Asmacaire Solution For Inhalation Special Precautions

Salbutamol (ASMACAIRE) Solution for Inhalation should be given with caution in hyperthyroidism, myocardial insufficiency, arrhythmias, susceptibility to QT-interval prolongation, hypertension and diabetes mellitus. Great care is also needed in patients withcardiovascular disease such as ischaemic heart disease, arrhythmia or tachycardia, occlusive vascular disorders including arteriosclerosis, hypertension, or aneurysms. Anginal pain may beprecipitated in patients with angina pectoris.
Excessive administration of sympathomimetic agents to the nasal mucosa may produce reboundcongestion and rhinorrhea.
Care is also required when sympathomimetic agents are given to patients with diabetes mellitus or closed-angle glaucoma.
In severe asthma, particular caution is also required to avoid inducing hypokalemia as this effect may be potentiated by hypoxia or by concomitant administration of other anti-asthma drugs; plasma-potassium concentrations should be monitored.
Should patients with mild asthma find that more than one dose is required daily, then that should be a sign for additional treatment with anti-inflammatory drugs. Increasing need for, or decreased effect of, short-acting beta₂ agonists indicates deteriorating asthma and the requirement for stepping up therapy.
Sympathomimetic agents should be avoided or used with caution in patients undergoing anaesthesia with cyclopropane, halothane, or other halogenated anaesthetics, as they may induce ventricular fibrillation. An increased risk of arrhythmias may also occur if sympathomimetic agents are given to patients receiving cardiac glycosides, quinine or tricyclic antidepressants.
Salbutamol nebulas 2.5 mg should be used with care in patients known to have received large doses of other sympathomimetic drugs. They should be administered cautiously to patients from thyrotoxicosis.