CHRONIC ASTHMA MEDICATIONS
|
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) |
24 & 96 caps |
|
||
|
Albuterol oral solution |
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 |
|
|||
|
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
|
DRUG |
LOW DOSE |
MEDIUM DOSE |
HIGH DOSE |
|---|---|---|---|
|
Beclomethasone dipropionate |
168 to 504 mcq |
504 to 840 mcq |
>840 mcq |
|
Budesonide turbuhaler |
200 to 400 mcq |
400 to 600 mcq |
>600 mcq |
|
Flunisolide |
500 to 1,000 mcq |
1,000 to 2,000 mcq |
>2,000 mcq |
|
Fluticasone |
88 to 264 mcq |
264 to 660 mcq |
>660 mcq |
|
Triamcinolone acetonide |
400 to 1,000 mcq |
1,000 to 2,000 mcq |
>2,000 mcq |
|
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. |
|||