Home Drug Guide Levalbuterol Tartrate

Drug Guide

Generic Name

Levalbuterol Tartrate

Brand Names Xopenex HFA

Classification

Therapeutic: Bronchodilator for asthma and COPD

Pharmacological: Selective beta2-adrenergic receptor agonist

FDA Approved Indications

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

Mechanism of Action

Levalbuterol stimulates beta2-adrenergic receptors in smooth muscle of the airways, leading to relaxation of bronchial muscles and resulting in bronchodilation.

Dosage and Administration

Adult: 90 mcg inhaled every 4 to 6 hours as needed; maximum dose varies based on patient's response

Pediatric: Same as adult, typically 45 mcg or 90 mcg per inhalation, based on age and severity; dosing should be individualized

Geriatric: Use with caution due to increased risk of cardiovascular side effects; start at lower end of dosing range

Renal Impairment: No specific adjustment; monitor for increased side effects

Hepatic Impairment: Use with caution; no specific dose adjustment

Pharmacokinetics

Absorption: Rapid after inhalation

Distribution: Widely distributed, minimal protein binding

Metabolism: Primarily metabolized in the liver by conjugation

Excretion: Excreted mainly in urine as metabolites

Half Life: Approximately 3.3 hours

Contraindications

  • Hypersensitivity to levalbuterol or other sympathomimetics

Precautions

  • Use with caution in patients with cardiovascular disorders, especially arrhythmias, hypertension, or ischemic heart disease; monitor for tachycardia, hypokalemia, and paradoxical bronchospasm

Adverse Reactions - Common

  • Tremor (Common)
  • Nervousness (Common)
  • Headache (Less common)
  • Throat irritation (Less common)

Adverse Reactions - Serious

  • Cardiac arrhythmias (Rare)
  • Hypokalemia (Rare)
  • Paradoxical bronchospasm (Rare)

Drug-Drug Interactions

  • Other sympathomimetics, tricyclic antidepressants, and MAO inhibitors may increase adrenergic side effects

Drug-Food Interactions

  • No significant interactions reported

Drug-Herb Interactions

  • Limited data; caution advised when combining with herbal supplements that have stimulant properties

Nursing Implications

Assessment: Monitor lung function (PEF, FEV1), heart rate, blood pressure, and potassium levels before and during therapy

Diagnoses:

  • Ineffective airway clearance
  • Risk for cardiovascular complications

Implementation: Educate patient on proper inhaler technique, monitor for adverse effects, and assess response to therapy

Evaluation: Determine improvement in airway function and symptom control, monitor for adverse reactions

Patient/Family Teaching

  • Use inhaler as prescribed, do not exceed recommended dose
  • Notify healthcare provider if paradoxical bronchospasm occurs or if symptoms worsen
  • Report new cardiovascular symptoms such as chest pain or irregular heartbeat
  • Carry rescue inhaler at all times

Special Considerations

Black Box Warnings:

  • None specifically for levalbuterol

Genetic Factors: None identified

Lab Test Interference: None known

Overdose Management

Signs/Symptoms: Severe tachycardia, hypokalemia, hypertension, tremors, nervousness, seizures in extreme cases

Treatment: Discontinue drug, monitor vital signs, treat symptoms supportively, administer beta-blockers cautiously if needed for severe reactions

Storage and Handling

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

Stability: Stable 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.