SABAs and SACAs Flashcards
SABAs
inhaled short acting B2 agonists
increases cAMP and antagonized bronchoconstriction
leads to smooth muscle relaxation
reverse obstruction and improve airflow
SABA drugs
albuterol HFA (proair, ventolin, proventil, proair respiclick, proair digihaler)
albuterol nebulizer
levalbuterol hfa (xopenex)
levalbuterol nebulizer
albuterol hfa brands
proair
ventolin
proventil
proair respiclick
proair digihaler
albuterol hfa (pro air, ventolin, proventil, proair respiclick, proair digihaler) dosage form
MDI - 90 mcg/inhalation
Aerosol powder inhaler - 90mcg/inhalation
albuterol hfa (pro air, ventolin, proventil, proair respiclick, proair digihaler) dosing
1 to 2 inhalations 5 minutes before exercise
2 inhalations q4-6h prn
albuterol hfa (pro air, ventolin, proventil, proair respiclick, proair digihaler) dosing in 0-11 yos for exacerbations
4-8 inhalations every 20 minutes for 30 doses, then every 1 to 4 hours inhalation maneuver prn
use VHC (and mask in 0-4 yos)
albuterol hfa (pro air, ventolin, proventil, proair respiclick, proair digihaler) dosing in adults for exacerbations
4 to 8 inhalations every 20 minutes for up to 4 hours, then every 1 to 4 hours prn
adverse effects of albuterol
tachycardia
tremor
hypokalemia
irritability
clinical pearls of albuterol
chronic use (over 2 times per day) indicates poor asthma control
may mix nebulizer solution with cromolyn solution, budesonide inhalant suspension, or ipratropium solution
in mild to moderate exacerbations, MDI plus VHC is as effective as nebulized therapy with appropriate admin technique and coaching by trained personnel
albuterol nebulizer solution dosage
0.63 mg/mL
1.25 mg/3mL
2.5mg/3mL
5mg/mL
albuterol nebulizer solution dosing in 0-4 yos
0.63 to 2.5mg in 3mL saline every 4-6h prn
albuterol nebulizer solution dosing in 5-11 yos and adults
1.25 to 5 mg in 3mL saline every 4-8 hours prn
albuterol nebulizer solution dosing for exacerbations in 0-11 yos
0.15mg/kg (minimum of 2.5mg) every 20 minutes for 3 doses, then 0.15 to 0.3mg/kg for up to 10mg every 1 to 4 hours prn
0.5mg/kg/hour by continuous nebulization
albuterol nebulizer dosing for exacerbations in adults
2.5 to 5mg every 20 minutes for 3 doses, then 2.5 to 10mg every 1 to 4 hours prn
10 to 15 mg/hour by continuous nebulization
levalbuterol hfa brand
xopenex
levalbuterol hfa (xopenex) dosage form
MDI
45 mcg/inhalation
levalbuterol nebulizer solution dosage form
0.31mg/3mL
0.63mg/3mL
1.25mg/0.5mL
1.25mg/3mL
levalbuterol hfa (xopenex) dosing in 0-11 yos
2 inhalations every 4-6h prn
levalbuterol hfa (xopenex) exacerbation dosing in 0-11 yos
4 to 8 inhalations every 20 minutes for 3 doses, then every 1 to 4 hours inhalation maneuver prn
use vhc
levalbuterol hfa (xopenex) dosing in adults
2 inhalations 5 minutes prior to exercise
2 puffs q4-6h prn
levalbuterol hfa (xopenex) exacerbation dosing in adults
4 to 8 inhalations every 20 minutes for up to 4 hours, then every 1 to 4 hours prn
adverse effects of levalbuterol
tachycardia
tremor
hypokalemia
irritability
clinical pearls of levalbuterol
reserved for patients who do not response to albuterol for quick relief
nebulizer solution compatible with budesonide inhalant suspension
levalbuterol administered in the 1/2 the mg dose of albuterol provides comparable efficacy and safety
has not been evaluated by continuous nebulization
levalbuterol nebulizer solution dosing in 0-4 yos
0.31 to 1.25 mg q4-6h prn
levalbuterol nebulizer solution dosing in 5-11 yos
0.31 to 0.63 mg q8h prn
levalbuterol nebulizer solution exacerbation dosing in 0-11 yos
0.075 mg/kg (minimum dose of 1.25) every 20 minutes for 3 doses, then 0.075 mg to 0.15mg/kg for up to 5mg every 1 to 4 hours prn
levalbuterol nebulizer solution dosing in adults
0.63 to 1.25 mg q8h prn
levalbuterol nebulizer solution exacerbation dosing in adults
1.25 to 2.5mg every 20 minutes for 3 doses then 1.25 to 5 mg every 1 to 4 hours prn
short acting anticholinergics
competitively inhibit cholinergic receptors in bronchial smooth muscles
decreased cGMP leads to bronchodilation
ipratropium hfa (atrovent)
ipratropium
ipratropium/albuterol (combivent respimat, duoneb)
ipratropium hfa brand
atrovent
iptratropium hfa (atrovent) dosage form
MDI
17 mcg/inhalation
ipratropium nebulizer solution dosage form
0.125mg/mL
0.25mg/mL
ipratropium/albuterol brand
combivent respimat
duoneb
ipratropium/albuterol (combivent respimat) dosage form
MDI
20mcg/100mcg/inhalation
iptratropium/albuterol (duoneb) dosage form
nebulizer solution
0.5mg/2.5mg per 3mL vial
ipratropium hfa (atrovent) and ipratropium/albuterol (combivent respimat) exacerbation dosing in 0-11 yos
4-8 inhalations every 20 minutes prn for up to 3 hours
use with VHC (and mask for under 4)
ipratropium hfa (atrovent) dosing in adults
2 inhalation q6h
ipratropium hfa (atorvent) exacerbation dosing in adults
8 inhalations every 20 minutes prn for up to 3 hours
adverse effects of ipratropium
dry mouth
urinary retention
infection
sinusitis
bronchitis
clinical pearls of ipratropium
used in combo with albuterol for asthma exacerbation treatment
may mix in same nebulizer with albuterol
should not be used as first-line therapy; should be added to saba therapy for severe exacerbations
ipratropium nebulizer solution exacerbation dosing in 0-11 yos
0.25 mg to 0.5 mg every 20 minutes for 3 doses then prn
ipratropium nebulizer solution dosing in adults
0.25mg q6h
ipratropium nebulizer solution exacerbation dosing in adults
0.5mg every 20 minutes for 3 does then prn
ipratropium/albuterol (combivent respimat) dosing in adults
1 inhalation q6h
ipratropium/albuterol (combivent respimat) exacerbation dosing in adults
8 inhalations every 20 minutes prn for up to 3 doses
ipratropium/albuterol (duoneb) dosing in 0-4 yos
1.5mL every 20 minutes for 3 doses then prn
ipratropium/albuterol (duoneb) dosing in 5-11 yos
3mL every 20 minutes for 3 doses then prn
ipratropium/albuterol (duoneb) dosing in adults
3mL every 20 minutes for 3 doses then prn
OFF LABEL
clinical pearls of ipratropium/albuterol (duoneb)
may be used for up to 3 hours in initial management of severe exacerbations
