Application
The main field of application of salbutamol is chronic lung diseases. This particularly concerns lung diseases that are associated with a narrowing of the airways. Salbutamol is therefore the first choice for bronchial asthma.
It is a strong and short-acting drug, which is especially needed in the case of an asthma attack. The effect sets in quickly and lasts about 4 – 6 hours. After 5 – 10 minutes the effect is already at maximum, the airways are wide again, paving the way for further inhaled asthma medication.
For example, inhaled glucocorticoids, the absolute basic medication in asthma therapy, reach the desired site of action more effectively, which leads to better effectiveness. Salbutamol is also used in chronic constrictive pulmonary disease (COPD). However, it is increasingly being replaced by more effective drugs.
In the case of COPD, salbutamol is more of a second choice. Since salbutamol is relatively selective in its excitation of the ß2-receptors, the active ingredient can also be used to inhibit premature labor (tocolysis). Salbutamol is available as a preparation that can be taken orally or given as an infusion through a vein. Here, too, the receptors are activated and can be administered from the 24th week of pregnancy in uncomplicated premature labor.
Side effect
If ß2-receptors are activated systemically, i.e. in the whole body, undesirable effects such as an increase in blood pressure or cardiac arrhythmia (e.g. too fast a heartbeat (tachycardia)) occur. There may also be a shift in the balance of salts in the blood (electrolytes).
The electrolyte potassium migrates from the blood into the muscle cell, so the blood level is then too low (hypokalemia). This in turn promotes cardiac arrhythmia. Furthermore, the blood sugar level is increased because the production of blood sugar (glucose) is stimulated (gluconeogenesis).
This should be considered especially in patients with a sugar disease (diabetes mellitus). If pregnant, Salbutamol should be discontinued before birth. With continuous use, ß2-receptors like salbutamol show a tolerance development.
The body wants to avoid permanent stimulation by reducing the receptor density at the cells. Furthermore, the signaling chain that is activated by the receptors is decoupled.This means that when bound to the receptor, the effect does not or no longer starts as well. Below the ß2-mimetics, cross-resistance is also observed. This means that no effect can be achieved by using other preparations from this group.
