SALBUTAMOL IV

• Severe bronchospasm
• Use slow bolus injection in patient with life-threatening features ONLY. See Asthma guideline

• Salbutamol injection 500 microgram in 1 mL ampoule, dilute for slow IV bolus injection
• Salbutamol solution for IV infusion 5 mg in 5 mL ampoule (1 mg/mL), dilute before use

• Sodium chloride 0.9% or glucose 5%

IV bolus injection

• For use in patient with life-threatening features ONLY

Preparation

• Use 500 microgram in 1 mL preparation
• take 0.5 mL. Make up to 20 mL with diluent in a Luer lock syringe (see Diluents) = 12.5 microgram/mL

Dosage

• IV bolus of 250 micrograms over 10 min
• administer via a syringe driver at a rate of 120 mL/hr = 2 mL/min

IV infusion

• Use this regimen for patients with non-life-threatening features
• Note that the concentration is different from the IV bolus injection guidance above

Preparation

• Use preparation for IV infusion (5 mg in 5 mL)
• Remove 5 mL from a 500 mL bag of diluent (see Diluents)
• add 5 mL (5 mg) of salbutamol to the bag = 5 mg in 500 mL = 10 microgram/mL

Dosage

• Initial rate = 5 microgram/min
• Adjust rate according to response and heart rate
• usual range:3–20 microgram/min or more if necessary

Pump rate for selected dose

IV infusion (5 mg salbutamol in 500 mL)

• Heart rate
• salbutamol increases heart rate with possible palpitations preventing dosage increase
• Cardiac monitoring is advised in patients with ischaemic heart disease
• Check plasma potassium 1–2 hr after starting IV salbutamol and after each dosage increase
• salbutamol causes rapid cellular uptake of potassium, which can lead to serious hypokalaemia