group members vida kwofie monique veney lyliane mbah natasha lomax reggie degraf
DESCRIPTION
Routes of Administration PO 2mg, 4mg tablets; 4mg, 8mg extended release tablets; 2mg/5ml syrup Inhalation 200mcg capsules; 0.083%, 0.5% inhalation solution; 90mcg actuationTRANSCRIPT
GROUP MEMBERS
VIDA KWOFIE MONIQUE VENEY LYLIANE MBAH NATASHA LOMAX REGGIE DEGRAF
Introduction: Name and Classification of Medication
Generic (nonproprietary) drug name: albuterol
Trade/Brand name: Proventil, Ventolin, ProAir
Drug Classification: Bronchodilator, Beta-adrenergic agonist
Routes of Administration
PO 2mg, 4mg tablets; 4mg, 8mg extended
release tablets; 2mg/5ml syrup
Inhalation 200mcg capsules; 0.083%, 0.5% inhalation
solution; 90mcg actuation
PHARMACODYNAMICS
Bronchialdilation – relaxes smooth muscles in the respiratory tract
Selective short-acting beta2 adrenergic agonist
Inhibits histamine release
INDICATION Asthma COPD Bronchitis Bronchospasm
CONTRAINDICATION
Allergy or hypersensitivity to albuterol or levalbuterol or any of their components
Congenital long QT syndrome
Oral syrup use in children < 2y.o.
PRECAUTION Administer w/ caution in patients w/
cardiovascular diseases, diabetes mellitus, hyperthyroidism, seizure disorders, elderly
Increased sympathomimetic effects when taking other sympathomimetic drugs
Enhanced toxicity in patients taking methylxanthines
Therapeutic effectiveness should be monitored closely as well as
May cause hyper-excitability and insomnia
REVIEW OF THE LITERATURE
Albuterol can induce exacerbation of hypokalemic periodic paralysis (HPP) (Tucker & Villanueva, 2013).
HPP is a rare event, which can also be due to other drugs or factors (Brosch, Sant, & Galomb, 2011).
Literatures suggest that there is controversy on the cause of elevated serum lactate levels in patients with acute asthma exacerbation (Lewis et al., 2014). Some studies attribute the elevated serum lactate level to increase work of breathing, while others attribute it to albuterol (Lewis et al., 2014). In one study, it was concluded that hyperlactemia was likely caused by albuterol than the disease severity (Lewis et al., 2014).
REVIEW OF THE LITERATURE
Lactic acidosis can occur as a result of inadequate oxygenation during an acute severe asthma episode (Ganaie & Hughes, 2011).
The treatment for albuterol intoxication is mostly supportive and symptomatic (Akta, Kostu, Unal, & Caksen, 2013). Gastric lavage is done if drug was ingested within a 4-6 hour period, also activated charcoal, lactulose, and intravenous fluid can also be administered (Akta et al., 2013).
Another study pointed that a reversible obstruction during spirometry testing 15-20minutes post albuterol is consistent with asthma (Broder, Desai, & Wilson, 2013).
IMPLEMENTATION PLAN INCLUDING CULTURAL CONSIDERATIONS, AGE, ETHNICITY
Ethnicity/Gender/Age
Number of noninstitutionalized adults who currently have asthma: 18.9 million
Number of children who currently have asthma: 7.1 million
From 2001 through 2009 asthma rates rose almost 50% among black children.
IMPLEMENTATION PLAN INCLUDING CULTURAL CONSIDERATIONS, AGE, ETHNICITY
African Americans have the highest asthma rates compared to other racial/ethnic groups.
African American women have the highest age-adjusted mortality rates due to asthma compared to any gender and racial/ethnic groups.
Death rate due to asthma was three times higher in the African American population.
Reference: CDC and American Academy of Allergy Asthma & Immunology websites
IMPLEMENTATION PLAN INCLUDING CULTURAL CONSIDERATIONS, AGE, ETHNICITY Assessment:
Patients should have an initial asthma severity assessment to determine the type and level of initial therapy needed.
Clinicians should review patient’s exposure to allergens and irritants.
Implementation Teaching:
Patients should be able to identify and avoid triggers.
Patient education regarding warning signs of an attack.
Patients should receive a written asthma action plan to guide their self-management.
Proper administration techniques for albuterol with different devices such as nebulizers, inhalers and spacers.
SPECIAL CONSIDERATION Pregnancy Category C
Albuterol may produce significant hypokalemia in some patients possibly through intracellular shunting. (Elderly)
Changes in systolic and diastolic blood pressure have been seen in individual patients.
Heath care providers should be aware if patients are taking certain medications. Drugs that will affect Albuterol Inhalation:
Diuretic Digoxin Beta-blockers Antidepressant Other Bronchodilators
EVIDENCE-BASED GUIDELINES Albuterol is indicated in the treatment of
Asthma and bronchiolitis. Research suggest safe for use in adults
and children in the primary care setting. Management of first time episode
Bronchiolitisin infants less than 1 year of age .
EVIDENCE-BASED GUIDELINES Recommendations: Inhaled short-acting beta2 agonists
should be used on an ‘as required’ basis to relieve symptoms (B).
They should be used before exercise in patients who have exercise-induced bronchospasm (A).
EVIDENCE-BASED GUIDELINES As there is no good evidence of clinically
important differences between different inhaled short-acting beta2 agonists, patients should be treated with the cheapest preparation that they can effectively use (D).
GROUP COHESION AND GROUP EFFORT SECTIONS 1-5: CLASSIFICATION- MONIQUE SECTION 6: REVIEW OF LITERATURE - LYLIANE SECTION 7 & 8: IMPLEMENTATION PLAN/SPECIAL
CONSIDERATIONS- NATASHA SECTION 9: EVIDENCE BASED GUIDELINES-
REGGIE POWER POINT: VIDA
GROUP COHESION AND GROUP EFFORT
http://www.mayoclinic.org/condition/asthma-attack/multimedia/asthma/VID-20084746
REFERENCE
S
Aktar, F., Köstü, M., Ünal, M., & Çaksen, H. (2013). Albuterol Intoxication in a Child. Journal Of Emergency Medicine, 45(1), 98-99. doi:10.1016/j.jemermed.2012.09.146
Broders, J. A., Desia,(2013). Help patients control their asthma. Journal Of Family Practice, 62(4), 184-190.
Brosch, J. R., Sant, R. V., & Golomb, M. R. (2011). Subacute Onset of Abnormal Gait and Head Drop in a 3-Year-Old With History of Extreme Prematurity. Journal Of Child Neurology, 26(3), 373-376. doi:10.1177/0883073810382142
Ganaie, M., & Hughes, R. (2011). An unusual case of Lactic Acidosis. British Journal Of Medical Practitioners, 4(2), 23-25.
Lewis, L. M., Ferguson, I., House, S. L., Aubuchon, K., Schneider, J., Johnson, K., & Matsuda, K. (2014). Albuterol Administration Is Commonly Associated With Increases in Serum Lactate in Patients With Asthma Treated for Acute Exacerbation of Asthma. Chest, 145(1), 53-59. doi:10.1378/chest.13-0930
TUCKER, C., & VILLANUEVA, L. (2013). Acute hypokalemic periodic paralysis possibly precipitated by albuterol. American Journal Of Health-System Pharmacy, 70(18), 1588-1591. doi:10.2146/ajhp130086