• Albuterol
  • Ipratropium


  • Mechanism of Action: Beta-2 agonist; relaxes smooth airway muscle and increases intracellular potassium uptake.
  • Indications: acute bronchospasm (asthma/COPD exacerbation); hyperkalemia. 
  • Contraindications: allergy, tachycardia, ischemic heart disease, hyperglycemia, hypokalemia
  • Dosage: Asthma/COPD: 5 mg nebulized q15 minutes; hyperkalemia: 15-20 mg nebulized
  • Onset: < 5 minutes
  • Duration: 2-4 hours
  • Adverse Reactions: hypertension, tachycardia, arrhythmias, tremors, nervousness
  • Special Considerations: N/A
Video Credit: Simple Nursing

*Deep Dive: Albuterol (


  • Mechanism of Action: Anticholinergic; blocks acetylcholine at cholinergic receptors, causing dilation of bronchial smooth muscle and decreased serous/seromucous secretion. 
  • Indications: Asthma, COPD
  • Contraindications: Allergy to drug/class
  • Dosage: 0.3-0.5 mg nebulized q20 minutes (max 3 dosages)
  • Onset: 20 minutes
  • Duration: 60 minutes
  • Adverse Reactions: Urinary retention, dry throat/cough, increased intraocular pressure
  • Special Considerations: None
Video Credit: Simple Nursing

*Deep Dive: The role of ipratropium bromide in the emergency management of acute asthma exacerbation: a metanalysis of randomized clinical trials (PubMed)

Brandon Simpson, PA-C
Latest posts by Brandon Simpson, PA-C (see all)