Bronchodilator and Antihyperkalemic Effects of Salbutamol (Albuterol) in Neonates and Young Infants

Salbutamol (albuterol) is a β 2 -agonist used for its bronchodilator activity and for its antihyperkalemic property. Salbutamol was specifically designed for use in infants and children. The preferred route of administration is by a nebulizer because systemic effects are lower than after oral or intravenous administration. Salbutamol is the most widely used bronchodilator in adults and children. When inhaled from metered-dose aerosol, it is easy to use, has a rapid onset of action, and does not have significant adverse effects. Compared with preadministration values, salbutamol yields a significant decrease in resistance and an increase in compliance. Salbutamol can alleviate bronchospasm in infants and children with chronic lung disease such as asthma. The bronchodilator effects of salbutamol are attributed to the R-enantiomer of salbutamol (levosalbutamol). The decrease in airway resistance reflects the relationship between the bronchial smooth muscle and the diameter of the airways. Infants who required intubation and mechanical ventilator support for respiratory syncytial virus-induced respiratory failure had an improvement of lung function following the administration of salbutamol. Nebulized salbutamol has not been reported to have cardiac side effects. Epinephrine was not found to be more efficacious than salbutamol in treating moderately ill infants with bronchiolitis. Hyperkalemia is a fatal disorder that requires treatment. The aim of this review is to summarize the published data on the activities of salbutamol as a bronchodilator and as an antihyperkalemia agent in neonates.