Symptomatic treatment of severe asthma attack, in combination with ipratropium
Forms and strengths
Solution for inhalation, in unit dose vial of 5 mg in 2.5 ml (2 mg/ml), to be administered via a nebuliser
Dosage and duration
Child under 5 years: 2.5 mg (1.25 ml) per nebulisation every 20 minutes for the first hour
Child 5 to 11 years: 2.5 to 5 mg (1.25 to 2.5 ml) per nebulisation every 20 minutes for the first hour
Child 12 years and over and adult: 5 mg (2.5 ml) per nebulisation every 20 minutes for the first hour
Then:
If symptoms do not improve, continue treatment every 20 minutes.
If symptoms improve, reduce gradually the frequency of nebulisations then change to salbutamol metered dose inhaler.
Contra-indications, adverse effects, precautions
May cause: headache, tremor and tachycardia, hyperglycaemia; hypokalaemia (afterhigh doses). Never use nebuliser solution by the parenteral route.
Pregnancy: no contra-indication
Breast-feeding: no contra-indication
Remarks
Nebulised salbutamol should be reserved for severe asthma attacks. Otherwise, salbutamol should be delivered via a metered-dose inhaler with a spacer:administration is easier and faster,the treatment is as effective, or even more effective, than with a nebuliser and causes fewer adverse effects.
Volumes of nebuliser solution to be administered are insufficient to obtain efficient nebulisation in most nebulisers: dilute salbutamol solution with 0.9% sodium chloride to obtain a total volume of 4 ml in the reservoir of the nebuliser. Stop the nebulisation when the reservoir is empty (after around 10 to 15 minutes).