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Intravenous salbutamol for childhood asthma: evidence-based medicine?
  1. E S Starkey1,
  2. H Mulla2,
  3. H M Sammons3,
  4. H C Pandya4
  1. 1Department of Paediatrics, Royal Derbyshire Hospital, Derby, UK
  2. 2Department of Pharmacy, Glenfield Hospital, Leicester, UK
  3. 3Division of Medical Sciences & Graduate Entry Medicine, School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
  4. 4Departments of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
  1. Correspondence to Dr Hitesh C Pandya, University of Leicester, Leicester, LE2 7 UK; hp28{at}le.ac.uk

Abstract

Intravenous salbutamol is commonly used to treat children with severe asthma unresponsive to inhaled β2-agonist therapy. However, in this setting, there is little clinical trial data demonstrating its effectiveness. Additionally, there are significant concerns that intravenous salbutamol-dosing recommendations for children with acute asthma are excessive, and unnecessarily raise the potential for adverse reactions, such as lactic acidosis and tachycardia which, by increasing respiratory workload, exacerbate respiratory failure. Here, we review salbutamol clinical pharmacology and toxicology, evidence relating to its use in acute asthma and highlight gaps in the evidence base.

  • Pharmacology
  • Respiratory
  • Evidence Based Medicine

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