Home Drug Guide Levalbuterol Hydrochloride

Drug Guide

Generic Name

Levalbuterol Hydrochloride

Brand Names Xopenex

Classification

Therapeutic: Bronchodilator for asthma and COPD

Pharmacological: Beta-2 adrenergic agonist

FDA Approved Indications

  • Relief of bronchospasm in patients with reversible airway obstruction due to asthma or COPD

Mechanism of Action

Levalbuterol selectively stimulates beta-2 adrenergic receptors in smooth muscle of the airways, causing relaxation and bronchodilation.

Dosage and Administration

Adult: 0.63-1.25 mg inhaled every 6-8 hours as needed

Pediatric: 0.31-0.63 mg inhaled every 20 minutes for up to 3 doses, then as needed; dosages may vary based on age and weight

Geriatric: Use with caution; start at lower end of dosing spectrum with monitoring

Renal Impairment: Adjust dose based on severity of impairment, if necessary

Hepatic Impairment: No specific adjustments necessary

Pharmacokinetics

Absorption: Rapid absorption after inhalation

Distribution: Wide distribution; minimal plasma protein binding

Metabolism: Primarily hepatic via conjugation to inactive metabolites

Excretion: Renal excretion of metabolites

Half Life: about 3-4 hours

Contraindications

  • Hypersensitivity to levalbuterol or other sympathomimetics

Precautions

  • Use cautiously in patients with cardiovascular disorders, diabetes, hyperthyroidism, or seizure disorders.

Adverse Reactions - Common

  • Tremor (Common)
  • Nervousness (Common)
  • Headache (Uncommon)
  • Dizziness (Uncommon)

Adverse Reactions - Serious

  • Cardiac arrhythmias (Rare)
  • Hypersensitivity (including bronchospasm, angioedema) (Rare)

Drug-Drug Interactions

  • Other sympathomimetics, beta-blockers, monoamine oxidase inhibitors (MAOIs)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, lung sounds, and pulse before and after administration.

Diagnoses:

  • Ineffective Airway Clearance
  • Impaired Gas Exchange

Implementation: Administer via inhaler or nebulizer as prescribed. Monitor for side effects.

Evaluation: Assess improvements in lung function and symptom relief.

Patient/Family Teaching

  • Use inhaler/spacer properly as instructed.
  • Notify healthcare provider if symptoms worsen or if adverse reactions occur.
  • Avoid exceeding prescribed dose.
  • Keep track of inhaler doses and when to replace.

Special Considerations

Black Box Warnings:

  • None currently

Genetic Factors: None specific to levalbuterol

Lab Test Interference: None known

Overdose Management

Signs/Symptoms: Severe tachycardia, hypertension, hypokalemia, chest pain.

Treatment: Discontinue drug, provide supportive care, monitor cardiac status, and treat symptoms symptomatically.

Storage and Handling

Storage: Store at room temperature, away from heat and moisture.

Stability: Stable for up to 24 months when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.