알부테롤 / 살부타몰
Albuterol
Albuterol sulfate
다른 이름: Proventil · Ventolin · ProAir · AccuNeb · VoSpire · Salbutamol hemisulphate · Salbutamol sulphate · Salbutamoli sulfas · Albuterol sulfate · Salbutamol sulfate
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Bronchodilation | 0.05 mg/kg (50 micrograms /kg) PO q8h | PO | q8h | — | 🌎 NA |
| Bronchodilation | 0.02 mg/kg PO q12h for 5 days; if no improvement and no adverse effects may increase to 0.05 mg/kg PO q8-12h. If patient responds, reduce to lowest effective dose. | PO | q12h initially, then q8-12h | 5 days initially | 🌎 NA |
| Bronchodilation (Inhalation) | 0.5 mL of the 0.5% solution for nebulization in 4 mL of saline nebulized every 6 hours | Inhalation | q6h | — | 🌎 NA |
- Bronchodilation: WARNING: Older references stating 50 mg/kg q8h are an obvious overdose and should not be followed.
- Bronchodilation (Inhalation): Based on a 60 lb dog.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Feline asthma (mild symptoms) | one puff albuterol as needed with one puff of 110 micrograms fluticasone twice daily. | Inhalation | PRN | — | 🌎 NA |
| Feline asthma (moderate symptoms) | albuterol one puff as needed with a 5 day course of prednisone at 1 mg/kg PO daily, and 220 micrograms of fluticasone twice daily. | Inhalation | PRN | — | 🌎 NA |
| Feline asthma (severely affected/emergency) | 90 micrograms (one puff) albuterol every 30 minutes as needed. | Inhalation | q30min PRN | — | 🌎 NA |
| Feline asthma (chronic therapy) | 90 micrograms albuterol as needed | Inhalation | PRN | — | 🌎 NA |
| Feline asthma (intermittent signs) | two puffs into an appropriate spacer ( e.g., Aerokat ®) twice daily; cat should breathe through the mask and spacer for 7-10 seconds. Positive clinical effect should be seen within 5-10 minutes. Can be used every 1/2 hour for 2-4 hours in crisis. | Inhalation | BID or q30min in crisis | — | 🌎 NA |
- Feline asthma (mild symptoms): Using the 90 micrograms/puff aerosol albuterol inhaler and an appropriate spacer and mask.
- Feline asthma (severely affected/emergency): Should be treated on an emergency basis with oxygen and an intravenous dose of a glucocorticoid.
- Feline asthma (chronic therapy): Should include fluticasone 220 micrograms twice daily and 1 mg/kg prednisone every other day.
- Feline asthma (intermittent signs): For intermittent signs (e.g., wheeze, increased cough or respiratory rate and effort at rest).
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Rescue therapy (respiratory difficulty at rest) | 360 micrograms (4 puffs) inhaled; if severe airway obstruction, may give at 15 minute increments for up to 2 hours. Continue as needed every 4-6 hours. | Inhalation | q15min up to 2h, then q4-6h PRN | — | 🌎 NA |
| Moderate to severe respiratory disease | 360 micrograms followed in 5 minutes with aerosolized corticosteroid (beclomethasone or fluticasone) therapy. | Inhalation | — | — | 🌎 NA |
| Bronchodilation | 2-3 micrograms/kg via inhalation using a specially designed mask and spacer ( Aeromask ® and Aerovent ®) | Inhalation | — | — | 🌎 NA |
| Heaves | 0.8-2 micrograms/kg in a metered dose inhaler | Inhalation | — | — | 🌎 NA |
| Short-acting bronchodilation | 450-900 micrograms (5-10 puffs) as needed, not to exceed 4 times per week unless in conjunction with a corticosteroid | Inhalation | PRN (max 4x/week without steroids) | — | 🌎 NA |
| Heaves | 360 micrograms (4 puffs) inhaled as needed. Tolerance develops rapidly if used as a sole therapy. | Inhalation | PRN | — | 🌎 NA |
- Rescue therapy (respiratory difficulty at rest): Beneficial effects may last approximately 1 hour in severely affected horses. ARCI UCGFS Class 3 Drug.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
알부테롤(국제 일반명: 살부타몰)은 속효성 $\beta_2$-아드레날린 수용체 작용제(SABA)입니다. 수의학에서는 하부 호흡기 질환과 관련된 기관지 경련 및 기침을 완화하는 강력한 기관지 확장제로 널리 사용됩니다.
