Albuterol Inhaler Dosing Guidelines for Adolescents

MDI Administration Guidelines

The American Academy of Pediatrics recommends using a spacer/holding chamber when administering metered-dose inhaler treatments to ensure optimal delivery 2
Each actuation of the albuterol MDI delivers 90 mcg per puff, with a recommended dose of 4-8 puffs every 20 minutes for 3 doses, then every 1-4 hours as needed 1
The MDI with spacer is as effective as nebulized therapy for mild-to-moderate exacerbations when proper technique is used 1
The actuator of the MDI should be periodically cleaned as medication may plug the orifice 3

For a 13-year-old weighing 72.4 kg, the recommended dose of albuterol nebulizer solution is 2.5-5 mg every 20 minutes for 3 doses, then 2.5-10 mg every 1-4 hours as needed 1
For continuous nebulization in severe cases, use 0.5 mg/kg/hour up to 10-15 mg/hour (approximately 10-15 mg/hour for this patient) 2, 1
The American Academy of Pediatrics recommends diluting the solution in a minimum of 3 mL of saline for adequate nebulization and using oxygen as the preferred gas source for nebulization 2

The American Academy of Pediatrics recommends monitoring for potential adverse effects including tachycardia, skeletal muscle tremor, hypokalemia, hyperglycemia, and headache 4
Administration can be repeated and dose adjusted until desired clinical effect is achieved, unless the patient develops symptomatic tachycardia 2
For severe exacerbations, consider adding ipratropium bromide to albuterol treatment for the first few hours 1

At 13 years of age and 72.4 kg, this patient should receive the adult dosing regimen rather than pediatric dosing 1
Proper technique is crucial for MDI administration - instruct the patient to exhale completely, place the mouthpiece in mouth, inhale slowly and deeply while activating the inhaler, and hold breath for 5-10 seconds 5