Question

While administering 3.5 mg of albuterol to a patient with asthma in the ICU, the respiratory therapist notes that the patient's heart rate increases from 120 to 150 beats/minute. What is the appropriate modification for the next treatment for this patient?

A. Reduce the dose of albuterol.
B. Discontinue the treatment.
C. Change to 3 puffs of beclomethasone dipropionate (Vanceril®).
D. Change to 0.63 mg of levalbuterol (Xopenex®).

Answer 1

Given the increase in heart rate after administering albuterol, the appropriate modification would be to consider reducing the albuterol dose or switching to levalbuterol (Xopenex®) which may have fewer cardiac side effects.

Step-by-step explanation:

When administering albuterol, a common side effect is an increased heart rate. Given that the patient's heart rate has increased from 120 to 150 beats per minute, there is a need to modify the treatment to prevent further cardiac stimulation. Reducing the dose of albuterol or changing to a different medication with fewer cardiac side effects would be appropriate.

For this specific case, option D, changing to a lower dose of levalbuterol (Xopenex®), which is similar to albuterol but often produces fewer cardiac side effects, would be a sound choice. Levalbuterol is an isomer of albuterol that can provide effective bronchodilation with potentially lower risks of increased heart rates. Before making this change, it would also be essential to consult the patient's healthcare provider for individualized treatment planning.