Critical Care Trauma Centre

SALBUTAMOL (Ventolin)

Name: SALBUTAMOL (VentolinR)
Classification: beta2 agonist, bronchodilator
Dose:
  • Inhalation:
    • 0.25 to 0.5 mg (up to 1 mg) q 4 - 6 h 
  • IV bolus: 
    • 250 mcg (~ 4 mcg/kg) over 2-5 mins
  • Infusion:
    • 5 mcg/min, increase by 5 mcg/min to a maximum of 20 mcg/min 
Administration:

IV Infusion: 
5 mg/500 mL dextrose 5% or sodium chloride 0.9%

dextrose containing solutions may be inappropriate for patients with diabetes because of salbutamol induced exaggerated hyperglycemia

Adverse Effects: more common with parenteral therapy than inhalational therapy
  • with inhalation:
    • headache
    • nervousness, tremor
    • tachycardias
  • with intravenous therapy:
    • hypertension or hypotension
    • hyperglycemia
    • hypokalemia
    • palpitations
    • arrhythmias
Caution:
  • in patients with cardiovascular disorders, hyperthyroidism and diabetes
Drug Interactions:
  • salbutamol + sympathomimetics = exacerbation of cardiovascular effects
  • salbutamol + beta blockers = mutual antagonism of therapeutic effect 
  • salbutamol + general anaesthetics = decreased BP, increased HR
Monitoring Therapy:
  • Efficacy:
    • breath sounds
    • respiratory rate
    • ventilatory pressures
    • blood gases
  • Adverse effects:
    • continuous heart rate and rhythm
    • blood pressure
    • serum glucose
    • serum potassium
CCTC Protocol:
  • May be administered IV infusion in Adult Critical Care provided that the first dose is given by an MD
  • Must be administered via Central Venous Line
  • Continuous infusions must be administered by infusion device and the pump library must be enabled
  • Patient requires the placement of an arterial line for continuous blood pressure monitoring
  • Patient requires full mechanical ventilation with continuous End Tidal CO2 monitoring


Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: October 11, 2018