Inhaled medication salbutamol

Although asthma is considered to be a reversible condition, severe acute attacks can cause obstruction that can take days to reverse and in some cases is not reversible at all. Such attacks need to be treated as a medical emergency requiring hospital treatment. Treatment includes oxygen, inhalation of salbutamol in oxygen, intravenous hydrocortisone and oral prednisolone. Sometimes inhaled antimuscarinics are also used and intravenous salbutamol and aminophylline plus antibiotics if there is infection as well. 

Mr JA s previous medical history includes porphyria and childhood asthma. His past drug history comprises salbutamol inhaler and beclometasone inhaler for childhood asthma. 

Mr DP, 35 years, has been taking asthma medication for 12 years and occasionally also suffers from eczema. His regular prescription is for salbutamol inhaler (100 micrograms/metered inhalation) 1-2 puffs as required and Clenil-Modulite (100 micrograms/dose) 2 puffs twice daily. Today he presents in your pharmacy with a new prescription for Betnovate scalp application. 

Step 1. Medications of first choice for the acute attack are short-acting, aerosolized fS2-sympathomimetics, e.g., salbutamol or feno-terol. Their action occurs within minutes after inhalation and lasts for 4-6 hours. 

A 35-year old Caucasian man with AIDS and multiple opportunistic infections, including Mycobacterium kansasii and Mycobacterium avium complex (MAC) disease developed moderate to severe primary sensorineural hearing loss after 4—5 months of therapy with oral azithromycin 500 mg/day. Other medications included ethambutol, isoniazid, rifabutin, ciprofloxacin, co-trimoxazole, fluconazole, zidovudine (later switched to stavudine), lamivudine, indinavir, methadone, mod-ified-release oral morphine, pseudoephedrine, diphenhydramine, megestrol acetate, trazodone, sorbitol, salbutamol by metered-dose inhaler and nebulizer, ipratropium, and oral morphine solution as needed. Significant improvement of the hearing impairment was documented 3 weeks after drug withdrawal. 

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