주요 임상 적용:
- 고양이 천식: 주로 급성 천식 발작 시 "응급(rescue)" 흡입기로 사용됩니다.
- 개 만성 기관지염: 기관지 경련의 증상 완화를 제공합니다.
- 말 재발성 기도 폐쇄(RAO): 호흡 곤란의 급성 완화에 사용됩니다.
임상 요점: 급성 응급 치료에는 매우 효과적이지만, 라세믹 알부테롤의 만성적인 단독 사용은(특히 고양이에서) 권장되지 않습니다. 라세믹 혼합물의 S-거울상 이성질체는 시간이 지남에 따라 역설적으로 기도 염증을 증가시킬 수 있습니다. 장기 관리를 위해서는 이상적으로 흡입용 코르티코스테로이드(예: 플루티카손)와 병용해야 합니다.
작용 기전
Albuterol selectively binds to and stimulates $\beta_2$-adrenergic receptors on bronchial smooth muscle.
Mechanism Pathway: $\beta_2$-receptor activation $\rightarrow$ stimulates adenylyl cyclase $\rightarrow$ increases intracellular cyclic AMP (cAMP) $\rightarrow$ activates protein kinase A (PKA) $\rightarrow$ decreases intracellular calcium concentrations $\rightarrow$ results in smooth muscle relaxation and bronchodilation.
- Secondary Effects: It also stabilizes mast cell membranes (preventing inflammatory mediator release) and increases mucociliary clearance.
- Metabolic/Electrolyte Effects: Beta-adrenergic stimulation activates the $Na^+/K^+$-ATPase pump, driving potassium from the serum into the intracellular space, which can cause temporary hypokalemia.
- Cardiac Effects: At standard doses, it has minimal $\beta_1$ (cardiac) activity, but at high doses or in sensitive individuals, it can cause tachycardia.
안전성·주의사항
금기사항
- Known hypersensitivity to albuterol
- Use with extreme caution in patients with cardiac disease (especially concurrent arrhythmias)
- Use with caution in patients with diabetes, hyperthyroidism, hypertension, or seizure disorders
- Use during late stages of pregnancy (may inhibit uterine contractions)
- Known hypersensitivity to salbutamol
- Severe cardiac tachyarrhythmias
부작용
- Tachycardia
- Tremors and trembling
- CNS excitement, nervousness, and agitation
- Dizziness
- Hypokalemia (decreased serum potassium)
- Paradoxical airway inflammation in cats (associated with chronic use of the S-enantiomer in racemic albuterol)
- Muscle tremors
- Restlessness or excitement
- Hypokalemia (with high doses)
주의
Albuterol should be used with caution in animals with underlying cardiovascular disease, particularly those prone to arrhythmias, as well as those with hyperthyroidism, hypertension, or seizure disorders.
Pregnancy Warning: In very large doses, albuterol is teratogenic in rodents. It may also delay preterm labor by inhibiting uterine contractions. Use only when potential benefits outweigh the risks (FDA Category C in humans).
Feline Specific Warning: Chronic use of racemic albuterol in cats can exacerbate airway inflammation. Its use in cats should generally be restricted to acute rescue therapy.
약물 상호작용
May antagonize the bronchodilatory actions of albuterol
Albuterol may increase the risk of cardiac arrhythmias
May predispose the patient to ventricular arrhythmias, particularly in patients with preexisting cardiac disease
Concurrent use may increase the risk of developing adverse cardiovascular effects
May potentiate the vascular effects of albuterol
Antagonizes the bronchodilating effects of salbutamol
May exacerbate hypokalemia
모니터링
- Clinical symptom improvement (respiratory rate, effort)
- Thoracic auscultation
- Blood gases (if indicated in severe respiratory distress)
- Cardiac rate and rhythm (especially in overdose or susceptible patients)
- Serum potassium levels (early in therapy if animal is susceptible to hypokalemia)
- Respiratory rate and effort
- Heart rate and rhythm
- Serum potassium levels (if used frequently or in high doses)
약동학
반감기
흡수
Absorbed rapidly and well after oral administration. Effects occur within 5 minutes after oral inhalation, and 30 minutes after oral administration (e.g., tablets).
