Brands of salbutamol
This list is not intended to be exhaustive
Inhaled: Airomir®, Salamol®, Ventolin®
Inhaled (combination products): Combivent®
Oral: Ventolin®
Issues for surgery
For asthma and chronic obstructive pulmonary disease (COPD) – no symptomatic relief of acute exacerbation if omitted.
Advice in the perioperative period
Elective and emergency surgery
Continue – including the following combination products.
Combination product: Salbutamol with ipratropium - also see Ipratropium monograph
Oral preparations
Consider checking serum potassium pre-operatively.
Inhaled or nebulised preparations
If patient requiring several ‘reliever’ doses per week confirm adherence to any prescribed ‘preventer’ medication before considering addition / up-titration of ‘preventer’ medication to optimise disease control prior to elective surgery.
Confirm the inhaler device with patient.
Post-operative advice
Oral preparations
Restart post-operatively, at usual dose, as soon as next dose is due.
If patients are unable to resume their usual oral salbutamol post-operatively consideration should be given to alternative routes of administration.
Inhaled or nebulised preparations
Restart when required post-operatively.
Interactions with common anaesthetic agents
Halogenated anaesthetics
Salbutamol may cause hypokalaemia. Concomitant use with medications that prolong the QT-interval (e.g. desflurane, isoflurane, sevoflurane and possibly thiopental) increases the risk of torsades de pointes. Monitor serum potassium and QT-interval with concomitant treatment.
Interactions with other common medicines used in the perioperative period
Corticosteroids
Dexamethasone and hydrocortisone may cause hypokalaemia which would potentiate any salbutamol-mediated hypokalaemia. Hypokalaemia increases the risk of torsades de pointes with medicines which prolong the QT-interval e.g. antiemetics (domperidone, droperidol, granisetron, haloperidol, ondansetron and possibly prochlorperazine), antimicrobials (ciprofloxacin, clarithromycin, erythromycin) and loperamide.
Further information
None relevant.
References
Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://about.medicinescomplete.com [Accessed on 27th June 2021]
Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://about.medicinescomplete.com [Accessed on 27th June 2021]
Summary of Product Characteristics – Salbutamol 2 mg Tablets BP. Accord-UK Ltd. Accessed via www.medicines.org.uk 27/06/2021 [date of revision of the text February 2021]