Bronchodilators

Section 8 - MEDICATION GUIDELINES

8.11 BRONCHODILATORS

Albuterol (PROVENTIL, VENTOLIN) / Bronchodilator

DESCRIPTION

• It is a synthetic sympathomimetic that causes bronchodilation with less cardiac effect than Epinephrine. The duration of effect is about four hours.

INDICATIONS

• Acute Asthma, COPD with wheezing.

CONTRAINDICATIONS

• Hypersensitivity to the medication.

PRECAUTIONS

• The patient may experience palpitations, anxiety, nausea, and/or dizziness. Vital signs must be monitored; use caution with cardiac or hypertensive patients.

DOSAGE

• Adult: 2.5 mg updraft AND refer to appropriate PRACTICE PARAMETER for specific dosage.
• Pediatrics: Refer to Handtevy System
  • Less than 12 months: 1.25 mg updraft
  • 1 year and older: 2.5 mg

Ipatropium Bromide (ATROVENT) / Bronchodilator

DESCRIPTION

• Inhibits interaction of acetylcholine at receptor sites on the bronchial smooth muscle, resulting in decreased cGMP and bronchodilation.

INDICATIONS

• For the treatment of bronchospasm associated with chronic pulmonary disease, including asthma, bronchitis, and emphysema.

CONTRAINDICATIONS

• Hypersensitivity to Ipratropium Bromide, or to atropine and its derivatives. Not for use in CHF or cardiac asthma.

PRECAUTIONS

• Use with caution in patients with narrow angle glaucoma, prostatic hypertrophy or bladder neck obstruction.

DOSAGE

• 0.5 mg updraft AND refer to appropriate PRACTICE PARAMETER for specific dosage.

Levalbuterol (XOPENEX) / Beta2-Adrenergic Receptor Agonist / Bronchodilator

DESCRIPTION

• Xopenex (levalbuterol HCl) Inhalation Solution is a sterile, clear, colorless, preservative-free solution of the hydrochloride salt of levalbuterol, the (R)-enantiomer of the drug substance racemic albuterol. Levalbuterol HCl is a relatively selective beta2-adrenergic receptor agonist

INDICATIONS

• For the treatment of bronchospasm associated with asthma or COPD with wheezing.

CONTRAINDICATIONS

• Xopenex (levalbuterol HCl) Inhalation Solution is contraindicated in patients with a history of hypersensitivity to levalbuterol HCl or racemic albuterol.

PRECAUTIONS

• Levalbuterol HCl, like all sympathomimetic amines, should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, hypertension, and cardiac arrhythmias; in patients with convulsive disorders, hyperthyroidism, or diabetes mellitus; and in patients who are unusually responsive to sympathomimetic amines.
• Use with Beta-blockers, diuretics, Digoxin, antihistamines or tricyclic antidepressants may cause adverse cardiac effects.

DOSAGE

• Adults: 1.25 mg nebulized via updraft
• Pediatrics: refer to Handtevy System
  • Less than 6 years of age: 0.31 mg nebulized via updraft added to 2.5 ml of normal saline
  • 6 years and older: 0.63 mg nebulized via updraft added to 2.5 ml of normal saline

Vaponefrine (RACEMIC EPINEPHRINE) / Bronchodilator, Adrenergic

DESCRIPTION

• Slightly different chemically from epinephrine. Stimulates both alpha and beta adrenergic receptors with a slight preference for the beta2 receptors in the lungs. This results in bronchodilation and a decrease in mucus secretion. It also helps in relieving the subglottic edema associated with croup when administered by inhalation.

INDICATIONS

• For the treatment of bronchospasm associated with croup.

CONTRAINDICATIONS

• Epiglottitis, severe tachyarrhythmias.

PRECAUTIONS

• Use with antihistamines or tricyclic antidepressants may cause adverse cardiac effects.

DOSAGE

• 0.5 mg nebulized via updraft added to 3 ml of normal saline AND refer to appropriate PRACTICE PARAMETER for specific dosage.