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Theophylline

Details About Generic Salt ::  Theophylline 

Main Medicine Class:: Respiratory System   Sub Medicine Class ::  Drugs For Asthma,COPD,ARDS

6A. DRUGS FOR ASTHMA/COPD/ARDS in 6. RESPIRATORY SYSTEM
THEOPHYLLINE
PDE INHIBITOR | BRONCHODILATOR, SPASMOLYTIC
PK: A: Rapid (PO) D: 0.45 L/kg (Vd) M: Hepatic E: Urine

Indications & Dose: ACUTE BRONCHOSPASM PO Adult Loading dose 5 mg/kg Child >1 yr: Same as adult dose | ACUTE SEVERE BRONCHOSPASM IV Adult Inf: Loading dose 4-5mg/kg over 20-30 min, MD 400-600µg/kg/h Child Initially loading dose 4-5mg/kg followed by MD, Neonates: <24days: 1mg/kg q12h, >24 days: 1.5mg/kg q12h, 1-9yr: 0.8-1mg/kg/h, 9-12yr: 0.7-0.77mg/kg/hIn patients who have not received theophylline, aminophylline, or other xanthine-containing medications in previous 24h | CHRONIC BRONCHOSPASM PO Adult Initially 300mg/day in divided doses may increase dose to 400mg/day in divided doses Child 6-15 yr (<45kg): Initially 12-14mg/kg/day in divided dose max 300mg may increase to 16mg/kg/day after 3 days if tolerated. May further increase to 20mg/kg/day after next 3 days max 600mg in divided dose, 6-15yr (>45kg): Initially 300mg/day in divided doses may increase dose to 400mg/day in divided doses. May further increase to 600mg/day after next 3 days max 600mg in divided dose, > 16 yr: Same as adult dose Elderly >60 yr: 400mg/day

Contra: Hypersensitivity, active peptic ulcer, seizures

Precautions: alcoholism, HF, HTN, renal/hepatic disease, COPD, hypoxemia, hyperthyroidism, DM, glaucoma, corticosteroids, elderly

ADR: Serious: SIADH, hypersensitivity, circulatory failure, ventricular arrhythmias, respiratory arrest, tachycardia, seizures, Others: fever, nausea, vomiting, insomnia, hyperglycemia

DDI: Serious β-blockers/Corticosteroids causes hypokalemia, Macrolides increases drug toxicity, Ceftibuten/cefalexin/Mexiletine leads to drug toxicity, Imipenem leads to seizures, Interferon α/Disulfiram/Phenylpropanolamine/Ticlopidine reduces drug clearance, Dobutamine results in marked tachycardia Others Tobacco/Cannabis increases drug clearance, Influenza vaccines/Allopurinol/Tetracyclines increases drug levels, Rifampicin/Phenytoin/Ritonavir lowers drug levels, Carbamazepine reduces drug effects

Diet: With/Without food

Monitor: ECG, CNS effects, respiratory rate, arterial/capillary blood gases,theophylline concentration

Formoterol

Details About Generic Salt ::  Formoterol 

Main Medicine Class:: Respiratory System   Sub Medicine Class ::  Drugs For Asthma,COPD,ARDS

6A. DRUGS FOR ASTHMA/COPD/ARDS in 6. RESPIRATORY SYSTEM
FORMOTEROL
SYMPATHOMIMETIC (SELECTIVE ß2-ADRENERGIC AGONIST) | BRONCHODILATOR
PK: A: Rapid (Inhalation) M: Hepatic E: Urine

Indications & Dose: ASTHMA Maintenance therapy Inh Adult 12µg (as capsule) q12h Child >5yr: 12µg (as capsule) inhaled q12hPatients with reversible obstructive airway disease | CHRONIC OBSTRUCTIVE PULMONARY DISEASE Inh Adult 12µg (as capsule) q12h | EXERCISE-INDUCED BRONCHOSPASM Inh Adult 12µg capsule inhaled 15min before exercise Child >5yr: 12µg (as capsule) inhaled 15min before exercise

Contra: Hypersensitivity

Precautions: CVD, DM, COPD, hyperthyroidism, hypokalemia, seizures, patients receiving other inhaled corticosteroids, acute asthma

