Читать книгу Fundamentals of Pharmacology for Paramedics - Группа авторов - Страница 33

Salbutamol, also known as albuterol, is a beta‐2 receptor agonist and is frequently administered in the out‐of‐hospital setting for management of bronchospasm. It can also be used in the management of hyperkalaemia because it stimulates the transport of potassium ions from the blood into skeletal muscle cells. This effect is also mediated by the action of salbutamol on beta‐2 receptors.

Many patients who have been prescribed salbutamol may have already self‐administered their own ‘puffer’ prior to your arrival and may be tachycardic as a result. This is due to binding to beta‐2 receptors in cardiac muscle after absorption of salbutamol into the bloodstream. Tachycardia may predispose the patient to arrhythmias, so regarding these patients as high risk for a cardiac event is warranted.

Muscle tremors may also occur in these patients, due to binding of the drug to beta‐2 receptors in skeletal muscle. Although the drug is quite selective for beta‐2 receptors, it will also bind to beta‐1 receptors at high doses, so if the patient has used their puffer very extensively prior to your treatment, there may be additional tachycardia due to an action on beta‐1 receptors in the heart, increasing cardiac risk.