沙丁胺醇 (Albuterol / Salbutamol)
Albuterol
Albuterol sulfate
別名: Proventil · Ventolin · ProAir · AccuNeb · VoSpire · Salbutamol hemisulphate · Salbutamol sulphate · Salbutamoli sulfas · Albuterol sulfate · Salbutamol sulfate
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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).
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
沙丁胺醇（國際通用名為 salbutamol）是一種短效 $\beta_2$-腎上腺素受體激動劑 (SABA)。在獸醫學中被廣泛用作強效的支氣管擴張劑，以緩解與下呼吸道疾病相關的支氣管痙攣和咳嗽。
主要臨床應用包括：
- 貓氣喘 (Feline Asthma)：主要作為急性氣喘發作時的「急救」吸入劑。
- 犬慢性支氣管炎：提供支氣管痙攣的症狀緩解。
- 馬復發性呼吸道阻塞 (RAO / 氣喘)：用於急性緩解呼吸窘迫。
臨床要點：雖然對於急性急救治療非常有效，但不建議長期單獨使用消旋沙丁胺醇（特別是在貓）。消旋混合物中的 S-對映異構體隨著時間推移可能會引起反常的呼吸道發炎。長期管理應理想地搭配吸入性皮質類固醇（例如 fluticasone）使用。
作用機制
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.
安全性與警告
禁忌症
- 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
不良反應
- 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)
注意事項
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.
藥物相互作用
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
監測
- 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)
藥物動力學
半衰期
吸收
Absorbed rapidly and well after oral administration. Effects occur within 5 minutes after oral inhalation, and 30 minutes after oral administration (e.g., tablets).
分佈
Does not cross the blood-brain barrier but does cross the placenta.
代謝
Extensively metabolized in the liver principally to the inactive metabolite, albuterol 4'-O-sulfate.
排除
Duration of effect generally persists for 3-6 hours after inhalation and up to 12 hours after oral administration.
過量
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.
可用產品
劑型
- Extended-release oral tablets
- Oral syrup
- Aerosol metered-dose inhaler (MDI)
- Solution for inhalation (nebulization)
- Inhalational: 100 μg per metered inhalation (Evohaler)
人用標示
- 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)
各地核准狀態
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
- 正確給藥：如果使用氣霧吸入器，使用前請充分搖勻。確保您了解如何正確使用輔助吸入器（例如 Aerokat, Aerodawg）和面罩，以最大程度地將藥物送達肺部。
- 急救使用：此藥物通常作為急性呼吸困難的「急救」吸入器。如果寵物的病情惡化、吸入器無法緩解症狀，或寵物突然病重，請立即聯繫獸醫師。
- 儲存與安全：請勿刺穿氣霧罐或在明火附近使用。請勿暴露於超過 120°F (49°C) 的高溫下，否則氣霧罐可能會爆炸。
- 毒性警告：請務必將吸入器放在狗絕對接觸不到的地方。 咬破氣霧罐的狗會吸收大量藥物，導致可能致命的藥物過量。如果發生此情況，請立即尋求緊急獸醫治療。
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