Indications And Dose
Asthma | Other conditions associated with reversible airways obstruction ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: 4 mg 3–4 times a day, maximum single dose 8 mg (but unlikely to provide much extra benefit or to be tolerated), inhalation route preferred over oral route, use elderly dose for sensitive patients ▶Elderly: Initially 2 mg 3–4 times a day, maximum single dose 8 mg (but unlikely to provide much extra benefit or to be tolerated), inhalation route preferred over oral route ▶BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR INJECTION ▶Adult: 500 micrograms every 4 hours if required ▶BY SLOW INTRAVENOUS INJECTION ▶Adult: 250 micrograms, repeated if necessary, injection to be diluted to a concentration of 50 micrograms/mL, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably ▶BY INTRAVENOUS INFUSION ▶Adult: Initially 5 micrograms/minute, adjusted according to response and heart rate, usual dose 3–20 micrograms/minute, higher doses may be required, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably ▶BY INHALATION OF AEROSOL ▶Adult: 100–200 micrograms, up to 4 times a day for persistent symptoms ▶BY INHALATION OF NEBULISED SOLUTION ▶Adult: 2.5–5 mg, repeated up to 4 times daily or more frequently in severe cases Prophylaxis of allergen- or exercise-induced bronchospasm ▶BY INHALATION OF AEROSOL ▶Adult: 200 micrograms Acute asthma ▶BY INTRAVENOUS INJECTION ▶Child 1–23 months: 5 micrograms/kg for 1 dose, dose to be administered over 5 minutes, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect ▶Child 2–17 years: 15 micrograms/kg (max. per dose 250 micrograms) for 1 dose, dose to be administered over 5 minutes, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect Moderate, severe, or life-threatening acute asthma ▶BY INHALATION OF NEBULISED SOLUTION ▶Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required, give via oxygen- driven nebuliser if available ▶Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available ▶Child 12–17 years: 5 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available ▶Adult: 5 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available Respiratory system Moderate and severe acute asthma ▶BY INHALATION OF AEROSOL ▶Child: 2–10 puffs, each puff is to be inhaled separately, repeat every 10–20 minutes or when required, give via large volume spacer (and a close-fitting face mask in children under 3 years), each puff is equivalent to 100 micrograms ▶Adult: 2–10 puffs, each puff is to be inhaled separately, repeat every 10–20 minutes or when required, give via large volume spacer, each puff is equivalent to 100 micrograms Exacerbation of reversible airways obstruction (including nocturnal asthma) | Prophylaxis of allergen- or exercise- induced bronchospasm ▶BY INHALATION OF AEROSOL ▶Child: 100–200 micrograms, up to 4 times a day for persistent symptoms ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Child 1 month–1 year: 100 micrograms/kg 3–4 times a day (max. per dose 2 mg), inhalation route preferred over oral route ▶Child 2–5 years: 1–2 mg 3–4 times a day, inhalation route preferred over oral route ▶Child 6–11 years: 2 mg 3–4 times a day, inhalation route preferred over oral route ▶Child 12–17 years: 2–4 mg 3–4 times a day, inhalation route preferred over oral route Uncomplicated premature labour (between 22 and 37 weeks of gestation) (specialist supervision in hospital) ▶BY INTRAVENOUS INFUSION ▶Adult: Initially 10 micrograms/minute, rate increased gradually according to response at 10-minute intervals until contractions diminish then increase rate slowly until contractions cease (maximum rate 45 micrograms/minute), maintain rate for 1 hour after contractions have stopped, then gradually reduce by 50% every 6 hours, maximum duration 48 hours
PDF page 289