No

Beta₂ Agonist

Prevention and treatment of reversible bronchospasm including asthma

C

Hypersensitivity to pirbuterol or albuterol

Excessive use may result in tolerance; some adverse reactions may occur more frequently in children 2-5 years of age; use with caution in patients with hyperthyroidism, diabetes mellitus; cardiovascular disorders including coronary insufficiency or hypertension or sensitivity to sympathomimetic amines

>10%:

Central nervous system: Nervousness, restlessness

Neuromuscular & skeletal: Trembling

1% to 10%:

Central nervous system: Headache, dizziness

Gastrointestinal: Taste changes, vomiting, nausea

<1%: Hypertension, arrhythmias, chest pain, insomnia, bruising, anorexia, numbness in hands, weakness, paradoxical bronchospasm

Symptoms of overdose include hypertension, tachycardia, angina, hypokalemia

In cases of overdose, supportive therapy should be instituted, and prudent use of a cardioselective beta-adrenergic blocker (eg, atenolol or metoprolol) should be considered, keeping in mind the potential for induction of bronchoconstriction in an asthmatic individual. Dialysis has not been shown to be of value in the treatment of an overdose with this agent.

Decreased effect with beta-blockers

Increased toxicity with other beta agonists, MAO inhibitors, TCAs

Pirbuterol is a beta₂-adrenergic agonist with a similar structure to albuterol, specifically a pyridine ring has been substituted for the benzene ring in albuterol. The increased beta₂ selectivity of pirbuterol results from the substitution of a tertiary butyl group on the nitrogen of the side chain, which additionally imparts resistance of pirbuterol to degradation by monoamine oxidase and provides a lengthened duration of action in comparison to the less selective previous beta-agonist agents.

Peak therapeutic effect: Oral: 2-3 hours with peak serum concentration of 6.2-9.8 mcg/L; Inhalation: 0.5-1 hour

Half-life: 2-3 hours

Metabolism: In the liver

Elimination: 10% kidney excretion as unchanged drug

Children >12 years and Adults: 2 inhalations every 4-6 hours for prevention; two inhalations at an interval of at least 1-3 minutes, followed by a third inhalation in treatment of bronchospasm, not to exceed 12 inhalations/day

Respiratory rate, heart rate, and blood pressure

Nervousness and restlessness are common; may cause dizziness; may rarely cause insomnia

Concurrent use with TCAs and MAOIs may results in increased toxicity; monitor

No information available to require special precautions

No effects or complications reported

Use exactly as directed (see Administration below). Do not use more often than recommended. Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake). You may experience nervousness, dizziness, or fatigue (use caution when driving or engaging in tasks requiring alertness until response to drug is known); or dry mouth, stomach upset (frequent small meals, frequent mouth care, chewing gum, or sucking hard candy may help). Report unresolved GI upset; dizziness or fatigue; vision changes; chest pain, rapid heartbeat, or palpitations; nervousness or insomnia; muscle cramping or tremor; or unusual cough. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Consult prescriber if breast-feeding.

Before using, the inhaler must be shaken well; assess lung sounds, pulse, and blood pressure before administration and during peak of medication; observe patient for wheezing after administration, if this occurs, call physician

Aerosol, oral, as acetate: 0.2 mg per actuation (25.6 g)

Aerosol (Autohaler™): 0.2 mg per actuation (2.8 g - 80 inhalations, 14 g - 400 inhalations)