Medical Sciences Paper on Labeling Medication

Labeling Medication

  1. Epinephrine

Generic: Adrenalin or Adrenaline (long acting drug)

Trade: EpiPen, Adrenaclick

Administration: Nebulizer, injection to the muscle, injection under the skin

Classification: Hormone, neurotransmitter, alpha and beta-adrenergic agonist

Action: Bronchodilation, tightening the blood vessels

Onset: Rapid, 2 minutes

Dosage:  aerosol, 0.3 mg/puff, 6455550.15 mg/ puff for anaphylaxis

Adverse Effects:         Shakiness, anxiety, sweating, vomiting, sweating, dizziness, nervousness, weakness, pale skin, headache, difficulty in breathing, irregular heartbeat

 

  1. Racemic Epinephrine

Generic: Racepinephrine (rescue)

Trade:  Asthmanefrin, S2

Administration:  Nebulizer,

Classification: alpha and beta-adrenergic agonist

Action: Bronchodilation

Onset: 3-4 hour

Dosage: 11.25 mg/0.5 mL of 2.25% solution diluted in 3 mL, 1-3 inhalations of 0.5 mL

of 2.25% solution through EZ breathe atomizer

Adverse Effects: headache, loss of appetite, nausea, tremors, trouble sleeping, difficulty

in breathing, tightness in the chest, swelling of the mouth, chest pain, wheezing

 

  1. Isoproterenol

Generic: Isoproterenol (rescue)

Trade:  Isuprel

Administration: Injection, as hydrochloride

Classification: non-selective adrenoreceptor agonist, TAAR1 agonist

Action: sympathomimetic

Onset: IV: Immediate, 10-15 minutes

Dosage: 0.2 mg/mL

Adverse Effects: Adams-Stokes syndrome, tachyarrhythmia, ventricular arrhythmia,

Diaphoresis, Nausea, vomiting, Tremor, weakness, Blurred vision, Dyspnea, pulmonary edema (Drugs.Com, 2017).

  1. Albuterol

Generic: Albuterol inhalation  (rescue/ long acting drug)

Trade: ProAir HFA, ProAir RespiClick, Proventil HFA, Ventolin HFA

Administration:  syrup, tablet

Classification: bronchodilator

Action: beta2-adrenergic bronchodilation,

Onset: IV: immediately, oral administration: 2 minutes

Dosage: oral administration of 2 or 4 mg of Albuterol, IV: 2.4 or 4.8 mg

Adverse Effects: Nervousness, Tremor,  Headache, Sleeplessness,

Weakness, Tachycardia, Palpitations, Muscle cramps, Nausea, Sleeplessness

 

  1. Levalbuterol

Generic: Levalbuterol hydrochloride (long acting drug)

Trade: Xopenex

Administration: nebulizer

Classification: short-acting β2 adrenergic receptor agonist

Action: beta 2 specific,

Onset: 1-5 minutes, duration: 4-6 hours immediately

Dosage: inhalation: 0.31 mg administered three times a day for children and 0.63 mg

administered three times a day for adults

Adverse Effects: palpitations, chest pain, fast heart rate, headache, dizziness, tremor and

nervousness

 

  1. Terbutaline

Generic: Terbutaline, Terbutaline sulfate (rescue)

Trade: Bronclyn, Brethine, Bricanyl, Brethaire, or Terbulin

Administration: injection through the skin, injection through the vein

Classification: β₂ adrenergic receptor agonist and a tocolytic

Action: fast-acting brochodilation, Beta 2 specific, anti-contraction medication

Onset: immediately: duration 48 hours

Dosage: Each milliliter of solution contains 1 mg of Terbutaline sulfate USP (0.82 mg of

the free base),

Adverse Effects: fast or irregular heartbeat, high blood sugar, low blood potassium levels,

Fluid in the lungs, and heart attack in pregnant women and fast heartbeat or low blood sugar in the fetus or newborn

 

  1. Bitolterol Mesylate

Generic: No brand existing (rescue)

