For those (many) that have come to depend on Albuterol for bronchial respiratory relief - do not despair. In time of need the alternative is levalbuterol: Xopenex. Xopenex is unfortunately more expensive but its half life in the body is nearly 50% longer. I labored for some years under the misconception that Xopenex was a β1 agent while albuterol was a β2 acting agent; they are both β2.
The advantage of levalbuterol is that it does not generally produce the side effects of albuterol, mainly shakiness and increased heart rate - decisive in my case as I am not very tolerant of βeta blocker heart medicine to slow my heart rate.
At any rate, in a shortage of albuterol, there is at least a near duplicate alternative - levalbuterol, Xopenex.
Albuterol does have the potential to cause tachycardia, but I have witnessed that very few times. The laboratory ‘twisting’ into ‘Levalbuterol’ reduces that effect. I have never really been convinced of the validity of this, but it is after all, not my area. I just watch the Vitals when administering these meds, and respond to undesired reactions.