CHRONIC ASTHMA MEDICATIONS

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Short Drug Index 

Full Drug Index

KMeds

 

Medication

Formulation

Recommended dosing schedule

Quantity

Other/ Sedation

Beta agonists

 

 

 

 

Albuterol MDI (Ventolin, Ventolin HFA, Proventil, Proventil HFA, Volmax, Ventodisk, Asmavent)

90 mug/ puff

 2 puffs tid-qid prn or 2 puffs 5min before exercise

200 puffs/ canister(17 g)

 

Albuterol Inhalation solution

 (0.63 mg & 1.25mg) & 2.5 mg 3ml unit dose 

one unit dose 3 ml nebulized tid-qid

single unit dose

 

5 mg/ml (0.5%)  inhalation soln

0.25 ml-1ml  in 2-3 cc NS nebulized tid-qid

20 ml/ bottle

Albuterol (Ventolin Rotahaler)

200 mug/capsule

200-400 mug Q4-6 hr
 

24 & 96 caps

 

Albuterol oral solution

Syrup  2 mg/5 ml
 

 < 6 yr: 0.1 mg/kg PO q 8 hr max dose: 12 mg/
24 hr
 

473 ml

 

Levalbuerol (Xopenex)

 0.63 & 1.25 mg in 3 ml unit doses

0.63 mg-1.25 mg nebulized q 6-8 hr

single unit dose

 

Fromoterol (foradil aerolizer)

 12 mug/ dose

1 inh bid

60 blisters/ pack

 

Metaproterenol MDI (Alupent, Metaprel, Pro-meta)

650 mug/ puff

2-3 puffs q 3-4hr to max 12 puffs/ 24 hr

100 doses/ canister (5ml) 200 doses/ canister (10 ml)

 

Metaproterenol nebulized solution

5% soln (50 mg/ml)

 

Dilute 0.1-0.3 ml of 5% solution in 2.5 ml NS;nebulized q 4-6 hr PRN
 

0.3 &10 & 30 ml

 

Metaproterenol single-dose solutions

0.4% (4 mg/ml), 0.6% (6 mg/ml)

Infants: 2.5 ml of 0.4%  Children: 2.5 ml of 0.6%
q 4-6 hr.

 (2.5 ml)

 

Pirbuterol (maxair) MDI

0.2 mg/ puff

1-2 inh q 4 -6hr

 300 puffs/ canister (25.6 g)

onset 5 min, duration 3-4 hr

Pirbuterol (Maxair autohaler)

0.2 mg/ inh

1-2 inh q 4 -6hr

 400 inh/ canister (14 g)

 

Salmeterol (Serevent) MDI

21 mug/ puff

 2 puffs q 12hr   or 30-60 min before exercise

120 puffs/canister (13 g)

onset 10-20 min with peak effect in 3 hr > 4 yr of age

Salmeterol (Servent diskus)

50 mug/ inh

1 inh/ bid or 30-60 min before exercise

(28 &) 60 blisters

Bitolterol (Tornalate)

0.2 % soln (2mg/2ml) 

 0.5-1ml tid-qid via intermittent flow or 1.25 ml via continuous flow

 

10 & 30 & 60 mL

 

Short acting Beta agonist

0.37 mg/puff

2 puffs q 8 hr

~300 puffs/ canister

Combinations

 

 

 

 

Fluticasone & Salmeterol (Advair Diskus)

100/50 & 250/50 & 500 mug fluticasone/   mug salmeterol

1 puff bid

60 blisters

 

Beclomethasone* (Beclovent) (Vanceril)

 42 mug/puff

 2 puffs tid-qid or 4 puffs bid

(80 &) 200 / canister

 

age <12 yr 4-8 puffs/d (low ) 8- 12 puffs/d (med)

age > 12 yr 4-12 puffs/d (low) 12-20 puffs/d (med)

Beclomethasone (QVAR MDI)F (small particle size)

 40 mug & 80 mug/ puff

40-160 mug bid (max 640 mug qd)

100 / canister

 

Budesonide* (Pulmicort Turbohaler)

 200 mug powder/ inh

 1-2 inh qd - bid (high 3/d)

200/ canister

 

Budesonide (Respules)

0.25 mg/2ml & 0.5 mg/2ml 

0.5 mg to 1 mg total daily (qd or divided bid)

single unit dose

 

Triamcinolone*(Azmacort)F

 100 mug/puff MDI

2 puffs tid-qid or 4 puffs bid

240/ canister

 Built in spacer

age <12 yr 4-8 puffs/d (low ) 8- 12 puffs/d (med)

age > 12 yr 4-12 puffs/d (low) 12-20 puffs/d (med)

Fluticasone (Flovent)F

44 mug/puff

110 mug/puff

(220 mug/puff)

2- 6 puffs(44) bid

1-3 puffs(110) bid (high > 4/d ped/ 6/d adult) (for 110)

(60 &) 120/canister

High dose likely to cause systemic effects

Fluticasone (Flovent Rotadisk)