Trade: Tornalate

Administration: Nebulizer: oral inhalation 2 inhalations

Classification: Sympathomimetic

Action: Rapid onset

Onset: 2 to 3 min, duration: 6 hours

Dosage: 0.8% (delivers 0.37 mg/actuation) as an aerosol and Solution for inhalation 0.2%

Adverse Effects: Palpitations, tachycardia, irregular pulse, hypertension, angina, Tremor,

lightheadedness, dizziness, nervousness, headache, tiredness, throat and mouth irritation, nausea, vomiting, cough, increased chest discomfort, dyspnea; bronchospasm

 

  1. Pirbuterol

Generic: Pirbuterol (rescue)

Trade: Maxair Autohaler

Administration: Nebulizer: oral inhalation

Classification: Short-acting β2 adrenoreceptor agonist

Action: Peak Effect: Therapeutic: 0.5 to 1 hour Duration: 5 hours

Onset: 5 minutes, Rapid

Dosage: 200 mcg/INH

Adverse Effects: Palpitations, tachycardia, Nervousness, tremor, headache, dizziness,

Nausea, Cough, Chest pain, confusion, depression, hypotension, insomnia, numbness of extremities, pruritus, skin rash, sore throat, syncope

  1. Combivent

Generic: Albuterol and Ipratropium Bromide (rescue)

Trade: Combivent, Combivent Respimat, DuoNeb

Administration: Nebulizer: oral inhalation, metered

Classification: anticholinergic bronchodilator

Action: rapid onset

Onset: 0-5 minutes: duration: 2 hours

Dosage: IV: 100 pg/mL

Adverse Effects: headache, nausea, coughing,  Upper Respiratory Tract Infection,

rhinitis, sinusitis, edema, fatigue, hypertension, dizziness, nervousness, paresthesia, tremor, dysphonia, insomnia, diarrhea, dry mouth, dyspepsia, vomiting, arrhythmia, palpitation, tachycardia, arthralgia, angina, increased sputum, taste perversion, and urinary tract infection/dysuria.

 

  1. Salmeterol

Generic: Fluticasone (rescue)

Trade: Serevent Diskus

Administration: Nebulizer

Classification: long-acting β2 adrenergic receptor agonist; Adrenergic bronchodilators

Action: immediately 20 minutes; Duration: 12 hours

Onset: Asthma: 30-48 minutes, COPD: 2 hours; Peak effect: Asthma: 3 hours, COPD: 2-

5 hours

Dosage: 50 mcg/dose

Adverse Effects: Headache, Pain, Hypertension, Dizziness, sleep disturbance, fever,

anxiety, migraine, eczema, urticaria, photo-dermatitis

 

  1. Formoterol Fumarate

Generic: Eformoterol (rescue)

Trade: Atock, Atimos/Atimos Modulite, Foradil/Foradile, Oxeze/Oxis, and Perforomist.

Classification: a long-acting β2 agonist,

Action: up to 12 hours

Onset: 4-6 hours

Dosage: 160 μg of formoterol per day

Adverse Effects: headache, nausea, coughing, rhinitis, sinusitis, edema, fatigue,

hypertension, dizziness, nervousness, paresthesia, tremor,

 

  1. Duoneb

Generic: Ipratropium bromide and Albuterol sulfate (long acting drug)

Trade: Albuterol

Administration: Nebulizer

Classification: Racemic albuterol and a relatively selective β2-adrenergic bronchodilator

Action: Rapid onset, 0-5 minutes

Onset: Dosage: 0.5 mg / 3 mg per 3 mL

Adverse Effects: pain chest, nausea, cramps leg,

 

  1. Symbicort

Generic: Budesonide and Formoterol fumarate dihydrate (long acting drug)

Trade: Formoterol

Administration: Tablet, Nebulizer: metered-dose inhaler, intranasal corticosteroids

Classification: Long-acting beta2-adrenergic agonists

Action: rapid onset

Onset: 0-2 minutes

Dosage: 80/4.5 mcg, or 160/4.5 mcg

Adverse Effects: angina pectoris, tachycardia, atrial and ventricular tachyarrhythmias,

atrial fibrillation, extrasystoles, palpitations, hypercorticism, growth velocity reduction in pediatric patients, cataract, glaucoma, increased intraocular pressure, oropharyngeal candidiasis, nausea, immediate and delayed hypersensitivity reactions, such as anaphylactic reaction, angioedema, bronchospasm, urticaria, exanthema, dermatitis, pruritus, hyperglycemia, hypokalemia, muscle cramps, tremor, dizziness, behavior disturbances, sleep disturbances, nervousness, agitation, depression, restlessness, hypotension, hypertension

