MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Beta-2 adrenoreceptor agonists - short acting

Drug Safety Update

CSM has advised that potentially serious hypokalaemia may result from beta-2 agonist therapy. This may be exacerbated by corticosteroids, theophylline, diuretics and hypoxia. Plasma potassium may need to be monitored in severe asthma

August 2022: Nebulised asthma rescue therapy in children: home use of nebulisers in paediatric asthma should be initiated and managed only by specialists

July 2018: Pressurised metered dose inhalers (pMDI): risk of airway  obstruction from aspiration of loose objects

 December 2014: Short-acting beta-2 agonists: restricted use for tocolysis in premature labour

December 2007: Short-acting beta-2 agonists may be associated with myocardial ischaemia

National Guidance:

NG80: Asthma diagnosis, monitoring and chronic asthma management, November 2017 (updated March 2021)

NG115: Chronic obstructive pulmonary disease in over 16s - diagnosis and management, December 2018 (updated July 2019)

BTS/SIGN British Guideline on the management of asthma, July 2019

Local Guidance

See here for available local respiratory system guidance

Where appropriate dry powder inhalers (DPIs) should be selected as the first line salbutamol product for all patients over the age of 4 years. The patient will require robust inhaler technique training - see here for more information.

For children and young people a Salbutamol MDI with a spacer is the preferred treatment.

NOTE: Ventolin Evohaler emits 28kg CO2e per inhaler. Salamol only emits 12kg CO2e, and dry powder inhalers are almost carbon neutral.