ADR: Serious: Chest pain, palpitation, Others: Anxiety, dizziness, fever, insomnia, dysphonia, diarrhea, nausea, xerostomia, gastroenteritis, abdominal pain, dyspepsia, bronchitis, sinusitis, tonsillitis, pruritus, rash

DDI: Serious Propranolol bronchodilating effects are reduced, Budesonide decreased drug levels, Theophylline leads to hypokalemia, TCAs/MAOIs prolongation of QTc interval & increases risk of ventricular arrhythmias

Monitor: FEV1, peak flow, pulmonary function tests, BP,HR, CNS stimulation, serum glucose & potassium

Montelukast

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Main Medicine Class:: Respiratory System   Sub Medicine Class ::  Drugs For Asthma,COPD,ARDS

14C. ANTI-ALLERGICS in 14. IMMUNOLOGY & ALLERGY
MONTELUKAST
LEUKOTRIENE RECEPTOR ANTAGONIST | ANTI-ASTHMA, ANTI-ALLERGIC
also comes under 6A. Drugs For Asthma/COPD/ARDS in 6. Respiratory System,  
PK: A: Rapid D: 8-11 L (Vd) M: Hepatic E: feces via bile

Indications & Dose: ASTHMA PO Adult 10mg OD Child 12-23 month: 4mg OD, 2-5 yr: 4mg OD, 6-14 yr: 5mg OD | EXERCISE-INDUCED ASTHMA Prophylactic therapy PO Adult 10mg/day 2h before exercise, additional doses should not be given within 24h Child >15yr: Same as adult dose | PERENNIAL/SEASONAL ALLERGIC RHINITIS PO Adult 10mg OD Child 6-23 month: 4mg OD, 2-5yr: 4mg OD, 6-14 yr: 5mg OD, >15yr: 10mg OD | SEASONAL ALLERGIC RHINITIS PO Adult 10mg OD Child 2-5yr: 4mg OD, 6-14 yr: 5mg OD, >15yr: 10mg OD

Contra: Hypersensitivity, hepatic impairment/cirrhosis, avoid monotherapy for prevention of exercise-induced bronchospasm, avoid drug in asthma patients sensitivity to aspirin or NSAIDs

Precautions: Acute asthma

ADR: Serious: Hypersensitivity reactions, increased ALT/AST concentrations, Churg-Strauss syndrome, arthralgia, myalgia, Others: Dizziness, fatigue, headache, fever, dyspepsia, gastroenteritis, weakness, cough, nasal congestion, sinusitis, epistaxis, URTI

DDI: Serious Prednisone leads to severe edema, Phenytoin/Phenobarbital/Rifampicin reduces drug levels

Monitor: Mood or behavior changes, including suicidal thinking & behavior

Fluticasone

Details About Generic Salt ::  Fluticasone 

Main Medicine Class:: Respiratory System   Sub Medicine Class ::  Drugs For Asthma,COPD,ARDS

6A. DRUGS FOR ASTHMA/COPD/ARDS in 6. RESPIRATORY SYSTEM
FLUTICASONE
CORTICOSTEROID | ANTI-ASTHMA, GLUCOCORTICOID
also comes under 2B. Corticosteroids in 2. Ear, Nose & Throat (ENT),   15A. Corticosteroids (Topical) in 15. Skin
PK: A: Rapid D: 4.2 L/kg (Vd) M: Hepatic E: Feces, urine

Indications & Dose: ASTHMA Prophylactic therapy Inh Adult Powder/aerosol: 100-250µg BID, may be increased to 1mg BID in severe conditions Child >4 yr: Initially 50-100µg BID, increased to 200µg BID if needed | Chronic/Severe Inh Adult Nebuliser: 0.5-2mg BID Child 4-16 yr: 1mg BID | ATOPIC DERMATITIS TP Adult Cream/lotion: Apply sparingly to affected area OD/BID, if no improvement within 2 wk reassess for diagnosis Child >3 month: Cream: Same as adult dose, >1 yr: Lotion: Apply sparingly to affected area OD | CHRONIC OBSTRUCTIVE PULMONARY DISEASE Inh Adult Powder/aerosol: 500µg BID | CORTICOSTEROID-RESPONSIVE DERMATOSES TP Adult Cream/lotion/ointment: Apply sparingly to affected area BID. If no improvement within 2 wk reassess for diagnosis Child >3 month: Cream: Same as adult dose | NASAL POLYPS NSL Adult 200µg instilled into each nostril OD/BID 4-6 wk | SEASONAL/PERENNIAL ALLERGIC RHINITIS/NONALLERGIC RHINITIS Symptomatic therapy Inh Adult Initially 2 sprays (100µg/spray) in each nostril OD, after first few days reduce dose to 1 spray (100µg) into each nostril OD for maintenance therapy Child >4 yr: Initially 1 spray (50µg) in each nostril OD, may increase to 2 sprays (100µg) per nostril in patients not adequately responding or those with severe symptoms, max 2 sprays in each nostril (200µg/day)

