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Indications & Dose: ASTHMA Acute IV Child Inj: 1 month–2 yr: 5µg/kg as single dose over 5min, 2-18 yr: 15µg/kg as single dose max 250µg, Inf: 1 month-18 yr: 1–2µg/kg/min can be increased to 5µg/kg/min adjusted according to response & HR | BRONCHOSPASM PO Adult 2-4mg/dose 3-4 times/day max 32mg/day (divided doses), ER: 8mg BID max 32mg/day in divided doses (4mg BID may be sufficient in patients with low body weight) Child 2-6 yr: 0.1-0.2mg/kg/dose TID max 12mg/day (divided doses), 6-12 yr: 2mg/dose 3-4 times/day max 24mg/day (divided doses), ER: 4mg BID max 24mg/day (divided doses), >12 yr: Same as adult dose Elderly 2mg 3-4 times/day max 8mg QID | Acute IV Adult Slow inj: 250µg, repeat if necessary | Acute Symptomatic therapy Inh Adult MDI: 2 puffs (90µg/puff) q4-6h if needed (quick relief), Nebulization: 2.5mg TID/QID (quick relief) Child 5-11 yr: 2 puffs q4-6h as needed (quick relief) Nebulization: 2-12 yr: 0.63-1.25mg TID/QID if needed, >12 yrs: Same as adult dose | EXACERBATION OF ASTHMA Acute/Severe Inh Adult MDI: 4-8 puffs (90µg/puff) q20min up to 4h then q1-4h as needed. Nebulization continuous: 10-15mg/h Child MDI: Upto 11 yr: 4-8 puffs (90µg/puff) q20min for 3 doses then q1-4h as needed, >12 yr: Same as adult dose. Nebulization continuous: Upto 11 yr: 0.5mg/kg/h | EXERCISE-INDUCED BRONCHOSPASM Inh Adult MDI: 2 puffs (90µg/puff) 5-30min before exercise Child <4 yr: 1-2 puffs (90µg/puff) 5min before exercise, >5 yr: 2 puffs 5-30min before exercise

Precautions: CVD, DM, glaucoma, hyperthyroidism, hypokalemia, seizures, susceptibility to QT-interval prolongation, HTN, severe asthma

ADR: Serious: Tremor, palpitations, tachycardia, nervous tension, peripheral vasodilatation, hypokalemia, MI, hypersensitivity, pulmonary edema, angina, vertigo, RTI, Others: CNS stimulation, dizziness, drowsiness, nausea, vomiting, headache

DDI: Serious Alcohol causes lactic acidosis, Atomoxetine increases HR & BP, Ipratropium leads to acute angle-closure glaucoma, Theophylline/Aminophylline leads to hypokalemia, Digoxin leads to hypokalemia & digitalis toxicity, β-blockers results in serious bronchoconstriction, Amphotericin-B results in serious cardiac arrhythmias

Monitor: PFT, HR, serum glucose, serum potassium, asthma symptoms