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Medications table for asthma and other respiratory conditions

This is an excerpt from Clinical Pharmacology in Athletic Training by Michelle A. Cleary,Thomas E. Abdenour & Mike Pavlovich.

Drugs Discussed in This Chapter

Drug class	generic (pronunciation) Trade names	Therapeutic uses	Clinical concerns
Expectorants	guaifenesin (gwye FEN e sin) Mucinex	Oral cough expectorant (granules mixed in hot water): 200 to 400 mg every 4 hr as needed; maximum dosage: 2,400 mg/24 hr Extended-release tablet: 600 mg to 1,200 mg every 12 hr as needed; maximum dosage: 2,400 mg/24 hr Immediate-release tablet: 200 to 400 mg every 4 hr as needed; maximum dosage: 2,400 mg/24 hr Liquid: 200 to 400 mg every 4 hr as needed; maximum dosage: 2,400 mg/24 hr	Adverse reaction: Central nervous system issues include dizziness, drowsiness, nervousness, and restlessness.
Antitussives	dextromethorphan (deks troe meth OR fan) Robitussin	Oral: 10 to 20 mg every 4 hr or 20 to 30 mg every 6 to 8 hr Extended release: 60 mg twice daily; maximum dosage: 120 mg/24 hr	Adverse reaction: Central nervous system issues include dizziness, drowsiness, nervousness, and restlessness.
Antivirals	oseltamivir (oh sel TAM i vir) Tamiflu	Influenza type A and B treatment: 75 mg by mouth twice daily Influenza type A and B prophylaxis: 75 mg by mouth once daily for 7 days postexposure (or for a minimum of 2 wk for control of outbreaks in long-term care facilities and hospitals, and continue for up to 1 wk for last known case)	May cause occasional nausea and vomiting.
	acyclovir (ay SYE kloe veer) Zovirax	For viral pneumonia: 5 to 10 mg/kg IV every 8 hr	Although pure viral pneumonia does occur, superimposed bacterial infections are common and require antibiotics directed against S. pneumoniae, H. influenzae, and S. aureus.
Antihistamines: sedating (first generation)	diphenhydramine (dye fen HYE dra meen) Benadryl	Oral: 25 to 50 mg every 4 to 8 hr; maximum dosage: 300 mg daily	Central nervous system issues include sedation, vertigo, ataxia, chills, confusion, dizziness, drowsiness, euphoria, excitement, fatigue, headache, irritability, and nervousness.
Antihistamines: nonsedating (second generation)	loratadine (lor AT a deen) Claritin	Oral: 10 mg once daily or 5 mg twice daily	Longer action; used at 5 mg dosage.
Nasal decongestants: alpha-adrenergic (α-1 adrenergic) receptor agonists	pseudoephedrine (soo doe e FED rin) Sudafed	Oral: Immediate release: 60 mg every 4 to 6 hr Extended release: 120 mg every 12 hr or 240 mg every 24 hr; maximum dosage: 240 mg per 24 hr	Adverse reactions: Cardiovascular issues include cardiac arrhythmia, chest tightness, circulatory shock (with hypotension), hypertension, palpitations, and tachycardia.
	phenylephrine (fen il EF rin) Neo-Synephrine Cold and Sinus nasal spray	Intranasal 0.25% to 1% solution: Instill 2 or 3 sprays in each nostril no more than every 4 hr for ≤3 d.	Provides temporary relief of nasal congestion due to the common cold, hay fever, or other upper respiratory allergies (allergic rhinitis). For intranasal use only. Before using for the first time, prime the pump by firmly depressing the rim several times. Keep head upright and insert nozzle into nostril, depress rim firmly, and inhale deeply.
	oxymetazoline (oks i met AZ oh leen) Afrin Nasal Spray	Intranasal: Instill 2 or 3 sprays into each nostril twice daily for ≤3 d (maximum dose: 2 doses/24 hr)	Dry nose, nasal congestion (rebound; chronic use), nasal mucosa irritation (temporary), sneezing
Asthma rescue drugs: short-acting beta-agonists (SABA)* or short-acting β-2 agonists	albuterol (al BYOO ter ole) Proventil, ProAir, Ventolin	MDI: 90 mcg/puff	Inhalation powder: 1 or 2 inhalations (90 to 180 mcg) orally every 4 to 6 hr
		Nebulized solution: 5 mg/mL and 0.63, 1.25, and 2.5 mg/3 mL	2.5-5 mg every 20 min for 3 doses, then 2.5-10 mg every 1-4 hr as needed
Asthma rescue drugs: Anticholinergics*	ipratropium (i pra TROE pee um) Atrovent	Nebulized solution: 500 mcg/2.5 mL (0.02%)	0.5 mg every 20 min for 3 doses, then every 2-4 hr as needed
Asthma rescue drugs: combination drugs	ipratropium and albuterol (i pra TROE pee um) and (al BYOO ter ole) DuoNeb combination drug	SMI: 20 mcg ipratropium 100 mcg albuterol/puff	1 puff every 30 min for 3 doses, then every 2-4 hr as needed
		Nebulized solution: 0.5 mg ipratropium and 2.5 mg albuterol in a 3-mL vial	3 mL every 30 min for 3 doses, then every 2-4 hr as needed
Asthma rescue drugs: systemic corticosteroids	prednisone (PRED ni sone) Mainly generic	Tablets: 1, 2.5, 5, 10, 20, and 50 mg Solution: 5 mg/mL	Tapering the dose is not needed if patients are also given inhaled corticosteroids.
Long-term asthma control: inhaled corticosteroids	fluticasone (floo TIK a zone) Flovent HFA	MDI: Initially based on previous asthma therapy and asthma severity. Take 88 mcg twice daily, approximately 12 hr apart. Higher dosages may provide additional asthma control. Maximum daily dosage: 1,760 mcg.	Each actuation delivers 44, 110, or 220 mcg of fluticasone. Not indicated for rapid relief of bronchospasm. Patients should contact their physicians immediately when episodes of asthma are not responsive to bronchodilators. During such episodes, patients may require therapy with oral corticosteroids.
Long-term asthma control: long-acting beta-adrenergic (or β-2 adrenergic) agonist	salmeterol (sal ME te role) Serevent Diskus	DPI: 1 inhalation (50 mcg) twice daily (~12 hr apart); maximum dosage: 2 inhalations per day.	For asthma control, long-acting beta-2 agonists (LABAs) should be used in combination with inhaled corticosteroids and not as monotherapy.

*Amount and timing of ongoing doses are dictated by clinical response.

It is preferable to use a higher mcg/puff or mcg/inhalation formulation to achieve as low a number of puffs or inhalations as possible.

Metered-dose inhaler (MDI) dosages are expressed as the actuator dose, which is the amount leaving the actuator and delivered to the patient. Dry powder inhaler (DPI) doses are expressed as the amount of drug in the inhaler following activation. Hydrofluoroalkane (HFA) inhalers, also called MDIs, are administered using a nebulizer or soft mist inhaler (SMI).

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