Medical Emergencies in the Dental Office – Part Four

Albuterol is a very well known essential drug found in the dental office emergency kit. You may know it better as Salbutamol – the ‘puffer’ or inhaler that is routinely used by individuals who suffer from asthma.

Mechanism of Action
Albuterol acts by dilating (opening up) the bronchioles that are in a state of spasm (closure) during an asthmatic attack. This is especially important during the acute phase of anaphylaxis, when the bronchioles (breathing passages that lead to the lungs) are closing off.

Epinephrine, as discussed in the blog posted on November 25th, 2015 also acts by causing bronchodilation. It is the primary drug that is required to deal with the bronchospasm during anaphylaxis. Epinephrine acts fast and it wears off quickly too. Albuterol is used to compliment the epinephrine (as an adjunct) during anaphylaxis to maintain the bronchioles in a dilated (open) state. It acts to provide the patient with longer relief of symptoms. Its peak effects occur in 30-60 minutes.

What is also important to know is that Albuterol is a selective Beta-2 agonist…please refer back to the blog on Epinephrine posted on November 25th,2015. This means that it just acts on the bronchioles and not the alpha-one or beta-one receptors that are located in the heart and skin (extremities) respectively. This is important and valuable because Albuterol’s actions are site specific. It provides selective bronchodilation with minimal systemic cardiovascular effects!

For adults, two sprays of the inhaler provides 180-200 micro grams and this can be repeated as necessary. A child’s dosage is half of this, 90-100 micrograms or one spray as necessary.

In the next blog we will look at the drug Nitro glycerine. It is used to treated acute angina…until then.

Yours in excellent dental health!

Dr. F. Keshavarz Dentistry, Brampton Dentist

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