Contra: Hypersensitivity, primary treatment of status asthmaticus/acute bronchospasm, presence of acute infect, administration of live vaccines, active/doubtfully quiescent TB

Precautions: CVD, thyroid disease, hepatic/renal impairment, DM, glaucoma, cataracts, myasthenia gravis, osteoporosis, GI diseases, history of seizures, acute MI, elderly, during drug withdrawal

ADR: Serious: Cushing’s Syndrome, hypersensitivity reactions, hypopigmentation, raised IOP, reduced visual function, osteoporosis, Churg-Strauss syndrome, Others: muscle wasting & nitrogen depletion, hyperglycemia, menstrual irregularities, mental & neurological disturbances, amenorrhea, atrophy, loss of skin collagen, dryness, irritation, ulceration/perforation of nasal septum, hoarseness & candidiasis of mouth/throat, increased susceptibility to infect, delayed wound healing

DDI: Serious Ketoconazole/Itraconazole increases drug levels, HIV protease inhibitors leads to Cushing’s syndrome

Monitor: Growth, signs/symptoms of HPA axis suppression/adrenal insufficiency, eosinophilic conditions, FEV1, peak flow, and other pulmonary function tests, asthma symptom

Budesonide

Details About Generic Salt ::  Budesonide 

Main Medicine Class:: Respiratory System   Sub Medicine Class ::  Drugs For Asthma,COPD,ARDS

6A. DRUGS FOR ASTHMA/COPD/ARDS in 6. RESPIRATORY SYSTEM
BUDESONIDE
CORTICOSTEROID (INHALATION) | ANTI-ASTHMA, ANTI-INFLAMMATORY
also comes under 2B. Corticosteroids in 2. Ear, Nose & Throat (ENT),   7H. Drugs for Inflammatory Bowel Disease in 7. Gastrointestinal System
PK: D: 2.2-3.9 L/kg M: Liver E: Urine

Indications & Dose: ASTHMA Inh Adult MDI: 400µg/day in 2 divided doses may increase dose in severe asthma (upto 1.6mg or 2mg/day), MD: 200-400µg/day, Dry powder inhaler: 200-800µg/day as 2 divided doses/single daily dose max 800µg BID, Nebulizer: 1-2mg BID, MD 0.5-1mg BID Child MDI: 50-400µg BID, Nebulizer: 3 months-12yr: Initially 0.5-1mg BID, MD 0.25-0.5mg BID | CROHN’S DISEASE Mild-to-moderate PO Adult Delayed release capsules: 9mg/day (in morning) 8 wks. For clinical remission MD 6mg/day 3 months. If symptoms are controlled, then discontinue by gradually tapering the doseinvolving ileum and/or ascending colon | CROUP Inh Child Nebuliser suspension: >1 month: 2mg in 1 or 2 divided doses separated by 30min, may repeat after 12h if required | NASAL POLYPS NSL Adult 1 spray (containing 64/100µg) into each nostril BID 3months Child >12yr: Same as adult dose | RHINITIS NSL Adult Initially 2 sprays into each nostril OD in the morning or 1 spray into each nostril BID, may reduce to dose (1 spray into each nostril OD) & continued for 3 month Child >12yr: Same as adult dose

Contra: Hypersensitivity

Precautions: HF, recent MI, HTN, DM, epilepsy, glaucoma, hypothyroidism, hepatic failure, osteoporosis, PUD, psychoses/severe affective disorders, renal impairment, children, elderly, quiescent TB

