Jul
16
Albuterol
July 16, 2009 | Leave a Comment
Generic Name
Albuterol (al-BUE-tuh-rawl) 91
Brand Names
AccuNeb Proventil HFA
ProAir HFA Ventolin HFA
Proventil* Vospire ER
Combination Products
Generic Ingredients: Albuterol + 1pratropium Bromide Combivent DuoNeb
The:nformation in this profile also applies to the following drugs:
Generic Ingredient: Levalbuterol Xopenex
Generic Ingredient., Pirbuterol Maxair
*Some products in this brand-name group are alcohol- or sugar-free. Consult your pharmacist.
Type of Drug Bronchodilator.
Prescribed for
Bronchospasm associated with asthma or other obstructive pulmonary diseases, or induced by exercise.
General Information
Albuterol is similar to other bronchodilator drugs, such as metaproterenol and isoetharine, but it has a weaker effect on nerve receptors in the heart and blood vessels; therefore, it is somewhat safer for people with heart conditions. Levalbuterol is a special form of albuterol that carries a lower risk of side effects.
Cautions and Warnings
Do not use Albuterol if you are allergic or sensitive to any of its ingredients. Albuterol should be used with caution by people with a history of angina pectoris (a condition characterized by brief attacks of chest pain), heart disease, irregularities in heart beat, high blood pressure, stroke or seizure, diabetes, thyroid disease, prostate disease, or glaucoma. Excessive use of albuterol inhalants may worsen asthma or other respiratory conditions, and may increase breathing difficulties rather than relieve them. In the most extreme cases, people have had heart attacks after using excessive amounts of inhalant.
Possible Side Effects
V Most common: worsening of asthma, ear infection, upper respiratory infection, stuffy nose, dizziness, headache, nausea, vomiting, and muscle cramps.
♦ Less common: angina, abnormal heart rhythms, rapid heartbeat and heart palpitations, allergic reaction, fever, and tremors.
Drug Interactions
• Albuterol’s effects on the cardiovascular system may be increased by monoamine oxidase inhibitor (MA01) and tricyclic antidepressants. These drugs should not be administered together or within 2 weeks of discontinuation of MAOls or tricyclic antidepressants.
• Beta-blocking drugs such as propranolol not only block the effects of albuterol but may cause severe bronchospasm in people with asthma.
• Albuterol may reduce the amount of digoxin in the blood of people taking both drugs. Digoxin dose adjustment may be required.
• Albuterol may exacerbate certain effects of non-potassium sparing diuretics (loop or thiazide diuretics).
Food Interactions
Albuterol tablets are more effective when taken on an empty stomach-1 hour before or 2 hours after meals—but can be taken with food if they upset your stomach.
Usual Dose
Albuterol and Pirbuterol Inhalation
Adult and Child (age 4 and over): 1-2 puffs every 4-6 hours. Asthma triggered by exercise may be prevented by taking 2 puffs 15 minutes before exercising.
Albuterol Inhalation Solution
Child (age 2-12): starting dose-0.63 mg or 1.25 mg 3 or 4 times a day. Deliver over 5-15 minutes by nebulizer.
Levalbuterol Inhalation Solution
Adult and Child (age 12 and over): 0.63 mg 3 times a day every 6-8 hours. Some people may benefit from 1.25 mg at each dose. Deliver over 5-15 minutes by nebulizer.
Child (age 6-11): 0.31 mg 3 times a day every 6-8 hours, by nebulizer.
Albuterol Inhalation Aerosol
Adult and Child (age 4 and over): 2 inhalations every 4-6 hours. Adults and children age 4 and over may prevent asthma brought on by exercise by inhaling twice 15 minutes before exercising.
Albuterol Sustained-Release Tablets
Adult and Child (age 12 and over): 4-8 mg every 12 hours. Dosage may be cautiously increased to a maximum of 32 mg a day. People being switched from regular to sustained-release tablets generally take the same dosage per day, in fewer tablets—for example, a 4-mg tablet every 12 hours (1 dose) instead of a 2-mg tablet every 6 hours (2 doses).
Child (age 6-12): 4 mg every 12 hours.
Overdosage
Overdose of albuterol inhalation usually results in exaggerated side effects, including chest pain and high blood pressure. People who inhale too much albuterol should see a doctor. Overdose of albuterol tablets may lead to changes in heart rate, palpitations, unusual heart rhythm, chest pain, high blood pressure, fever, chills, cold sweats, nausea, vomiting, and dilation of the pupils. Convulsions, sleeplessness, anxiety, and tremors may also develop, and the victim may collapse. If the albuterol overdose was taken within the past 1/2 hour, give the victim syrup of ipecac to induce vomiting. Do not give ipecac if the victim is unconscious or convulsing. If symptoms have already begun to develop, the victim may need to be taken to a hospital emergency room. Call for instructions, and ALWAYS bring the prescription bottle or container.
Special Information
If you are inhaling albuterol, be sure to follow the inhalation instructions that come with the product. The drug should be inhaled during the second half of your inward breath, since this will allow it to reach deeper into your lungs. Wait about 1-2 minutes between inhalations. Do not inhale albuterol if you have food or anything else in your mouth.
Do not take more albuterol than your doctor prescribes. Taking more than you need can worsen your symptoms. If your condition worsens after taking your medicine, call your doctor at once and stop taking it.
