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Salbutamol Medication for Bronchospasms

Info: 3081 words (12 pages) Nursing Essay
Published: 19th Apr 2021

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Tagged: medication

Introduction:

 Salbutamol can be described as the bronchodilator medication that actually helps in relaxation of the muscles of airways that leads to lungs and thereby helps in the improvement of thee amount of airflow to and from the lungs. This medication is mainly helpful in the prevention as well as the treatment for the symptoms of asthma as well as chronic obstructive pulmonary disorder (Aronson 2015). This assignment would mainly be showing how the medication can help in alleviating a person suffering from symptoms of bronchospasms and bronchoconstrictions that occur during respiratory disorders like that of asthma. It would also show the various interactions and the limitations that the drugs have and the important points that nurses need to keep in mind while administering this medication in patients.

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Classification of salbutamol as the short acting beta2 agonists:

 Salbutamol is mainly classified as the short acting beta-2 agonists and is referred to as the reliever or the rescue medications. This is mainly because these medications are seen to treat sudden as well as severe or new asthma symptoms. Researchers are of the opinion that this medications start working within 15 to 20 minutes and can be seen to last for about four to that of six hours (Kostenko et al. 2018). Even, it had been found that if these medications are taken 15 to 20 minutes before undertaking exercises by the patients who are prone to develop exercise-induced asthma symptoms. It has been found that of the medications would be needed by the patient o be used more than twice a week, healthcare professionals should be immediately called and consulted (Andrzejowski and Carroll 2016). This is because it signifies that the patient is prone to be suffering from unstable asthma and denotes that the healthcare professionals would need to change the dose of the long-term control medications that one takes.

Pathophysiology occurring during asthma:

 During the times of Asthma episode, the inflammation of the airways takes place from the reaction of the different types if environmental triggers like that of smoke, dust as well as pollens and others. The airways in such circumstances are seen to become narrow which in turn proceeds to formation of excess amounts of mucus and this makes it difficult for the affected patient to breathe. Therefore, asthma is seen to be the result of the immune response in the bronchial airways (Ciprés et al. 2019). Studies are of the opinion that in response to the various types of triggers, the bronchi would be contracting into the spasms which are soon seen to be followed by that of the inflammation. This mainly results in the further narrowing of the airways and thereby results in excessive prediction of mucus which makes the affected individuals to undergo coughing and many other breathing difficulties. Bronchospasms are seen to take place which is then followed by broncho-constriction as well as inflammation within a very few number of hours of 3 to 12. A study had undertaken an in-depth analysis where the researchers had stated that the normal caliber of the bronchus is mainly cared for and maintained by a successful balanced functioning of that of the autonomic nervous system. These are seen to operate reflexively (Tuladhar 2017). It has been found that the parasympathetic reflex look mainly comprises of the afferent nerve ending. These are mainly found to be originating under that of the lining of the bronchus. Studies have stated that whenever the afferent nerve endings are excited by the stimulants, impulses are seen to be travelling to that of the brain-stem vagal center. Then they flow through the vagal efferent pathway so that they can again reach the bronchial small airways. Acetylcholine is seen to be released from that of the efferent bereve endings which actually contributes to excessive formation of that of the inositol 1,4,5-trisphosphate (IP3) in bronchial smooth muscle cells.  They are actually seen to result in muscle shortening and this causes initiation of the broncho-constriction.

 Airway obstruction is mainly because of the variety of the changes that are seen to include acute broncho-constriction as mentioned above or due to airway edema, formation of chronic mucous plug and also airway remodeling. Studies have found that broncho-constriction is mainly the result of the consequences of the immune globulin E-dependent mediator release that occurs because of the exposure to that of the aeroallergens (Hostrup et al. 2018). This is mainly the primary component found in the early asthmatic releases. It is seen that the airway edema is mainly seen to occur within that of the 6 – 24 hours which follow an allergen challenge and is also stated to be as the late asthmatic response. Rao and Andrade (2016) is of the opinion that chronic mucous plug formation mainly comprises of the exudates of the serum proteins as well as cellular debris which might result in needing two weeks for resolution. Airway obstruction mainly causes an increase in the resistance towards the airflow and at the same time decrease the rates of the expiratory flow. These changes are seen to lead to the decreased ability in expelling the air and might also result in hyperinflation. This situation of over distention helps in maintaining the airway patency that increases the expiratory airflow but at the same time, it also alter pulmonary mechanisms and increase the wok of breathing (Bhattacharya and Banerjee 2016).

