomatic (Akta, Kostu, Unal, &
Caksen, 2013). Gastric lavage is done if drug was
ingested within a 4-6 hour period, also activated
charcoal, lactulose, and intravenous fluid can also be
administered (Akta et al., 2013).
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Another study pointed that a reversible obstruction
during spirometry testing 15-20minutes post albuterol is
consistent with asthma (Broder, Desai, & Wilson, 2013).
IMPLEMENTATION PLAN INCLUDING CULTURAL
CONSIDERATIONS, AGE, ETHNICITY
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Ethnicity/Gender/Age
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Number of noninstitutionalized adults who currently have
asthma: 18.9 million
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Number of children who currently have asthma: 7.1 million
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From 2001 through 2009 asthma rates rose almost 50% among
black children.
IMPLEMENTATION PLAN INCLUDING CULTURAL
CONSIDERATIONS, AGE, ETHNICITY
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African Americans have the highest asthma rates compared to
other racial/ethnic groups.
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African American women have the highest age-adjusted
mortality rates due to asthma compared to any gender and
racial/ethnic groups.
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Death rate due to asthma was three times higher in the African
American population.
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Reference: CDC and American Academy of Allergy Asthma &
Immunology websites
IMPLEMENTATION PLAN
INCLUDING CULTURAL
CONSIDERATIONS, AGE, ETHNICITY
 Assessment:
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Patients should have an initial asthma
severity assessment to determine the type
and level of initial therapy needed.
Clinicians should review patient’s exposure
to allergens and irritants.
Implementation
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Teaching:
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Patients should be able to identify and avoid
triggers.
Patient education regarding warning signs of an
attack.
Patients should receive a written asthma action
plan to guide their self-management.
Proper administration techniques for albuterol
with different devices such as nebulizers, inhalers
and spacers.
SPECIAL CONSIDERATION
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Pregnancy Category C
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Albuterol may produce significant hypokalemia in some
patients possibly through intracellular shunting. (Elderly)
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Changes in systolic and diastolic blood pressure have been
seen in individual patients.
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Heath care providers should be aware if patients are taking
certain medications.
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Drugs that will affect Albuterol Inhalation:
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Diuretic
Digoxin
Beta-blockers
Antidepressant
Other Bronchodilators
EVIDENCE-BASED GUIDELINES
 Albuterol
is indicated in the treatment of
Asthma and bronchiolitis.
 Research suggest safe for use in adults
and children in the primary care setting.
 Management of first time episode
Bronchiolitis
in infants less than 1 year of age .
EVIDENCE-BASED GUIDELINES
 Recommendations:
 Inhaled
short-acting beta2 agonists should
be used on an ‘as required’ basis to
relieve symptoms (B).
 They should be used before exercise in
patients who have exercise-induced
bronchospasm (A).
EVIDENCE-BASED GUIDELINES
 As
there is no good evidence of clinically
important differences between different
inhaled short-acting beta2 agonists,
patients should be treated with the
cheapest preparation that they can
effectively use (D).
GROUP COHESION AND
GROUP EFFORT
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SECTIONS 1-5: CLASSIFICATION- MONIQUE
SECTION 6: REVIEW OF LITERATURE - LYLIANE
SECTION 7 & 8: IMPLEMENTATION PLAN/SPECIAL
CONSIDERATIONS- NATASHA
SECTION 9: EVIDENCE BASED GUIDELINES- REGGIE
POWER POINT: VIDA
GROUP COHESION AND
GROUP EFFORT
 http://www.mayoclinic.org/condition/ast
hma-attack/multimedia/asthma/VID20084746
REFERENCES
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Aktar, F., Köstü, M., Ünal, M., & Çaksen, H. (2013). Albuterol Intoxication in a Child.
Journal Of Emergency Medicine, 45(1), 98-99. doi:10.1016/j.jemermed.2012.09.146
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Broders, J. A., Desia,(2013). Help patients control their asthma. Journal Of Family
Practice, 62(4), 184-190.
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Brosch, J. R., Sant, R. V., & Golomb, M. R. (2011). Subacute Onset of Abnormal Gait and
Head Drop in a 3-Year-Old With History of Extreme Prematurity. Journal Of Child
Neurology, 26(3), 373-376. doi:10.1177/0883073810382142
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Ganaie, M., & Hughes, R. (2011). An unusual case of Lactic Acidosis. British Journal Of
Medical Practitioners, 4(2), 23-25.
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Lewis, L. M., Ferguson, I., House, S. L., Aubuchon, K., Schneider, J., Johnson, K., &
Matsuda, K. (2014). Albuterol Administration Is Commonly Associated With Increases in
Serum Lactate in Patients With Asthma Treated for Acute Exacerbation of Asthma.
Chest, 145(1), 53-59. doi:10.1378/chest.13-0930
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TUCKER, C., & VILLANUEVA, L. (2013). Acute hypokalemic periodic paralysis possibly
precipitated by albuterol. American Journal Of Health-System Pharmacy, 70(18), 15881591. doi:10.2146/ajhp130086