Pirbuterol; Uses, Dosage, Side Effects, Interactions

Pirbuterol; Uses, Dosage, Side Effects, Interactions

Pirbuterol is a short-acting, beta-adrenergic receptor agonist with bronchodilator activity. Pirbuterol selectively binds to beta-2 adrenergic receptors in bronchial smooth muscle, thereby activating intracellular adenyl cyclase, an enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3′,5′-adenosine monophosphate (cAMP). Increased cAMP levels cause relaxation of the bronchial smooth muscle, relieve bronchospasms, improve mucociliary clearance and inhibit the release of mediators of immediate hypersensitivity from cells, especially from mast cells.

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Pirbuterol is a beta-2 adrenergic bronchodilator. In vitro studies and in vivo pharmacologic studies have demonstrated that pirbuterol has a preferential effect on beta-2 Adrenergic receptors compared with isoproterenol. While it is recognized that beta-2 adrenergic receptors are the predominant receptors in bronchial smooth muscle, data indicate that there is a population of beta-2 receptors in the human heart, existing in a concentration between 10-50%.

Mechanism of Action of Pirbuterol

The pharmacologic effects of beta-adrenergic agonist drugs, including pirbuterol, are at least in proof attributable to stimulation through beta-adrenergic receptors of intracellular adenyl cyclase, the enzyme which catalyzes the conversion of adenosine triphosphate (AlP) to cyclic-3†, 5†-adenosine monophosphate (c-AMP).In vitro studies and in vivo pharmacologic studies have demonstrated that pirbuterol has a preferential effect on beta-2 adrenergic receptors compared with isoproterenol. While it is recognized that beta-2 adrenergic receptors are the predominant receptors in bronchial smooth muscle, data indicate that there is a population of beta-2 receptors in the human heart, existing in a concentration between 10-50%. Increased c-AMP levels are associated with relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.

Indications of Pirbuterol

  • Bronchospasm
  • Asthma, 
  • Asthma, acute
  • Bronchiectasis
  • Bronchospasm Prophylaxis
  • Bronchial asthma,
  • Chronic bronchitis,
  • Chronic bronchopulmonary disorders
  • Levosalbutamol’s bronchodilator properties give it indications in the treatment of COPD (chronic obstructive pulmonary disease, also known as chronic obstructive lung disease) and asthma.
  • Prevention and reversal of bronchospasm in patients 12 years of age and older with reversible bronchospasm including asthma.

Contra-Indications of Pirbuterol

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Dosage of Pirbuterol

Strengths: 400 mcg or 0.4 mg

Asthma – Acute

  • 2 puffs (0.4 mg) orally repeated every 4 to 6 hours. One puff (0.2 mg) repeated every 4 to 6 hours may be sufficient for some patients. A total daily dose of 12 inhalations should not be exceeded.

Asthma – Maintenance

  • 2 puffs (0.4 mg) orally repeated every 4 to 6 hours. One puff (0.2 mg) repeated every 4 to 6 hours may be sufficient for some patients. A total daily dose of 12 inhalations should not be exceeded.

Chronic Obstructive Pulmonary Disease – Acute

  • 2 puffs (0.4 mg) orally repeated every 4 to 6 hours. One puff (0.2 mg) repeated every 4 to 6 hours may be sufficient for some patients. A total daily dose of 12 inhalations should not be exceeded.

Chronic Obstructive Pulmonary Disease – Maintenance

  • 2 puffs (0.4 mg) orally repeated every 4 to 6 hours. One puff (0.2 mg) repeated every 4 to 6 hours may be sufficient for some patients. A total daily dose of 12 inhalations should not be exceeded.

Pediatric  Asthma – Acute

>=12 years

  • 2 puffs (0.4 mg) orally repeated every 4 to 6 hours. One puff (0.2 mg) repeated every 4 to 6 hours may be sufficient for some patients. A total daily dose of 12 inhalations should not be exceeded.

Pediatric Asthma – Maintenance

>=12 years

  • Fast heartbeat
  • 2 puffs (0.4 mg) orally repeated every 4 to 6 hours. One puff (0.2 mg) repeated every 4 to 6 hours may be sufficient for some patients. A total daily dose of 12 inhalations should not be exceeded.

Normal dosage

  • The usual dose for adults and children 12 years and older is two inhalations (400 mcg) repeated every 4-6 hours. One inhalation (200 mcg) repeated every 4-6 hours may be sufficient for some patients.
  • A total daily dose of 12 inhalations should not be exceeded.
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Side Effects of Pirbuterol

The most common

More common

Rare

Drug Interactions of Pirbuterol

Pirbuterol may interact with the following drugs, supplements & may change the efficacy of drugs

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Pregnancy Catagory of Pirbuterol

FDA Pregnancy Category C

Pregnancy

There are no good studies that have been done in humans with pirbuterol. But in animal studies, pregnant animals were given pirbuterol, and the babies did not show any medical issues related to this medication.

Lactation

It is not known if pirbuterol crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using pirbuterol.

References

Pirbuterol

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