 

  1. Advair

Generic: Fluticasone Propionate and Salmeterol Xinafoate (long acting drug)

Trade: Advair HFA, Salmeterol

Administration: Nebulizer, metered

Classification: Long-acting beta2-adrenergic agonists, Bronchodilator combinations

Action: rapid onset

Onset: 2 minutes, duration: 12 hours

Dosage: 2 inhalations twice daily by the orally inhaled route only

Adverse Effects: Arrhythmias, hypertension, ventricular tachycardia, Aphonia, earache,

facial and oropharyngeal edema, paranasal sinus pain, rhinitis, throat soreness, tonsillitis, Cushing’s syndrome, Cushingoid features, growth velocity reduction in children/adolescents, hypercorticism, osteoporosis, mmediate and delayed hypersensitivity reactions, including rash and rare events of angioedema, bronchospasm, and anaphylaxis, Esophageal candidiasis

 

  1. Ipratropium Bromide

Generic: Bromure d’ipratropium, Ipratropii Bromidum, (long acting drug)

Trade: Atrovent, Atrovent HFA

Administration: Spray metered, Aerosol metered

Classification: Muscarinic antagonist effective for inhalation use, Anticholigergic

Action: Rapid

Onset: 15 to 30 minutes, duration: 3-5 hours

Dosage: 21 ug/1

Adverse Effects: dry mouth, cough, and inflammation of the airways, urinary retention,

worsening spasms of the airways, and a severe allergic reaction

 

  1. Tiotropium Bromide

Generic: Tiotropium (long acting drug)

Trade: Spiriva HandiHaler, Spiriva Respimat

Administration: Inhalation, Inhalation, capsule

Classification: anticholinergic agent, Anticholinergic Agent Long-Acting

Action: Rapid

Onset: Dry powder inhalation: Plasma: 7 minutes (following inhalation), Inhalation

solution: Plasma: 5 to 7 minutes (following inhalation)

Dosage: 1.25 mcg/actuation (4 g), Two inhalations (2.5 mcg) once daily (maximum: 2

inhalations per 24 hours)

Adverse Effects: Xerostomia, pharyngitis, Chest pain, edema, angina pectoris,

palpitations

 

  1. Beclomethasone

Generic: Vanceril (rescue/ long acting drug)

Trade: Qvar

Administration: Aerosol Solution, Inhalation, as dipropionate

Classification: Inhaler corticosteroids

Action: moderate at 0.5 hours

Onset: 1 to 2 weeks; Maximum effect: 3 to 4 weeks

Dosage: 40 mcg/actuation (8.7 g); 80 mcg/actuation (8.7 g)

Adverse Effects: Headache, Voice disorder, Nausea, Dysmenorrhea, Back pain,

pharyngitis, rhinitis

 

  1. Flunisolide

Generic: Flonase/ Syntaris (long acting drug)

Trade: AeroBid, Nasalide, Nasarel

Administration: nasal spray

Classification: anti-inflammatory steroid, nasal steroids, cortisteroid

Action: rapid onset

Onset: 20 minutes; duration 4 hours

Dosage: 100 mg formulation containing 25 mcg of Flunisolide, 2200 mcg, equivalent to

88 sprays/day) in 2 subjects for 4 days

Adverse Effects: nasal burning and stinging, nasal congestion, sneezing, epistaxis and/or

bloody mucous, nasal irritation, watery eyes, sore throat, nausea and/or vomiting, and headaches

 

  1. Triamcinolone Acetonide

Generic:  Kenalog (topical) and Volon A as an injection (long acting drug)