How salbutamol helps in overcoming the situation through its working mechanism:

 Salbutamol is seen to be comprised of the tertiary butyl group and therefore, this makes the medication more appropriate for the different beta2 receptors. Beta2 receptors are actually the predominant receptors on the different bronchial smooth muscles. Researches who have worked on this topic had stated that activation of these receptors would result in the conversion of that of the ATP to CAMP with the help of the adenylyl cyclase resulting in the increase of the CAMP as well as the activation of the protein kinase A (Koch et al. 2015) . This would result in the beginning of the signaling cascade which can be seen to be ending with the inhibition of that of the myosin phosphorylation as well as causes lowering of the intracellular concentration of calcium ions. It is already known that myosin phopshorylation as well as calcium ions are necessary for that of the contractions of the muscles. Studies are of the opinion that increase in the CAMP would also result in the inhibition of the inflammatory cells in the airways like that of the basophils, eosinophils as well as most especially in the mast cells. It prevents from the release of the inflammatory mediators as well as the cytokines which prevents the inflammation activities (Katsunuma et al. 2019). Moreover, Salbutamol is also seen to increase that of the conductance of the channels that are sensitive towards the calcium as well as the potassium ions. This would lead to that of the hyperpolarisation as well as the relaxation of the bronchial smooth muscles.

 Through the above mechanisms, salbutamol can be seen to relax the smooth muscles of all the airways from the trachea to that of the terminal bronchioles. This medication is thereby seen to act as the functional antagonist and helps in relaxing the airways irrespective of the different types of spasmogens involved. In this way, the medication is seen to protect against all that of the broncho-constrictor challenges. Moreover, an increment in that of the concentrations of that of cyclic AMP is also seen to be associated with that of the inhibitions from the release of the mediators from that of the mast cells in the passages of the airways (Mukerjee et al. 2017). Studies have shown that there are considerable decrease in the airway resistances and is typically observed to take place within that of 5 to 15 minutes after the patients are seen to inhale salbutamol. Researchers have observed that the maximum improvement in the pulmonary functions mainly take place from 60 to that of the 90 minutes immediately after the treatment with salbutamol. The significant activity of the bronchodilator is seen to be observed to be persisting for about 3 to 6 hours (Demey et al. 2017).

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Interactions of Salbutamol with other disorders:

 This medication has the ability in interacting with a large number of disorders and hence it would become extremely important for the healthcare professionals to be very careful about the patient and know the entire history of the patient before administering the medication into such patients. Firstly, this medication use can be associated with an increase in the heart rate as well as the various changes in the blood pressure. This medication can be well-used with caution among the patients who have an active or that of the historic case of the hear disorders. The nursing professionals should therefore screen the risk factors of the heart disorders in the patient before they start the treatment with that of the medication of salbutamol (Anderson 22018). Secondly, the utilization of this medication can be found to be associated with that of the mild to moderate rise in the blood sugar levels in the affected patients. Hence, the nurse should exercise cautions if the patient is seen to suffer from diabetes (Sharif et al. 2018). Third, the administration of the medication can be seen to ve associated with the reduction of the decrease in the blood potassium levels. The nursing professionals thereby needs to use the medication with caution in any patients who have ailments where potassium levels in the body had been already found to be unbalanced (Forbes et al. 2018). Fourth, this medication is seen to be administered with caution to any patients who have the tendency to suffer from seizure disorders as this medication increases the risk as well as the increased frequency as well as severity of the convulsions that are significantly quite high. Fifth, this medication can be used by the nurse with caution for any patients who have been found to suffer from impairment if the normal kidney functions. The healthcare professionals need to be very careful about selecting the dose and they should also monitor the kidney function on the regular basis. Six, this medication can also have interactions with specific foods and hence, the nursing professionals need to be very careful about this medication administration (Gaugg et al. 2017). The medication should be utilized with caution if the patients are seen to utilize mineral oil like that of castor oil as the laxative. The risks of the adverse effects associated with the disorder are seen to become quite high and hence, the usage would be reported by the patient before the nurse initiates the treatment with the disorder.

