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Nebulized AlbuterolAka: Albuterol Nebulizer, Levalbuterol Nebulizer, Nebulized Xopenex

Dosing: Albuterol
1. Weight <10 kg or age under 12 months
  1. Albuterol 1.25 mg (0.25 cc) in 2 cc NS q1-4 hours
2. Weight 10-35 kg or age 12 months to 10 years
  1. Albuterol 2.5 mg (0.5 cc) in 2 cc NS q1-4 hours
3. Weight >35 kg or age over 10 years
  1. Albuterol 5.0 mg (1.0 cc) in 2 cc NS q1-4 hours
Co-administered Medications (May add to Nebulizer)
1. Ipratropium (Atrovent) 250 mcg (1.25 ml) q6-8 hours
2. Cromolyn Sodium (Intal) (10 mg/ml) 2cc q6 hours
3. Flunisolide (Nasalide) (.25%=250 ug/ml) 1-2 ml q6 hours
Dosing: Levalbuterol (Xopenex) for Age over 12 years
1. Dose: 0.63 to 1.25 mg nebulized q6-8 hours
Adverse Effects
1. Hypokalemia
2. Tachycardia
Efficacy
1. Albuterol MDI and spacer/mask as effective as nebulizer
  1. Studied Wheezing children aged two years and younger
  2. Delgado (2003) Arch Pediatr Adolesc Med 157:76
2. Antiinflammatory added to nebulizer in RSV
  1. Study showed significant improvement
    1. Much fewer hospitalizations with Nasalide or Intal
  2. Reference
    1. Reijonen T (1996) Arch Pediatr Adolesc 150:512
3. Levalbuterol (Xopenex): Active R-Isomer of Albuterol
  1. Appears to have no advantage over Albuterol
  2. Reference
    1. (1999) Med Lett Drugs Ther 41(1054):51

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.