Inhaled Drugs UABD – Nebulized Liquid MDI – Pressurized Meter Dose Inhaler Canister DPI – Dry Powder Inhaler

Classifications by Mechanism I. Bronchodilators – Reduces bronchial smooth muscle constriction II. Corticosteroids – Reduce bronchial wall inflammation (swelling) III. Mucoactive Agents – has an effect on mucus IV. Antimicrobial – kills microorganisms V. Other

I. Bronchodilators Rescue Drug A. Short Acting - B. Long Acting - 1) Beta Agonists: Albuterol 2.5 mg Xopenex 1.25 mg 2) Anti Cholinergic: Atrovent (Ipratropium Bromide) B. Long Acting - Serevent (in Advair) Spiriva Rescue Drug

Short Acting Beta Agonists (beta-2)

II. Steroids Controller Flovent (in Advair) Pulmicort (MDI or UABD) Aerobid Qvar Controller Must use as directed may take several doses/days to have therapeutic effect!

Most come in MDI / DPI

III. Mucoactive Agents Normal saline – is the carrier in UABD treatments (MDI version doesn’t have) Acetylcystine – Mucomyst 10%-20% solutions – irritating and smells! (give with a bronchodilator NaHCO3- (Bicarbonate solution) Pulmozyme – expensive $$$

IV. Antimicrobials Pentamidine – Pneumocystis Tobi (Tobramycin) G- bacteria Colystin – bacteria Ribrivirin

V. Others Chromolyn Sodium – allergy drug Lidocaine – numbing medicine

Da rules: Don’t give drugs in the exact same class together: examples: Pulmicort & Flovent (both steroids) Xopenex and Albuterol (both short acting beta agonists)