Salbutamol Spray

salbutamol

Introduction

Salbutamol is a drug belonging to the group of beta2 sympathomimetics or beta2 receptor agonists. It leads to the slackening of the smooth muscles as it occurs in the bronchial system. Therefore, salbutamol is used in diseases associated with narrowing of the airways and is called a bronchospasmolytic or bronchodilator.

Among these diseases are bronchial asthma and chronic obstructive pulmonary disease (COPD). It is mainly applied by inhalation, its effect starts very quickly and lasts for about 4-6 hours. Salbutamol is on the doping list because of its respiratory dilating and probably anabolic properties. Only athletes with proven bronchial asthma or similar diseases are allowed to use the drug by inhalation during the competition period.

Side effects

With the introduction of bronchodilators, a drug was found that was relatively specific to beta2 receptors on smooth muscle and hardly any to beta1 receptors on the heart. Nevertheless, drugs like salbutamol can have cardiac side effects. An increase in the heart rate (tachycardia) can occur, which increases the oxygen consumption of the heart.

Particularly in patients with cardiac preload, this can lead to so-called angina pectoris attacks with pressure on the chest and shortness of breath. Furthermore, central nervous symptoms such as restlessness, nervousness and tremor of the hands can occur during therapy with salbutamol. Other possible side effects are headaches, dizziness, palpitations, nausea, sweating, muscle cramps and a disturbance of the sense of taste.

An increase in blood sugar (hyperglycemia) and a decrease in the potassium level (hypokalemia) in the blood may also occur. The latter carries the risk of triggering cardiac arrhythmia. Hallucinations and psychoses occur very rarely. It should be noted that even when taken in therapeutic doses, the ability to react can be limited, so that active participation in traffic and the operation of machines is no longer possible without risk.

Interactions

Simultaneous therapy with salbutamol and drugs from the beta-blocker group leads to a mutual reduction in the effect. It should also be noted that beta-blockers should generally be used with great caution in patients with asthma and COPD, as they can cause critical narrowing of the airways. In patients with diabetes mellitus, treatment with salbutamol can weaken the blood sugar-lowering effect of antidiabetics, and a dose adjustment may be necessary.

However, the risk exists in particular with high-dose therapy or systemic treatment with salbutamol in tablet form or intravenously. The risk of the above-mentioned undesirable effects is increased with simultaneous therapy with salbutamol and other sympathomimetic drugs such as adrenaline, as well as with simultaneous therapy with theophylline, the thyroid hormone L-thyroxine, antiarrhythmic drugs for the treatment of cardiac arrhythmia, cardiac glycosides such as digitoxin, and the group of psychotropic drugs known as MAO inhibitors (e.g. tranylcypromine) and tricyclic antidepressants (e.g. amitriptyline).

A combination with alcohol can also increase the risk of side effects. Simultaneous treatment with ergotamines to treat migraine should be undertaken with caution, as it can lead to both critical dilation (vasodilation) and constriction (vasoconstriction) of blood vessels. In case of an imminent anaesthesia with halogenated hydrocarbons, such as halothane or enflurane, the intake of salbutamol should be paused in time and the doctor informed about the intake, otherwise dangerous cardiac arrhythmia can occur.