Trade: Corticosteroid

Administration: nasal spray form, intra-articular injection, applied as a topical ointment

to the skin

Classification: synthetic corticosteroid

Action: Slow rate, 1-2 weeks, effective over daily use for a week

Onset: 24-48 hours intra-articular injection, 12 hours nasal spray form

Dosage: applied 3-4 times on the skin

Adverse Effects: fat and muscle loss at an injection site,

 

  1. Prednisone

Generic: Prednisone (long acting drug)

Trade: Rayos, Sterapred, Deltasone

Administration: tablet, oral solution; oral solution, concentrate,

Classification: synthetic corticosteroid, Glucocorticoid, Antileukemic Drug, commodity c

Chemicals

Action: Immediately

Onset: 5 hours-24 hours

Dosage: 5 mg per 5 mL

Adverse Effects: anaphylactoid, bradycardia, cardiac arrest, cardiac arrhythmias, cardiac

enlargement, circulatory collapse, congestive heart failure, acne, acneiform eruptions, allergic dermatitis, alopecia, angioedema, angioneurotic edema, atrophy and thinning of skin, dry scaly skin, ecchymoses and petechiae,

 

  1. Solumedrol

Generic: Medrol, A-Methapred, Solu-Medrol, Depo-Medrol, Hybrisil (rescue)

Trade: Depo-Medrol and Solu-Medrol

Administration: Intravenous or Intramuscular

Classification: corticosteroid

Action: Rapidly absorbed when administered intramuscularly

Onset: 1 hour Duration: 4-6 hours

Dosage: 1 gram/day

Adverse Effects: hypersensitivity reactions, anaphylactoid reaction, anaphylaxis,

angioedema, Leukocytosis, Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis, Acne, allergic dermatitis, burning, Congestive heart failure in susceptible patients, fluid retention, hypokalemic alkalosis, potassium loss, sodium retention

 

  1. Beclomethasone

Generic: beclomethasone inhalation (rescue/long-acting drug)

Trade: Qvar, Beclovent, Vanceril, Vanceril DS, Qvar with Dose Counter

Administration: inhaler, cream, pills, and nasal spray

Classification: steroid medication

Action: slow onset

Onset: Slow rate: 24 hours, but may take 1-2 weeks

Dosage: 40 to 80 mcg via oral inhalation twice a day

Adverse Effects: respiratory infections, headaches, throat inflammation, cataracts,

Cushing’s syndrome, severe allergic reactions, adrenal insufficiency, adrenal insufficiency

 

  1. Alvesco

Generic: Ciclesonide (long acting drug)

Trade: Omnaris, Omniair, and Zetonna

Administration: Inhalation Aerosol.

Classification: glucocorticoid

Action: moderately slow, best effects: 4 weeks

Onset: 0.71 hours  duration: 5-7 hours

Dosage: 80 mcg/actuation, and 160 mcg/actuation

Adverse Effects: Immunosuppression, Hypercorticism and adrenal suppression, Growth

effects, Glaucoma and cataracts (Drugs.Com, 2017).

 

  1. Nedocromil

Generic: Tilade, (long acting drug)

Trade: Alocril

Administration: inhaler, aerosol

Classification: mast cell stabilizer, pyranoquinolone derivative

Action: moderately fast, duration: 4 hours

Onset: 5-90 minutes

Dosage: 1.75 mg/actuation, 2 inhalations 4 times daily at regular intervals to provide

14 mg/day

Adverse Effects: Headache, Ocular burning; irritation and stinging; unpleasant taste;

nasal congestion; conjunctivitis; eye redness; photophobia, Nausea; vomiting; dyspepsia; abdominal pain, Unpleasant taste

 

  1. Cromolyn Sodium

Generic: (long acting drug)

Trade:

Administration: oral solution, concentrate

Classification: Mast cell stabilizer, Antiallergic

Action: Rapid

Onset: 5-30 minutes

Dosage: 100 mg/5 mL

Adverse Effects: headache and diarrhea, Pruritus, nausea, and myalgia, abdominal pain,

rash, and irritability

 

  1. Accolate

Generic: Zafirlukast (long acting drug)

Trade: Accolate

Administration: Tablet, coated

Classification: selective peptide leukotriene receptor antagonist; Leukotriene modifiers

