Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnosed asthma. When teaching the patient about this drug, the nurse should explain that it may cause:
A. Nasal congestion
B. Nervousness
C. Lethargy
D. Hyperkalemia
Correct Answer: B. Nervousness
Albuterol may cause nervousness. The primary adverse effects of albuterol therapy are tremors and nervousness, mostly seen in children who are 2 to 6 years of age, though can be seen at any age. Tremors are the result of activation of the beta-2 receptors found on the motor nerve terminals which increases intracellular cAMP. These side effects occur in approximately one in every five patients. Other adverse effects of albuterol include tremor, dizziness, headache, tachycardia, palpitations, hypertension, heartburn, nausea, vomiting and muscle cramps.
Option A: The inhaled form of the drug may cause dryness and irritation of the nose and throat, not nasal congestion. Monitoring parameters for albuterol include forced expiratory volume, peak flow, blood pressure, heart rate, central nervous system stimulation, serum potassium, serum glucose, and asthma symptoms.
Option C: Other side effects include insomnia and nausea, which occur in approximately 1 in every ten patients. Less common adverse effects may include fever, bronchospasm, vomiting, headache, dizziness, cough, allergic reactions, otitis media, epistaxis, increased appetite, urinary tract infections, dry mouth, gas, hyperhidrosis, pain, dyspepsia, hyperactivity, chills, lymphadenopathy, ocular pruritus, sweating, conjunctivitis, and dysphonia.
Option D: Albuterol also has been shown to increase blood pressure and may cause hypokalemia. Increased blood glucose concentrations and prolonged QTc interval and ST-segment depression have occurred, although rarely.
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