Levalbuterol

Provider Level

EMT/AEMT/RN/Paramedic

Class

Sympathomimetic, Beta-2 selective agonist, Bronchodilator

Mechanism of Action

Stimulates beta-2 adrenergic receptors in the lungs resulting in relaxation of bronchial smooth muscle and bronchodilation. It is the active R-enantiomer of albuterol.

Indications

Treatment or prevention of bronchospasm in patients with reversible obstructive airway disease such as asthma or COPD.

Contraindications

Known hypersensitivity to levalbuterol, racemic albuterol, or any of the formulation components.

Routes

ET

Onset / Duration

Onset: 10 to 15 minutes. Peak: 1.5 hours. Duration: 5 to 8 hours.

Adverse Effects

Tachycardia, palpitations, tremors, anxiety, headache, dizziness, hypokalemia, paradoxical bronchospasm.

Precautions & Interactions

Use with caution in patients with cardiovascular disorders, coronary insufficiency, cardiac arrhythmias, hypertension, hyperthyroidism, and diabetes mellitus.

Special Considerations

Monitor vital signs and ECG. May cause fewer cardiac side effects than racemic albuterol, though clinically this remains debated.