Pirbuterol Acetate

A to Z Drug Facts

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

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

 Contraindications Hypersensitivity to drug components; cardiac arrhythmias associated with tachycardia.

 Route/Dosage

ADULTS & CHILDREN ³ 12 YR: Inhalation 1 to 2 inhalations q 4 to 6 hr; not to exceed 12 inhalations/day.

 Interactions

MAO inhibitors, tricyclic antidepressants: May increase the effects of pirbuterol.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: 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. RESP: Cough; throat irritation. OTHER: Flushing; anorexia/appetite loss; unusual/bad taste; taste/smell change.

 Precautions

Pregnancy: Category C. Children: Safety and efficacy in children £ 12 years of age have not been established. Lactation: Undetermined. Elderly: Lower doses may be required. Cardiovascular effects: Toxic symptoms in patients with cardiovascular 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. Labor and delivery: May inhibit uterine contractions and delay preterm labor. Tolerance: If previously effective dose fails to provide relief therapy may need to be reassessed.

 Administration/Storage

• Give pressurized inhalation during second half of breath intake.
• If > 1 inhalation is needed, wait 1 to 2 minutes before administering second dose.
• Discard any discolored solutions of drug.
• Store at room temperature in light-resistant container.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Obtain baseline ABGs prior to initiation of therapy.
• Assess BP and pulse before and after each dose.
• Assess for CNS response, and adjust dose and frequency accordingly.
• To prevent respiratory depression, administer oxygen based on ABGs and symptoms.
• Assess vital capacity and forced expiratory volume.
• If 3 to 5 aerosol treatments have been given within 6 to 12 hours with minimal relief, notify physician and do not give further treatment.

 Patient/Family Education

• 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 physician: 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 physician instead of increasing dose. Also if > 3 aerosol treatments are needed in 24 hours, notify physician.
• 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.
• Instruct patient not to take any otc medications without consulting physician.
• 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.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts