Pulmonology Book

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Nebulized Albuterol

Aka: Nebulized Albuterol, Albuterol Nebulizer, Levalbuterol Nebulizer, Nebulized Xopenex
  1. 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
  2. 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
  3. Dosing: Levalbuterol (Xopenex) for Age over 12 years
    1. Dose: 0.63 to 1.25 mg nebulized q6-8 hours
  4. Adverse Effects
    1. Hypokalemia
    2. Tachycardia
  5. 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]
    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]
    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]

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