What is the recommended albuterol dose for wheezing?

• A. 1.25 mg/3 mL via nebulizer, repeat as needed (max 2 times).
• B. 2.5 mg/3 mL via nebulizer, repeat as needed (max 3 times).
• C. 5 mg/3 mL via nebulizer, every 6 hours.
• D. 2.5 mg via inhaler.

Answer: (B)

Albuterol works quickly to relax airway smooth muscle and open the airways during wheezing. For nebulized use in an acute episode, the standard single dose is 2.5 mg delivered in 3 mL of saline, given repeatedly at short intervals (commonly every 20 minutes) for up to three doses, with reassessment after each dose. This dosing provides rapid, repeated bronchodilation to relieve symptoms. The smaller dose (1.25 mg/3 mL) isn’t the typical starting amount for acute care, the higher dose (5 mg/3 mL) isn’t used on a fixed every-6-hours schedule for acute relief, and an inhaler delivers the medication as puffs rather than a milligram-per-dose neblication, so it isn’t the same dosing approach.