Albuterol is a beta 2 adrenergic agonist which can be used in the treatment of asthma symptoms (Ahrens & Smith, 1984). Beta 2 adrenergic agonists are drugs which a class of drugs which are bronchodilators. This class of drugs bind to Beta 2 adrenergic receptors which are found on the smooth muscle and lead to muscle relaxation. Smooth muscle is found in the bronchial passages, therefore these medications are also known as bronchodilators, as they bind to the receptors and relax the muscles leading to an opening of the airways (Barisione, Baroffio, Crimi, & Brusasco, 2010). During an asthma attack there are several different symptoms. These include tightness in the chest, shortness of breath, coughing and wheezing (Krishnan et al., 2012). There are two main types of asthma medication, short acting (also known as quick acting) and long acting medications. Both of which can be used in combination to help manage symptoms (Lomholt, 2013).
Beta 2 adrenergic receptor drugs, like Albuterol is a short-acting bronchodilator. These short-acting medications are used during an attack to immediately relieve the symptoms of an asthma attack. They typically begin to work within several minutes after inhalation and range in duration from two to four hours. As well these short-acting medications can be used as a preventative measure before exercise to prevent the occurrence of attacks (Lomholt, 2013) .
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As they are typically used as a rescue medication, they are usually given in the form of an inhaler or nebulizer. Although pill forms of albuterol are also available (Schuh et al., 1989). Of all the beta 2 adrenergic agonist drugs available, albuterol is one of the most prescribed. Although Albuterol can be a useful drug for the treatment of asthma symptoms, it is also possible for adverse side effects and/or overdosing to occur. One potential problem with this is that it could be possible to overdose if the inhaler is used repeatedly (Wiley, Spiller, Krenzelok, & Borys, 1994).
For example, in small children it is often advised that parents assist them with their medication. However, it is also important that the child be able to use their inhalers in case of an emergency when the parents are not around. One possible legal situation that could occur is in the accidental overdosing of a child on albuterol. Symptoms of toxicity appear at 1mg/kg which is 3-10 times higher than the recommended daily dosage. If a child is having an attack and uses the inhaler repeated over a short period of time it is possible for them to overdose (Wiley et al., 1994).
Typical signs of toxicity are vomiting, tachycardia and hyperglycemia. Usually the symptoms resolve themselves without treatment. However there have been reports of children experiencing hyperglycemia and ketonuria after overdose, which is usually only found in diabetics (King, Holloway, & Palmisano, 1992). As well it is also possible for children to experience hypoglycemia after overdose, which can be dangerous if not detected and treated right away (Ozdemir, Yilmaz, Duman, Unal, & Tuncok, 2004; Wasserman & Amitai, 1992).
It is for this reason that it is important that health care professionals educate parents and their children on the best way to take their asthma medication. The child needs to understand that the medication should not be taken repeatedly and when possible parents should supervise the child to make sure they are inhaling and not swallowing the medication. While Albuterol is a popular asthma medication and helps in relieving symptoms it is important to understand that overdosing and adverse side effects can occur. However, through education and proper management it is possible to reduce the occurrence of overdose and prevent a legally charged situation from occurring.
- Ahrens, R. C., & Smith, G. D. (1984). Albuterol: an adrenergic agent for use in the treatment of asthma pharmacology, pharmacokinetics and clinical use. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 4(3), 105-120.
- Barisione, G., Baroffio, M., Crimi, E., & Brusasco, V. (2010). Beta-adrenergic agonists. Pharmaceuticals, 3(4), 1016-1044.
- King, W., Holloway, M., & Palmisano, P. (1992). Albuterol overdose: a case report and differential diagnosis. Pediatric emergency care, 8(5), 268-271.
- Krishnan, J. A., Lemanske, R. F., Canino, G. J., Elward, K. S., Kattan, M., Matsui, E. C., . . . Minnicozzi, M. (2012). Asthma outcomes: symptoms. Journal of Allergy and Clinical Immunology, 129(3), S124-S135.
- Lomholt, T. (2013). Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better. Journal of asthma and allergy, 6, 117-125.
