Albuterol Basics
Albuterol is a selective beta-2 agonist that relaxes bronchial smooth muscle. The standard nebulized adult dose is 2.5 mg in 3 mL of saline, repeated as needed. Expect side effects such as tachycardia, tremor, and nervousness.
Ipratropium
Ipratropium is an anticholinergic that blocks muscarinic receptors in the airway, reducing secretions and bronchoconstriction. It is often combined with albuterol in a DuoNeb for COPD and asthma exacerbations. Onset is slower than albuterol, but the combination improves outcomes in severe attacks.
Clinical Pearls
Silent chest in an asthmatic is an ominous sign, not an improvement. Provide oxygen as needed, consider CPAP for severe distress, and prepare for ventilatory support. Reassess lung sounds, work of breathing, and oxygen saturation after each treatment.