ADR: Serious: Increased susceptibility to infect, increased severity of varicella & measles, ocular changes, mental & neurological disturbances, benign intracranial HTN, acute pancreatitis, avascular necrosis of bone, adrenal atrophy, cushingoid symptoms, flushing, hypersensitivity reactions, corneal ulcers, raised IOP, reduced visual function, Others: Menstrual irregularities, hyperhidrosis, skin thinning, increased bruising, ecchymoses, dryness, hoarseness & candidiasis of the mouth/throat, irritation, urticaria, weight gain or loss, hyperglycemia

DDI: Serious Metformin/Glibenclamide deterioration in diabetic control, Itraconazole increases drug levels, Ritonavir increases the drug levels, Clarithromycin leads to cushing’s syndrome, Colestyramine reduces the absorption of drug

Mometasone

Details About Generic Salt ::  Mometasone 

Main Medicine Class:: Respiratory System   Sub Medicine Class ::  Drugs For Asthma,COPD,ARDS

6A. DRUGS FOR ASTHMA/COPD/ARDS in 6. RESPIRATORY SYSTEM
MOMETASONE
CORTICOSTEROID | ANTI-ALLERGIC, ANTI-ASTHMATIC
also comes under 2B. Corticosteroids in 2. Ear, Nose & Throat (ENT),  ,   15A. Corticosteroids (Topical) in 15. Skin

Indications & Dose: ASTHMA Mild-to-moderate Prophylactic therapy Inh Adult Dry powder: Initially 400µg OD, MD 200µg OD/BID Child 12-18 yr: 200-400µg as single dose/ in 2 divided doses, increased to 400µg BID if needed | CORTICOSTEROID RESPONSIVE DERMATOSES TP Adult Lotion: Apply few drops to affected area OD, Cream/ointment: Apply thin film to affected area OD Child Lotion: >12 yr same as adult dose, Cream/ointment:>2 yr: Same as adult dose | NASAL POLYPS NSL Adult 100µg (2 sprays) in each nostrils BID, total daily dose 400µg | SEASONAL ALLERGIC RHINITIS Prophylactic therapy NSL Adult 200µg/day (2 sprays in each nostrils) initiated 2-4 wks prior to start of pollen season Child >12 yrs: Same as adult dose | SEASONAL/PERENNIAL ALLERGIC RHINITIS Symptomatic therapy NSL Adult 100µg (2 sprays) in each nostril daily, total daily dose 100µg Child 2-11 yr: 50µg (1 sprays) in each nostril daily, total daily dose 100µg, >12 yr: Same as adult dose

Contra: Hypersensitivity to drug, intolerance of alcohol/bisulfites/tartrazine, active untreated infect, hypersensitivity to milk proteins, primary treatment of status asthmaticus, acute bronchospasm

Precautions: HTN, osteoporosis, DM, glaucoma, immunosuppression, seizure disorders, renal disease, hypothyroidism, cirrhosis, diverticulitis, active/latent PUD, IBD, UC, thromboembolic disorder/tendency, myasthenia gravis, HF, metastatic cancer, emotional instability, recent GI surgery, children <6 yr

ADR: Serious: Increased ICP, seizures, HF, thrombophlebitis, thromboembolism, fat embolism, arrhythmias, shock, adrenal suppression, hypothalamic-pituitary adrenal suppression, bronchospasm, hypotension/HTN, glaucoma, increased IOP, throat irritation, pancreatitis, cushingoid state, sodium & fluid retention, hypercholesterolemia, tendon rupture, osteoporosis, nasopharyngeal/oropharyngeal fungal infect, immunosuppression, hypersensitivity reaction, Others: hoarseness, rash, acne, hirsutism, thin & fragile skin, petechiae, weight gain, muscle wasting, myopathy, dry mouth, anorexia, amenorrhea/irregular menses, nausea, vomiting, abdominal distention, esophageal candidiasis/ulcer, nasal congestion & irritation, Churg-Strauss syndrome, headache, nervousness, restlessness, personality changes, vertigo, euphoria, paresthesia, insomnia

DDI: Serious Antidiabetics effects/levels decreases by drug, HIV protease inhibitors/Azoles increases levels/effects of drug, Loop diuretics/Amphotericin-B/Thiazides levels/effects increases by drug

Monitor: ECG, blood glucose & electrolyte levels, urinalysis, LFT, cushing’s syndrome, RFT