Labeling Medication
- 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
- 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
- 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).
- 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
- 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
- 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
- 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
- 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
- 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.
- 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
- 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,
- 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,
- 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
- 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
- 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
- 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
- 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
- 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
- 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,
- 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,
- 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
- 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
- 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).
- 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
- 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
- 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,
- 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
- 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
- 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
- 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
- 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
- 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
- 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