I. 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

II. 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

III. Dosing: Levalbuterol (Xopenex) for Age over 12 years

  1. Dose: 0.63 to 1.25 mg nebulized q6-8 hours

IV. Adverse Effects

V. 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 157:76-80 [PubMed] (or open in [QxMD Read])
  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 150:512-7 [PubMed] (or open in [QxMD Read])
  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):51-3 [PubMed] (or open in [QxMD Read])

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