Action: slow reacting

Onset: 3 hours

Dosage: 40 mg/day; 20 mg twice daily

Adverse Effects: severe liver problems, inflammation of blood vessels, changes in

behavior or mood, hypersensitivity reactions, headache, infection, nausea, diarrhea, pain,

 

  1. Singulair

Generic: Montelukast sodium (long acting drug)

Trade: Singulair

Administration: tablet, a chewable tablet, flash tablet and granules to take by mouth

Classification: leukotriene receptor antagonist, methylxanthine

Action: slow reacting

Onset: 3-4 hours

Dosage: one 10-mg tablet daily

Adverse Effects: upper respiratory infection, fever, headache, pharyngitis, cough,

abdominal pain, diarrhea, otitis media, influenza, rhinorrhea, sinusitis, otitis

 

  1. Omalizumab

Generic: (rescue/ long acting drug)

Trade: Xolair

Administration: injection subcutaneously

Classification: whole antibody

Action: slow reacting

Onset: once every 2 or 4 weeks

Dosage: 300 mg per four weeks, subcutaneously

Adverse Effects: anaphylaxis, strokes, and heart disease

 

  1. Theophylline

Generic: 1,3-dimethylxanthine, Theophylline anhydrous (rescue/ long acting drug)

Trade: Theo-24, Theolair, Quibron-T, Uniphyl, Elixophylline, Quibron-T, Slo-Bid

Administration: tablet, extended release

Classification: methylxanthine

Action: rapid onset

Onset: 90 minutes

Dosage: Two 200 mg tablets daily

Adverse Effects: nausea, diarrhea, increase in heart rate, abnormal heart rhythms, and

CNS excitation

 

  1. Mucomyst

Generic: Acetylcysteine (rescue/ long acting drug)

Trade: No brands available

Administration: Nebulization, Oral administration

Classification: Mucolytics

Action: rapid

Onset: 0-20 minutes

Dosage: 3 to 5 mL of the 20% solution or 6 to 10 mL of the 10% solution

Adverse Effects: stomatitis, nausea, vomiting, fever, rhinorrhea, drowsiness, clamminess,

chest tightness, and bronchoconstriction

 

  1. Pulmozyme

Generic: dornase alfa (rescue/ long acting drug)

Trade: Pulmozyme

Administration: inhalation solution

Classification: Miscellaneous Respiratory agents

Action: Rapid

Onset: 0-20 minutes

Dosage: 2.5 mg/2.5 mL in single-use ampules

Adverse Effects: Voice alteration, apnea, cardiac arrest, cardiopulmonary arrest, cor

pulmonale, heart failure, massive hemoptysis, pneumonia, pneumothorax, and respiratory failure

 

  1. Tobramycin (inhaled)

Generic: Tobramycin sulfate (long acting drug)

Trade: no brand available

Administration: Intramuscular administration

Classification: aminoglycoside antibiotics

Action: rapid onset

Onset: 30 and 90 minutes

Dosage: 12 mcg/mL

Adverse Effects: dizziness, vertigo, tinnitus, roaring in the ears, and hearing loss, anemia,

granulocytopenia, and thrombocytopenia; and fever, rash, exfoliative dermatitis, itching, urticaria, nausea, vomiting, diarrhea, headache, lethargy, pain at the injection site, mental confusion, and disorientation

 

  1. Heliox

Generic: (rescue/ long acting drug)

Trade:

Administration: a mask with a reservoir bag or via endotracheal tube, nebulization

Classification: Gases

Action: slow

Onset:

Dosage: helium: oxygen mix of 80:20 or 70:30

Adverse Effects: expensive (10x the cost of oxygen), lack of availability, can’t use on

those with a high FiO2 (>0.4), ventilators require recalibration for FiO2 and TV – interferes with valve function, requires heated humidified circuits as helium conducts heat 6x faster than nitrogen, alteration of vocal pitch, may reduce the efficiency of coughing

References

Drugs.Com. Indications and Usage for Alvesco. 2017. Retrieved from

https://www.drugs.com/pro/alvesco.html

Drugs.Com. Indications and Usage for Isoproterenol. 2017. Retrieved from

https://www.drugs.com/pro/isoproterenol.html