Pulmolin® 4 mg Tablet: Salbutamol Sulfate BP equivalent to Salbutamol 4 mg.
Pulmolin® 60/100 ml Syrup: Each 5 ml contains Salbutamol Sulphate BP 2.4 mg equivalent to Salbutamol 2 mg.
Salbutamol (Pulmolin®) is a selective β2 adrenergic stimulant. Therefore, when accepted in therapeutic doses, it produces an effective bronchodilation without any marked cardiac stimulation.
Mode of action:
Salbutamol is a selective β2 adrenoceptor agonist with effects on smooth and skeletal muscle. The drug binds with receptor and converts ATP to cyclic-AMP, which activates protein kinase. This leads to phosphorylation of proteins, which ultimately reduces availability of ionized intracellular calcium. The consequent inhibition of actin-myosin linkage causes relaxation of smooth muscle.
Pharmacokinetics:
After oral administration, salbutamol is well absorbed from the gastrointestinal tract and undergoes considerable first-pass metabolism to the phenolic sulphate. Both unchanged drug and conjugate are excreted primarily in the urine. The bioavailability of orally administered salbutamol is about 50%. Salbutamol is bound to plasma proteins to the extent of 10%.
Acute and chronic bronchial asthma, chronic bronchitis, bronchospasm, reversible airways obstruction.
Adults: 4 mg (elderly and sensitive patients, initially 2 mg) 3-4 times daily; maximum single dose 8 mg. Children: Under 2 years, 100 mcg/kg body weight 4 times daily; 2-6 years, 1-2 mg 3-4 times daily; 6-12 years, 2 mg 3-4 times daily.
No potentially hazardous interactions have been reported, but treatment with diuretics may augment the hypokalemia that occurs with large doses of salbutamol.
Overdose:
Overdose of salbutamol with doses between 5 and 240 mg in patients produces no fatalities. The common symptoms are tremor, flushing, agitation and palpitations due to sinus tachycardia. The preferred antidote for overdosage with salbutamol is a cardio-selective beta-blocking drug but beta-blocking drugs should be used with caution in patients with a history of bronchospasm. Hypokalemia may occur following overdose with salbutamol. Therefore, serum potassium levels should be monitored.
Salbutamol should be used in pregnancy only if the expected benefit to the mother is greater than any possible risk to the foetus. As salbutamol is probably secreted in breast milk, its use in nursing mother requires careful consideration.
Salbutamol and non-selective beta-blocking drugs, such as propranolol, should not usually be prescribed together. Salbutamol should be administered cautiously to patients with thyrotoxicosis. Salbutamol can induce reversible metabolic changes such as increased blood glucose levels.
Store in a cool and dry place, protected from light.