50mug/inh, 100 mug/inh, (250 mug/inh)

 1 dose bid

4 blisters in 15 rotadisks Total = 60 blisters

> 4yrs of age

Flunisolide (Aerobid, Aerobid-M) MDI

250 mug/puff

2-4 puffs bid

100/canister

 

Inhaled Antinflamatory

 

 

 

 

Cromolyn (intal)

 800 mug/puff   MDI

 2 puff tid-qid

120 (& 200)/canister

May require 4-6 wk trial to work

Cromolyn

 20 mg/ampule nebulized

 20 mg nebs qid

 120/ box

Nedocromil MDI

1.75mg/puff

2 puffs bid-qid

 120/canister

 

 

PEAK FLOW METER

Aztec

Optihaler

 

TABLE -- Estimated Comparative Daily Doses for Inhaled Corticosteroids (Children <12 Y)

DRUG

LOW DOSE

MEDIUM DOSE

HIGH DOSE

Beclomethasone dipropionate
  42 mcq/puff
  84 mcq/puff

84 to 336 mcq
(2 to 8 puffs = 42 mcq)
(1 to 4 puffs = 84 mcq)

336 to 672 mcq
(8 to 16 puffs = 42 mcq)
(4 to 8 puffs = 84 mcq)

>672 mcq
(>16 puffs = 42 mcq)
(>8 puffs = 84 mcq)

Budesonide turbuhaler
  200 mcq/puff

100 to 200 mcq
(1 to 2 inhalations)

200 to 400 mcq
(1 to 2 inhalations)

>400 mcq
(>2 inhalations)

Flunisolide
  250 mcq/puff

500 to 750 mcq
(2 to 3 puffs)

1,000 to 1,250 mcq
(4 to 5 puffs)

>1,250 mcq
(>5 puffs)

Fluticasone
  MDI: 44, 110, 220 mcq/puff
  DPI: 50, 100, 250 mcq/dose

88 to 176 mcq
(2 to 4 puffs = 44 mcq)
(2 to 4 inhalations = 50 mcq)

176 to 440 mcq
(4 to 10 puffs = 44 mcq)
(2 to 4 puffs = 110 mcq)
(2 to 4 inhalations = 100 mcq)

>440 mcq
(>4 puffs = 110 mcq)
(>2 puffs = 220 mcq)
(>4 inhalations = 100 mcq)
(>2 inhalations = 250 mcq)

Triamcinolone acetonide
  100 mcq/puff

400 to 800 mcq
(4 to 8 puffs)

800 to 1,200 mcq
(8 to 12 puffs)

>1,200 mcq
(>12 puffs)

Source: National Institutes of Health, National Heart, Lung and Blood Institute. Guidelines for the Diagnosis and Management of Asthma, Expert Panel Report 2. NIH Publication No. 97-4051, April 1997.

 

 

Estimated Comparative Daily Doses for Inhaled Corticosteroids (Adults and Children  12 Y)

DRUG

LOW DOSE

MEDIUM DOSE

HIGH DOSE

Beclomethasone dipropionate
  42 mcq/puff
  84 mcq/puff

168 to 504 mcq
(4 to 12 puffs = 42 mcq)
(2 to 6 puffs = 84 mcq)

504 to 840 mcq
(12 to 20 puffs = 42 mcq)
(6 to 10 puffs = 84 mcq)

>840 mcq
(>20 puffs = 42 mcq)
(>10 puffs = 84 mcq)

Budesonide turbuhaler
  200 mcq/puff

200 to 400 mcq
(1 to 2 inhalations)

400 to 600 mcq
(2 to 3 inhalations)

>600 mcq
(>3 inhalations)

Flunisolide
  250 mcq/puff

500 to 1,000 mcq
(2 to 4 puffs)

1,000 to 2,000 mcq
(2 to 4 puffs)

>2,000 mcq
(>8 puffs)

Fluticasone
  MDI: 44, 110, 220 mcq/puff
  DPI: 50, 100, 250 mcg/dose

88 to 264 mcq
(2 to 6 puffs = 44 mcq)
(2 puffs = 110 mcq)
(2 to 6 inhalations = 50 mcq)

264 to 660 mcq
(2 to 6 puffs = 110 mcq)
(3 to 6 inhalations = 100 mcq)

>660 mcq
(>6 puffs = 110 mcq)
(>3 puffs = 220 mcq)
(>6 inhalations = 100 mcq)
(>2 inhalations = 250 mcq)

Triamcinolone acetonide
  100 mcq/puff

400 to 1,000 mcq
(4 to 10 puffs)

1,000 to 2,000 mcq
(10 to 20 puffs)

>2,000 mcq
(>20 puffs)

Source: National Institutes of Health, National Heart, Lung and Blood Institute. Guidelines for the Diagnosis and Management of Asthma Expert Panel Report 2. NIH Publication No. 97-4051, April 1997.



 

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