분포
Does not cross the blood-brain barrier but does cross the placenta.
대사
Extensively metabolized in the liver principally to the inactive metabolite, albuterol 4'-O-sulfate.
배설
Duration of effect generally persists for 3-6 hours after inhalation and up to 12 hours after oral administration.
과다투여
Significant overdose (often occurring when dogs puncture an aerosol canister with their teeth) leads to massive systemic absorption and severe sympathomimetic toxicity.
Clinical Signs:
- Severe tachycardia and arrhythmias (extrasystoles)
- Hypertension
- Tremors, agitation, and CNS stimulation
- Panting, tachypnea, and fever
- Vomiting
- Mydriasis
- Hypokalemia and hypophosphatemia (due to intracellular shifts)
Treatment:
- Oral Ingestion (Tablets): If recent and asymptomatic, perform standard decontamination (emesis, activated charcoal, cathartic).
- Inhaler Puncture: Decontamination is generally not effective as absorption across the oral mucosa is extremely rapid.
- Medical Management:
- Use beta-blocking agents (e.g., atenolol, metoprolol, or propranolol) to control severe tachycardia and arrhythmias.
- Administer diazepam for severe tremors or agitation.
- Monitor electrolytes closely; potassium supplementation via IV fluids is frequently required to correct hypokalemia.
- Contact an animal poison control center for guided management.
제품
제형
- Extended-release oral tablets
- Oral syrup
- Aerosol metered-dose inhaler (MDI)
- Solution for inhalation (nebulization)
- Inhalational: 100 μg per metered inhalation (Evohaler)
인용의약품
- Albuterol Oral Tablets: 2 mg & 4 mg
- Albuterol Extended Release Oral Tablets: 4 mg & 8 mg (VoSpire ER)
- Albuterol Oral Syrup: 2 mg/5 mL
- Albuterol Aerosol (MDI): 90 micrograms/actuation (ProAir HFA, Proventil HFA, Ventolin HFA)
- Albuterol Solution for Inhalation ('Nebs'): 0.083% (2.5 mg/3 mL), 0.5% (5 mg/mL), 0.021% (0.63 mg/3mL), 0.042% (1.25 mg/3 mL) (AccuNeb, Proventil)
- Combination Aerosol: 103 mcg albuterol / 18 mcg ipratropium bromide per puff (Combivent)
- Combination Solution for Inhalation: 3 mg albuterol / 0.5 mg ipratropium bromide (DuoNeb)
- Ventolin Evohaler (100 μg per metered inhalation)
규제 현황
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Oral albuterol sulfate products should be stored at 2-30°C. The inhaled aerosol should be stored at room temperature; do not allow exposure to temperatures above 120°F or the canister may burst. The 0.5% nebulizer solutions should be stored at room temperature; the 0.083% nebulizer solutions should be stored in the refrigerator. Discard solutions if they become colored.
보호자 정보
- 올바른 투여 방법: 에어로졸 흡입기를 사용하는 경우, 사용 전에 충분히 흔들어 주십시오. 폐로의 약물 전달을 극대화하기 위해 스페이서(예: Aerokat, Aerodawg)와 마스크의 올바른 사용법을 숙지하십시오.
- 응급 사용: 이 약물은 일반적으로 급성 호흡 곤란 시 "응급(rescue)" 흡입기로 사용됩니다. 반려동물의 상태가 악화되거나, 흡입기가 증상을 완화하지 못하거나, 반려동물이 급격히 아파보이면 즉시 수의사에게 연락하십시오.
- 보관 및 안전: 에어로졸 캔에 구멍을 뚫거나 화기 근처에서 사용하지 마십시오. 캔이 폭발할 수 있으므로 120°F(49°C) 이상의 온도에 노출시키지 마십시오.
- 독성 경고: 흡입기는 반드시 개의 손이 닿지 않는 곳에 보관하십시오. 개가 캔을 씹어서 구멍을 뚫게 되면 엄청난 양의 약물이 흡수되어 치명적인 과다 복용을 유발할 수 있습니다. 이런 일이 발생하면 즉시 응급 수의학적 치료를 받으십시오.
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