Nurses Compass
Drug Guide
Pirbuterol Acetate
Classification
Therapeutic: Bronchodilator for asthma and COPD
Pharmacological: Beta2-adrenergic agonist
FDA Approved Indications
- Relief of bronchospasm in patients with reversible airway obstruction due to asthma or COPD
Mechanism of Action
Pirbuterol binds to beta2-adrenergic receptors on airway smooth muscle, leading to relaxation of bronchial muscles and bronchodilation.
Dosage and Administration
Adult: Inhalation of 400 mcg (two inhalations) every 4-6 hours as needed; maximum 12 inhalations per 24 hours.
Pediatric: Typically 200 mcg (one inhalation) three to four times daily; use with caution and under medical supervision.
Geriatric: Adjust doses based on individual response and tolerability, usual adult dosing applies.
Renal Impairment: No specific adjustment known; use cautiously.
Hepatic Impairment: No specific adjustment indicated.
Pharmacokinetics
Absorption: Rapid absorption via inhalation.
Distribution: Widely distributed in tissues; minimal plasma protein binding data available.
Metabolism: Minimal systemic metabolism; primarily excreted unchanged.
Excretion: Excreted mainly via urine.
Half Life: Approximately 5-6 hours.
Contraindications
- Known hypersensitivity to pirbuterol or other beta-agonists.
- Tachyarrhythmias, including atrial fibrillation or flutter.
Precautions
- Use with caution in patients with cardiovascular disorders (e.g., hypertension, ischemic heart disease).
- Monitor for paradoxical bronchospasm.
Adverse Reactions - Common
- Tremor (Common)
- Headache (Common)
- Nervousness (Common)
- Throat irritation (Common)
Adverse Reactions - Serious
- Cardiac arrhythmias (Rare)
- Paradoxical bronchospasm (Rare)
- Hypersensitivity reactions (Rare)
Drug-Drug Interactions
- Other beta-adrenergic agonists, MAO inhibitors, tricyclic antidepressants.
- Use cautiously with other sympathomimetic agents.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor lung function (e.g., peak expiratory flow), assess for adverse effects.
Diagnoses:
- Ineffective airway clearance
- Imbalanced nutrition: less than body requirements (if side effects occur)
Implementation: Administer via inhalation device as prescribed, instruct on proper inhaler technique.
Evaluation: Assess improvement in symptoms and lung function; monitor for adverse effects.
Patient/Family Teaching
- Use inhaler exactly as prescribed.
- Notify healthcare provider if symptoms worsen or adverse effects occur.
- Carry inhaler at all times for emergency use.
Special Considerations
Black Box Warnings:
- Potential for severe bronchospasm if used improperly.
Genetic Factors: No major genetic considerations.
Lab Test Interference: None known.
Overdose Management
Signs/Symptoms: Severe tachycardia, hypertension, hypokalemia, chest pain.
Treatment: Supportive care, monitoring, and possibly administering beta-blockers if appropriate (with caution).
Storage and Handling
Storage: Store at room temperature, away from heat and moisture.
Stability: Stable under recommended storage conditions.