Considerations by the healthcare professionals while using the drugs:

 The nursing professionals mainly need to ensure that the patients do not have the chance of developing allergic reaction to that of salbutamol. The patients who have a rare inherited digestive disorder like that of galactose intolerance as well as Lapp lactase deficiency as well as that of the glucose-galactose malabsorption should not be given the medication. The limitation of this medication is that many of the salbutamol products are seen to be comprising of the lactose and hence this medication can initiate negative reactions in the patients. this medication is mainly safe in its action but might show some common side effects like feeling of shakiness, faster heartbeat, headaches as well as muscle cramps which are usually found to occur in very few individuals taking the medication (Svedstater et al. 2019). Some of the severe side effects are other set of limitations like that of dizziness and fainting, pain in the chest and heart-beat being abnormal   as well as intense heartbeat. Nursing professionals can suggest the patient of this medication to have the best efficiency when taken as 1 or 2 puffs when needed when the patients suffer from certain symptoms like coughing, wheezing, shortness of breath and tightness in the chest. They may be also advised to take this medication when the patients have to undertake any exercise like climbing medications or playing sports. The medication would benefit then by overcoming the tendencies of having asthma attacks.

Conclusion:

 The medication salbutamol is a bronchodilator and falls in the category of short acting beta2 agonists. This medication helps the patients to overcome the symptoms of bronchospasms as well as broncho-constrictions by relaxing the muscle bands around the airway passages. The nursing professionals need to be well aware of the side effects as well as the various conditions which might interact with the medication making situation worse for the patients. The nurse should also educate the patients about how to use the medication successfully so that they can overcome symptoms of the asthma attacks successfully.

References:

