Medications for the respiratory system Domina Petric, MD

Nose I.

Nasal decongestants for local use: SYMPATHOMIMETICS xylometasolinum oxymetasolinum naphazolinum

Indications acute rhinitis allergic rhinitis rhinosinusitis otitis media during endoscopic nasal procedures

Dose For children from age 2 to age 7 there is usually a medication labeled for children. For older children and adults the medication is labeled for adults. Maximum dose is 2 drops or inhalations (if spray) in each nostril three times a day. Maximum treatment duration is 5 days!

rhinitis sicca (atrophic rhinitis) Contraindications rhinitis sicca (atrophic rhinitis) hypersensitivity children under the age of 2 years

Nasal decongestants for local use: CORTICOSTEROIDS fluticasonum mometasonum triamcinolonum ...

allergic rhinitis (sesonal, chronic) Indications allergic rhinitis (sesonal, chronic)

Dose For the most of medications dose is two inhalations (if spray) or nose drops in each nostril once a day (in the morning) or maximum twice a day. Most of medications are not recommended for small children (under the age of 3 to 6 years depending on the medication) and for children age 6 to 12 years, treatment duration should not be longer than 3 months maximum. Older children and adults should use minimal effective dose in minimal treatment duration, but if necessary, treatment duration can be longer than 3 months.

Decongestives for oral use (tbl.) Aerinaze: desloratadine + pseudophedrine sulphate Recommended dose is one tbl. per os twice a day. Maximum treatment duration is 10 days. Contraindicated for children under the age of 12 years. Other contraindications are hypersensitivity, MAO-inhibitors, narrow angle glaucoma, urinary retention, ishemic heart disease, tachyarrhythmias, severe arterial hypertension, hyperthyreosis, hemorrhagic cerebrovascular insult (in history or risk for developing one).

Antiasthmatic drugs II.

Short acting beta-2 agonists + Diagnosis Daytime symptoms <2 times a week >2 times a week Daily Continous Nightime symptoms <2 times a month >2 times a month >5 times a month Frequent FEV1 >80% 60-80% <60% Type of asthma Intermittent Mild persistent Moderate persistent Severe persistent Treatment Short acting beta-2 agonists + Low dose inhaled CS Low to medium dose inhaled CS High dose inhaled CS Long acting beta-2 agonists Oral steroid therapy

Inhalation selective beta-2 adrenergic medications salbutamolum salmeterolum indacaterol maleate formoterolum

Indications, dose and contraindications First line treatment of asthma and for acute asthmatic attack. Usually for children older than 4 years, adolescents and adults. For children age 4 to 11 years, dose is one inhalation. For adults, dose is two inhalations. For children up to 12 years, maximum dose in chronic treatment is one inhalation up to four times a day. For chronic treatment in adults and children older than 12 years, maximum dose is two inhalations four times a day. Contraindications are hypersensitivity and risk for spontaneous abortion.

Inhalation drug combinations (adrenergics and corticosteroids) salmeterol + fluticasone budesonide + formoterolum beclometasonum + formoterolum ...

Indications, dose and contraindications Indicated for more severe forms of asthma. Dose is usually two inhalations twice a day. Contraindicated in children under the age of 4 years and in case of hypersensitivity.

Xanthine derivates Theophyllinum

Teolin (teophyllinum) tbl. 125 mg, 200 mg, 300 mg and 350 mg Indications are bronchial asthma, chronic obstructive pulmonary disease (COPD), bronchoconstriction in exertion. Start dose for adults is 125 mg to 150 mg per os every 12 hours. Every third day dose can be increased up to maximum 600 mg per os twice a day. Usually the effective dose is 300 mg per os twice a day. Contraindicated for children under the age of 6 years. Dose for children age 6 to 12 years is 125 mg per os twice a day up to maximum two tbl. of 125 mg twice a day.

Leucotriene receptor antagonists: montelukast 4 mg, 5 mg or 10 mg tbl. Indicated for more severe forms of asthma. For children age ≥15 years and adults recommended daily dose is 10 mg per os at evening. Contraindicated in children under the age of 15 and in the case of hypersensitivity.

Roflumilast 500 mcg Indicated as maintenance therapy in case of severe COPD (FEV1<50%) in dose 500 mcg per os once a day. Contraindications are children under the age of 18 years, moderate to severe liver damage and hypersensitivity.

Antihistaminic drugs III.

Dimenhydrinatum (Dramina 50 mg) For children age more than 5 years and adults: prevention of nausea, vomiting and vertigo in travel sickness and Menier´s disease. Dose: children 5-6 years old: 25 mg every 6-8 hours, maximum dose is 75 mg per os a day children 7-14 years old: 25-50 mg every 6-8 hours, maximum dose is 150 mg per os a day children more than 14 years and adults: 50-100 mg every 6 hours, maximum daily dose is 400 mg per os

Contraindications children under the age of 5 years hypersensitivity acute asthmatic attack narrow angle glaucoma pheochromocytoma porphiria epilepsy eclampsia prostate hypertrophy

Fenistil oral drops 1 mg/mL Indications: pruritus caused with eczema, dermatoses, chicken pox, insect bites and urticaria sesonal rhinitis chronic allergic rhinitis allergic reactions on food and drugs

Fenistil oral drops 1 mg/mL Dose for children of one month to 12 years old: 0,1 mg/kg/day or 2 drops/kg/day divided in three doses. 20 drops is 1 mL (1mg). Children older than 12 years and adults: 3-6 mg per os a day divided in three doses, means 20-40 drops three times a day. Contraindicated in children under one month and in case of hypersensitivity.

Other antihistaminics desloratadinum (one tbl. per os a day) loratadinum (one tbl. per os a day) fexofenadinum ...

Literature HALMED MEDIATELY