Indications

Salmolin syrup (2mg/5ml) (Salbutamol) is a bronchodilator indicated for use in:

• Asthma
• Chronic Bronchitis
• Emphysema
• Other conditions associated with airways obstruction

Pharmacology

Salbutamol is a synthetic sympathomimetic agent that primarily stimulates beta-2 adrenergic receptors in the smooth muscles of the bronchial tubes. This action causes the muscles to relax, leading to bronchodilation and an improvement in pulmonary function.

Dosage & Administration

Tablet or Syrup:

• Adults: 2-4 mg tablet, 3-4 times daily. Maximum single dose is 8 mg.
• Children 2-6 years: 2.5 ml syrup, 3-4 times daily.
• Children 6-12 years: 5 ml syrup, 3-4 times daily.
• Children >12 years: 5-10 ml syrup, 3-4 times daily (or 2-4 mg tablet, 3-4 times daily).

Respirator Solution (for nebulizer):

• Intermittent Administration:
  • Adults: 0.5-1.0 ml of solution, diluted to 2-4 ml with sterile normal saline, up to 4 times a day. Can also be used undiluted (2.0 ml of solution).
  • Children <12 years: 0.5 ml of solution, diluted to 2.0-4.0 ml with normal saline, up to 4 times a day.
• Continuous Administration: 1-2 ml of solution diluted to 100 ml with normal saline.

Nebulizer Solution:

• Adults & Elderly: 2.5 mg to 5 mg up to 4 times a day.
• Children <12 years: 2.5 mg up to 4 times a day. A higher dose of up to 5 mg may be used if needed.

I.V. Infusion:

• Adults: Prepare a solution by diluting 5 mL of Salmolin I.V. infusion solution in 500 mL of a suitable I.V. solution to a concentration of 10 mcg/mL. Infusion rates usually range from 3 to 20 micrograms/minute.
• Children: Dosage has not been established.

Inhalation Capsule (for device):

• Adults: One or two 200 microgram capsules as a single dose for relief. For maintenance, one capsule every 4 to 6 hours.
• Children >4 years: One capsule for acute bronchospasm. For maintenance, one capsule 3-4 times a day. The dose may be increased to two capsules if necessary.
• Exercise-induced Asthma: 400 microgram for adults, 200 microgram for children, 15-30 minutes before exercise.

Side Effects

Common side effects include a fine tremor of skeletal muscles, palpitations, and muscle cramps. Tachycardia, tenseness, headaches, and peripheral vasodilation have also been reported with large doses.

Pregnancy & Lactation

Salmolin should only be used during pregnancy if the potential benefit justifies the potential risk. It is unknown whether the drug is excreted in human milk. A decision on whether to discontinue nursing or discontinue the drug should be made based on the importance of the drug to the mother.

Precautions & Warnings

Use with caution in patients with hyperthyroidism, cardiovascular disease, hypertension, and aneurysms. High doses may cause hypokalaemia, which increases the risk of digitalis-induced cardiac arrhythmia. Care is also necessary in patients with diabetes mellitus, closed-angle glaucoma, and those receiving antihypertensive therapy.

Overdose Effects

Symptoms of overdose include angina, headache, nausea, vomiting, and tremors. A cardio-selective beta-blocking agent is the preferred antidote, but it should be used with caution in patients with a history of bronchospasm.

Therapeutic Class

Salmolin is classified as a Short-acting selective beta-2 adrenoceptor stimulant.

Storage Conditions

Store below 30°C, away from light and moisture. Keep out of the reach of children.