Call your doctor immediately if you develop chest pain, palpitations, rapid heartbeat, muscle tremors, dizziness, headache, facial flushing, or urinary difficulty, or if you continue having breathing difficulties after taking the medicine.
Do not crush or chew the extended-release tablets.
If you forget a dose of albuterol, take it as soon as you remember. If it is almost time for your next dose, skip the one you forgot. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: When used during childbirth, albuterol can slow or delay natural labor. It can cause rapid heartbeat and high blood sugar in the mother and rapid heartbeat and low blood sugar in the baby. Albuterol also causes birth defects in animal studies. When your doctor considers this drug crucial, its benefits must be cautiously weighed against its risks.
It is not known if albuterol passes into breast milk. Nursing mothers who must take it should use infant formula.
Seniors: Seniors with cardiovascular disease should use albuterol with caution.
Jul
1
Drugs for Angina Treatment
July 1, 2009 | Leave a Comment
Angina pectoris
angina pectoris is a painful cardiac condition that occurs when the work load on the heart and the onsequent oxygen demand of the myocardium exceed the ability of the cardiovascular system to meet that demand. The pain may vary from a relatively mild ache to a crushing chest pain which may radiate to the left shoulder and left arm and other areas. It is often triggered off by exertion, and usually subsides rapidly
with rest. It is basically a stress response to factors that increase cardiac demand and output, and is often linked with an atheromatous narrowing of the coronary arteries.
Treatment of angina is with coronary vasodilator drugs that reduce cardiac drive and
lower the myocardial oxygen demand (many of which are also used in the treatment of hypertension – see page 148. They include the time-honoured glyceryl trinitrate (which can be given by several routes), other nitrates, calcium channel blocking agents, beta-adrenergic receptor blocking agents and potassium channel activators.
Glyceryl trinitrate is of particular value when a rapid response is required. The following Table gives an indication of the wide range of anti-anginal products currently available.
sublingual tablets 300, 500, 600 mg spray 400 mg/dose spray 400 mg/dose 400 mg/dose
long-acting tablets, 6.4 mg long-acting tablets, I mg, 3 mg, 5 mg long-acting tablets, 2.6 mg, 6.4 mg
IM9 1 mg
patches 5 mg
patches 5 mg, 10 mg, 15 mg
patches 2.5 mg, 5 mg, 10 mg, 15 mg patches 5 mg, 10 mg
ointment 2%
glyceryl
trinitrate Coro-Nitro Spray* Glytrin Spray Nitrolingual Spray
Nitro-Continua Suscard
Sustac
Nitrocine injection Nitronal injection
Deponit
Minitran
Nitro-Dur Trasiderm-Nitro
Percutol
Note: Sprays (1 -2 doses) are given under the tongue; the mouth should then be closed.
sorbide Isordil tablets 5mg, 10 mg, 30 mg
idinitrate Sorbichew tablets 5 mg
Sorbitrate tablets 10 mg, 20 mg
long-acting products Cedocard-Retard 20 mg, 40 mg
Isoket Retard 20 mg, 40 mg
Isordif Tembids 40 mg
Sorbid-SA 20 mg, 40 mg
Isoket injection 500 mg
tablets 10, 20, 40 mg tablets 10, 20, 40 mg tablets 20mg
tablets 10, 20mg
tablets 10, 20, 40 mg
long-acting products
capsules 25 mg, 50 mg
capsules 60 mg tablets 40 mg capsules 50 mg tablets 40 mg capsules 40mg
Table 4 Drugs used in angina. Continued over.
isosorbide mononitrate
Elantan
Ismo
Isotrate
Monit Mono-Cedocard
Elantan LA lmdur
Ismo Retard MCR-50
Monit SR Monomax SR
pentaerythritol Mycardol tablets 30 mg tetranitrate
acebutolol Sectral capsules 100mg, 200mg tablets 400 mg
atenolol Tenormin tablets 25, 50, 100mg
bisoprolol Emcor, Monocr tablets 5 mg, 10 mg
metoprolol Betaloc, Lopresor tablets 50 mg, 100 mg
nadolol Corgard tablets 40 mg, 80 mg
oxprenolol Trasicor tablets 20 mg, 40 mg, 80 mg
Slow-Trasicor tablets 160 mg
pindolol Visken tablets 5 mg, 15 mg
propranolol Inderal tablets 10, 40, 80 mg
Inderal-LA tablets 160 mg
amlodipine Istin tablets 5mg, 10 mg
dittiazem Adizem tablets 60 mg
Tildiem tablets 60 mg (long-acting diltiazem products are:
Adizem-XL AAngil SR Calcicard CR, Diazem SR, Diazem XL, Slozem,
Tildiem LA, Tildiem Retard)
felodipine Plendil tablets 5 mg, 10 mg
Anicardipine Cardene tablets 20 mg, 30 mg
nifedipine Adalat capsules 5mg, 10 mg (long-acting nifedipine products are:
Adalat LA, Adalat Retard, Adipine MR, Angiopine MR, Cardilate MR,
Coracten, Hypolar Retard, Nifelease, Nifensar XL, Unipine XL)
(verapamil Cordilox tablets 40, 80, 120, 160 mg
Securon tablets 40 mg, 80 mg, 120 mg:potassium channel activator
nicorandil Ikorel tablets 10mg, 20mg