Pirbuterol Acetate

Pronunciation: pihr-BYOO-tuh-role ASS-uh-TATE
Class: Sympathomimetic

Trade Names

Maxair Autohaler
- Aerosol 0.2 mg/actuation

Pharmacology

Produces bronchodilation by relaxing bronchial smooth muscle through beta-2 receptor stimulation.

Slideshow: Flashback: FDA Drug Approvals 2013

Pharmacokinetics

Absorption

Rapidly absorbed following aerosol administration.

Elimination

51% of the dose is excreted in the urine plus its sulfate conjugate. T ½ and plasma is approximately 2 h (oral).

Onset

5 min (inhalation).

Duration

5 h (inhalation).

Indications and Usage

Prevention and treatment of reversible bronchospasm associated with asthma or other obstructive pulmonary diseases.

Contraindications

Hypersensitivity to drug components; cardiac arrhythmias associated with tachycardia.

Dosage and Administration

Adults and Children 12 yr of age and older

Inhalation 1 to 2 inhalations every 4 to 6 h; not to exceed 12 inhalations/day.

Storage/Stability

Store at room temperature.

Drug Interactions

MAOIs, tricyclic antidepressants

May increase the effects of pirbuterol.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Palpitations; tachycardia; BP changes; chest tightness/pain/discomfort; angina; arrhythmias/skipped beats.

CNS

Tremor; anxiety; confusion; fatigue; dizziness; nervousness; headache; weakness; hyperactivity/hyperkinesia/excitement; insomnia.

EENT

Dry nose; throat irritation.

GI

GI distress; dry mouth; diarrhea; nausea/vomiting.

Respiratory

Cough; throat irritation.

Miscellaneous

Flushing; anorexia/appetite loss; unusual/bad taste; taste/smell change.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy in children 12 yr of age and younger not established.

Elderly

Lower doses may be required.

Labor and Delivery

May inhibit uterine contractions and delay preterm labor.

CV effects

Toxic symptoms in patients with CV disorders may occur.

CNS effects

CNS stimulation may occur; use cautiously in patients with history of seizure or hyperthyroidism.

Diabetes

Dosage adjustment of insulin or oral hypoglycemic agent may be required.

Excessive use

Paradoxical bronchospasm and cardiac arrest have been associated with excessive inhalant use.

Hypokalemia

Decreases in potassium levels have occurred.

Tolerance

If previously effective dose fails to provide relief therapy may need to be reassessed.

Overdosage

Symptoms

Tremor, palpitations, tachycardia, elevated blood pressure, anginal pain, hypokalemia, seizures.

Patient Information

  • Advise patient to take drug early in day to prevent insomnia.
  • Explain that implementing therapy in morning and after meals may reduce fatigue and improve lung ventilation.
  • Encourage patient to increase fluid intake to help liquify secretions.
  • Tell patient to report the following symptoms to health care provider: Dizziness, chest pain, palpitations, muscle spasms, headache, difficult urination, dyspnea or nervous tremor.
  • Explain that if no relief is obtained from normal daily dose, call health care provider instead of increasing dose. Also if more than 3 aerosol treatments are needed in 24 h, notify health care provider.
  • Tell patient to wait at least 1 to 2 min before administering second inhalation.
  • Instruct patient that regular, consistent use of medication is required for maximum benefits.
  • Explain benefits of and demonstrate technique for postural drainage and chest vibration.
  • Emphasize that it is important to avoid getting aerosol medication in eyes.
  • Tell patient to avoid smoking, smoke-filled rooms, and persons with respiratory infections.
  • Explain how to use and care for inhalers and any other respiratory equipment.

Copyright © 2009 Wolters Kluwer Health.

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