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Chapter 2 Index
A. Evaluation by system:
1. General
2. HEENT 3.
Cardiopulmonary
--Heart Murmurs: When to Refer
--How to Feed Infants with Heart Disease
--Syncope in the Pediatric Age-Group
--Asthma: Classification and Management |
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Asthma Medication
Introduction: It is essential that we learn all the generic
and trade names of the various preparations available. This list is taken
from the handout supplied by pulmonology as well as other sources. Side
effects of medications are not discussed here
I. Beta Agonists:
a. Short-Acting Albuterol:
|
Method of administration |
Mech of action |
How Supplied |
Dose : give TID |
|
PO |
Beta 2 adrenergic agonist – short acting |
2 mg/5 ml |
Under 6: 0.3 mg/kg per 24 hours;
Over 6: 6 mg/24 hours; |
|
Nebulized |
|
2.5 mg in 3 ml NS |
Variable: If need to use more than q 3h, go to ED |
b. Long-Acting: Salmeterol (Serevent)
| |
Mechanism |
How Supplied |
Dose |
|
MDI |
Long acting beta 2 agonist |
21 mcg/dose |
1-2 puffs q12 hrs |
|
Diskus |
(dry powder inhaler) |
50 mcg/dose |
1 puff BID |
II. Combined Beta Agonist and Steroid ( Advair:Serevent and Flovent)
| |
Mechanism |
How Supplied |
Dose : use BID |
|
Inhaled |
Combined |
100/50 mcg
250/50 mcg |
1 puff |
III. Most Frequently Used Inhaled Steroids:
1. Budesonide DPI (Pulmicort) : Use BID or QD
| Method |
How Supplied |
Low Dose (100-200 mcg) |
Medium Dose (200-400 mcg) |
High Dose (>400 mcg) |
|
Inhaled |
200 mcg/dose |
|
1-2 inhalations per day |
2 inhalations per day |
2. Fluticasone (Flovent)
| Method |
How Supplied |
Low Dose (88-176 mcg) |
Medium Dose (176-440 mcg) |
High Dose (>440 mcg) |
|
MDI |
44, 110, 220 mcg per puff |
2-4 puffs (44) per day |
4-10 puffs (44) 2-4 puffs (110) |
>4 puffs (110) >2 puffs (220) |
|
DPI |
50,100,250 mcg per dose |
2-4 inhalations (50 mcg) |
2-4 inhalations (100 mcg) |
4 inhalations (100 mcg) or >2 puffs (220 mcg) |
IV. Leukotriene Modifiers: Montelukast (Singulair)
|
Admin |
How Supplied |
Dose : 2-5 yrs |
6-15 yrs old |
> 16 yrs old |
|
PO |
10 mg tab; 5 mg and 4 mg chewable |
4 mg chewable qhs |
5 mg po qhs |
10 mg po qhs |
Written 3/02/02
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