Albuterol is a very high-yield topic. You
can guarantee yourself that you will be asked a question about Albuterol. Very high yield.
You’ve got to know it. Two very common brandnames for Albuterol include Ventolin and Proventil.
Albuterol is a direct-acting, synthetic, Beta 2 agonist, which, by far and away, is mostly
used for the dilation of the bronchials and it’s given via a metered-dose inhaler, which
is represented by this drawing on the right. Bascially, you inhale as it sprays medicine
and thus delivers the medicine directly to the bronchials, where it can have it’s effect.
The mechanism of action of Albuterol is pretty straight-forward. As I already mentioned,
it’s a selective Beta 2 agonist. Mostly used in cases of asthma, but also for things like
COPD or cystic fibrosis. As I mentioned in the previous slide, because it’s taken oftentimes
via an inhaler, it is delivered directly to the bronchials, thus the effects are contained
as much as possible. There is a little bit of spillage outside of the local area, but
most of the effects are felt in the bronchials, where they reduce bronchospasm. And remember
that the Beta 2 receptor acts through the Gs protein-coupled pathway. Most of the side
effects can be described as an adrenergic overdose or adrenergic response. Basically,
from the systemic absorbtion of Albuterol from the bronchial tissues, from the oral
mucosa (anywhere it touches, really). So, even though we are trying to keep the medicine
localized to the bronchials, there’s always going to be a little bit of crossover into
the systemic circulation. Most commonly, you’re going to see (5 out of 5, most important one
there) a tremor. Albuterol can cause a little bit of a tremor. Tachycardia, Anxiety and
Restlessness are also very common. And, related to the Tachycardia, is this contraindication.
You need to be careful about using Albuterol with people who have coronary artery disease
or that are prone to any kind of arrhythmias, espcially tachyarrhythmias. We have called
Albuterol a Beta 2 selective drug, however, there is a little bit of overlap or crossover
onto Beta 1. Very small, but still, something to think about. Be very careful about who
you give this drug to.