DRUG	SUPPLIED	DOSE	COMMENTS
SALBUTAMOL (Paeds) (Ventolin, Albuterol) Mechanism of action: Beta-2-adrenergic receptor agonist. Ref: 44, 127, 272, 273 Last update: 2019-08-26	MDI inhaler: 100 mcg/puff. nebulizer solution (10 mL multidose bottle): 5 mg/mL. unit dose nebules: 2.5 mg/2.5 mL; 1.25 mg/2.5 mL.	Asthma Exacerbation (see Emergency Dept. protocol): Metered Dose Inhaler (MDI): 5 - 10 puffs/dose Q20 minutes x 3 doses in first hour then Q1-6H PRN. Respiratory Solution: 2.5 - 5 mg Q20 minutes x 3 doses then Q1-6H PRN. Chronic Management: Metered Dose Inhaler: 2-4 puffs/dose inhaled Q4-6H as needed. Respiratory Solution: 1.25-5 mg/dose inhaled Q4-6H as needed.	Onset of action: 5-15 minutes. Duration of effect: 3-6 hours. MDI use with valved holding chamber (e.g. Aerochamber) recommended. Document number of puffs used with each dose and contact pharmacy for refill when almost empty (200 puffs/canister). 5 mg of nebulized salbutamol is approximately equivalent to 8-10 puffs of a metered dose inhaler. (Conversion from nebulizer to MDI is controversial.) Dilute respiratory solution with NS to a total volume of 4 mL and administer via nebulizer at 68 L/min over 10 minutes. Note: different salbutamol nebulizer solutions have different concentrations. Always order by milligram, not milliliters. Side effects: tachycardia, tremor, nervousness, hypokalemia, GI symptoms and headaches. Standard Prescription: salbutamol __puffs inh Q__H {PRN} salbutamol __mg nebulized Q__H {PRN}