LEVALBUTEROL HYDROCHLORIDE
(lev-al-bu¢ter-ole)
Xopenex
Classifications: AUTONOMIC NERVOUS SYSTEM AGENT (SYMPATHIOMIMETIC); BETA-ADRENERGIC AGONIST; BRONCHODILATOR (RESPIRATORY SMOOTH MUSCLE RELAXANT)
Prototype: Isoproterenol Hydrochloride
Pregnancy category: CAVAILABILITY
0.63 mg/3 mL, 1.25 mg/3 mL inhalation solution
ACTIONS/THERAPEUTIC EFFECTS
Isomer of albuterol with beta2-adrenergic agonist properties. It has a strong effect on the beta2 receptors of the smooth muscles of the bronchial tree, thus resulting in bronchodilation. Levalbuterol decreases airway resistance, facilitates mucous drainage, and increases vital capacity.
USES
Treatment or prevention of bronchospasm in patients with reversible obstructive airway disease.
ROUTE & DOSAGE
Bronchospasm
Adult: Inhalation 0.63 mg by nebulization t.i.d. every 6-8 h, may increase to 1.25 mg t.i.d. if needed.
PHARMACOKINETICS
Onset: 5-15 min. Duration: 3-6 h. Elimination: Half-life 3.3 h.
ADMINISTRATION
Inhalation
- Use vials within 2 wk of opening pouch. Protect vial from light and use within one wk after removal from pouch. Use only if solution in vial is colorless.
- Store at 15-25°C (59-77°F) in protective foil pouch.
INCOMPATIBILITIES
Compatibility when mixed with other drugs in a nebulizer has not been established.CONTRAINDICATIONS
Hypersensitivity to levalbuterol or albuterol; pregnancy (category C); lactation.
PRECAUTIONS
Cardiovascular disorders especially coronary insufficiency, cardiac arrhythmias, and hypertension; convulsive disorders; diabetes mellitus, diabetic ketoacidosis; hypersensitivity to sympathetic amines; hyperthyroidism.
ADVERSE EFFECTS
Body as Whole: Allergic reactions, flu syndrome, pain. CNS: Migraine, dizziness, nervousness, tremor, anxiety. CV: Tachycardia. GI: Dyspepsia. Respiratory: Increased cough, viral infection, rhinitis, sinusitis, turbinate edema, paradoxical bronchospasm. Other: Increase in serum glucose.
INTERACTIONS
Drug: BETA-ADRENERGIC BLOCKERS may antagonize levalbuterol effects; MAOI, TRICYCLIC ANTIDEPRESSANTS may potentiate levalbuterol effects on vascular system; ECG changes or hypokalemia may be exacerbated by LOOP or THIAZIDE DIURETICS.
NURSING IMPLICATIONS
Assessment & Drug Effects
- Therapeutic effectiveness: Indicated by improvement of asthmatic symptoms.
- Monitor for S&S of CNS or cardiovascular stimulation (e.g., BP, HR, respiratory status).
- Lab tests: Periodic serum potassium levels especially with coadministered loop or thiazide diuretics.
- Monitor diabetics for loss of glycemic control.
Patient & Family Education- Seek medical advise immediately if a previously effective dose become ineffective.
- Report immediately: chest pains or palpitations, swelling of the eyelids, tongue, lips or face; increased wheezing or difficulty breathing.
- Do not use drug more frequently than prescribed.
- Exercise caution with hazardous activities; dizziness and vertigo are possible side effects.
- Check with physician before taking OTC cold medication.
- Do not breast feed infants while taking this drug.