  • Anderson, S.D., 2018. Repurposing drugs as inhaled therapies in asthma. Advanced drug delivery reviews133, pp.19-33.
  • Andrzejowski, P. and Carroll, W., 2016. Salbutamol in paediatrics: pharmacology, prescribing and controversies. Archives of Disease in Childhood-Education and Practice101(4), pp.194-197.
  • Aronson, J.K. ed., 2015. Meyler’s side effects of drugs: the international encyclopedia of adverse drug reactions and interactions. Elsevier.
  • Bhattacharya, S.S. and Banerjee, S., 2016. Design, Development, and Delivery of Salbutamol Sulfate from an Adhesive Matrix System. The Journal of Adhesion92(2), pp.147-169.
  • Ciprés-Flores, F.J., Segura-Uribe, J.J., Orozco-Suárez, S., Guerra-Araiza, C., Guevara-Salazar, J.A., Castillo-García, E.L., Soriano-Ursúa, M.A. and Farfán-García, E.D., 2019. Beta-blockers and salbutamol limited emotional memory disturbance and damage induced by orchiectomy in the rat hippocampus. Life sciences.
  • Demey, L., Van Muylem, A., Michils, A. and Haccuria, A., 2017. Protective effect of salbutamol on peripheral airway constriction induced by sputum induction in asthma patients.
  • Forbes, L., Cooper, L., Barton, R. and Pritchard, L., 2018. Abstract P-027: Iv Salbutamol Dosing In Paediatric Asthma Management. Pediatric Critical Care Medicine19(6S), p.56.
  • Gaugg, M.T., Engler, A., Nussbaumer-Ochsner, Y., Bregy, L., Stöberl, A.S., Gaisl, T., Bruderer, T., Zenobi, R., Kohler, M. and Sinues, P.M.L., 2017. Metabolic effects of inhaled salbutamol determined by exhaled breath analysis. Journal of breath research11(4), p.046004.
  • Gonem, S., Cumella, A. and Richardson, M., 2019. Asthma admission rates and patterns of salbutamol and inhaled corticosteroid prescribing in England from 2013 to 2017. Thorax, pp.thoraxjnl-2018.
  • Hostrup, M., Reitelseder, S., Jessen, S., Kalsen, A., Nyberg, M., Egelund, J., Kreiberg, M., Kristensen, C.M., Thomassen, M., Pilegaard, H. and Backer, V., 2018. Beta2‐adrenoceptor agonist salbutamol increases protein turnover rates and alters signalling in skeletal muscle after resistance exercise in young men. The Journal of physiology596(17), pp.4121-4139.
  • Katsunuma, T., Fujisawa, T., Maekawa, T., Akashi, K., Ohya, Y., Adachi, Y., Hashimoto, K., Mizuno, M., Imai, T., Oba, M.S. and Sako, M., 2019. Low-dose l-isoproterenol versus salbutamol in hospitalized pediatric patients with severe acute exacerbation of asthma: A double-blind, randomized controlled trial. Allergology International.
  • Koch, S., MacInnis, M.J., Sporer, B.C., Rupert, J.L. and Koehle, M.S., 2015. Inhaled salbutamol does not affect athletic performance in asthmatic and non-asthmatic cyclists. Br J Sports Med49(1), pp.51-55.
  • Koch, S., MacInnis, M.J., Sporer, B.C., Rupert, J.L. and Koehle, M.S., 2015. Inhaled salbutamol does not affect athletic performance in asthmatic and non-asthmatic cyclists. Br J Sports Med49(1), pp.51-55.
  • Kostenko, M.O., Pokrovskiy, O.I., Parenago, O.O. and Lunin, V.V., 2018. Effect of the type and concentration of mobile phase additives on the separation of salbutamol sulfate enantiomers in supercritical fluid chromatography. Russian Chemical Bulletin67(11), pp.1997-2002.
  • Mukherjee, M., Cingolani, E., Pritchard, D.I. and Bosquillon, C., 2017. Enhanced expression of Organic Cation Transporters in bronchial epithelial cell layers following insults associated with asthma–Impact on salbutamol transport. European Journal of Pharmaceutical Sciences106, pp.62-70.
  • Ozer, M., Buyuktiryaki, B., Sahiner, U.M., Teksam, O., Karaatmaca, B., Soyer, O. and Sekerel, B.E., 2018. Repeated doses of salbutamol and aeroallergen sensitisation both increased salbutamol‐induced hypoxia in children and adolescents with acute asthma. Acta Paediatrica107(4), pp.647-652.
  • Rao, T.S. and Andrade, C., 2016. Classification of psychotropic drugs: Problems, solutions, and more problems. Indian journal of psychiatry58(2), p.111.
  • Sharif, Z. and Al-Alawi, M., 2018. Beware of beta! A case of salbutamol-induced lactic acidosis in severe asthma. BMJ case reports2018, pp.bcr-2017.
  • Svedsater, H., Jacques, L., Powell, D., Lay-Flurrie, J. and Collier, S., 2019. Reduced Prescriptions of Salbutamol in Patients Initiated on Fluticasone Furoate/Vilanterol (FF/VI) Compared with Continuing Usual Care (UC) in the Asthma Salford Lung Study (SLS Asthma). In A32. ASTHMA: CLINICAL STUDIES II (pp. A1318-A1318). American Thoracic Society.
  • Tuladhar, L.R., 2017. Tamrakar (Tuladhar) ET. Efficacy of Salbutamol in Mixed Obstructive and Restrictive Pattern Spirometry. Kathmandu Univ Med J60(4), pp.279-83.

 

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