Medication Child Dose Adolescent dose Comments
Albuterol MDI with spacer (90 mcg/puff) 4-8 puffs at 1-2 minute intervals every 20 minutes for 3 dosing cycles, then every 1-4 hours. Use spacer/holding chamber. As effective as nebulizer therapy if patient is able to coordinate (Cates 2000 [M])
Albuterol Nebulizer
0.5 mL (2.5 mg) albuterol 0.5% solution in 2.5 mL normal saline, or 3ml of 0.083% unit dose vial or

1 mL (5 mg) albuterol 0.5% solution in 2.5 mL normal saline
2.5 mg up to 5 mg every 20 minutes for 3 doses, then 2.5 mg up to 5 mg every 1-4 hours as needed.

(May be given continuously to those in severe distress.)
Prefer use of nebulizer when ipratropium bromide is also likely to be administered.

For optimal delivery, dilute aerosols to 3 mL at gas flows of 6-8 L/min. (Oxygen, if available, is preferable to compressed air.)
Epinephrine 1:1000 (1mg/mL) 0.01 mg/kg subcutaneous up to 0.3-0.5 mg 0.3-0.5 mg subcutaneous See Note 4 under Short-acting inhaled beta2-agonists.
Terbutaline (1mg/mL) 0.01 mg/kg subcutaneous up to 2.5 mg. 0.25 mg subcutaneous