The professional's guide to product selection
Long acting muscarinic antagonist, long-acting beta 2 agonist and inhaled corticosteroid.
Two inhalations twice daily
The Turbohaler Trainer Whistle is an educational tool designed to help teach patients how to use a Turbohaler correctly.
It works as follows:
1. The user breathes out.
2. The mouthpiece is placed gently between the teeth and the lips closed.
3. The user breathes in forcefully and deeply through the device. The whistle inside the trainer will sound when then they have achieved the inspiration flow required to use the actual Turbohaler.
Stockists: Astra Zeneca
Antimuscarinic bronchodilator with long-acting selective beta2 agonist.
• Adult for maintenance treatment of COPD: by inhalation of powder, 1 inhalation, once daily.
Antimuscarinic bronchodilator with long-acting selective beta2 agonist.
• Adult over 18 years for maintenance treatment of COPD: by inhalation of powder, 1 inhalation, once daily.
For chronic asthma, Uniphyllin Continus® by mouth using modified-release medicines
Child 2–11 years: 9 mg/kg every 12 hours (max. per dose 200 mg). Dose may be increased in some children with chronic asthma to 10–16 mg/kg every 12 hours (max. per dose 400 mg).
Child 12–17 years: 200 mg every 12 hours, adjusted according to response to 400 mg every 12 hours.
For reversible airways obstruction, severe acute asthma, chronic asthma, Uniphyllin Continus® by mouth using modified-release medicines
Adult: 200 mg every 12 hours, adjusted according to response to 400 mg every 12 hours.
Short-acting selective beta2 agonist.
Injection
• Child 1–23 months, by intravenous injection over 5 minutes: 5 mcg/kg as a single dose.
• Child 2–17 years, by intravenous injection over 5 minutes: 15 mcg/kg (maximum 250 mcg) as a single dose.
• Adult, subcutaneous or intramuscular injection: 500 mcg, repeated every four hours if necessary.
• Adult, by slow intravenous injection: (dilute to a concentration of 50 mcg/ml), 250 mcg, repeated if necessary.
Infusion
• Child 1 month–18 years: 1–2 mcg/kg/minute, adjusted according to response and heart rate, up to 5 mcg/kg/minute. Doses above 2 mcg/kg/minute should be given in an intensive care setting.
• Adult, by intravenous infusion: initially 5 mcg/minute, adjusted according to response and heart rate, usually in range 3–20 mcg/minute, or more if necessary.
Inhaled
• Child, by aerosol inhalation: 100 mcg (1 puff), increased to 200 mcg (2 puffs) if necessary. For persistent symptoms, up to four times daily.
• Adult, by aerosol inhalation: 100–200 mcg (1–2 puffs), for persistent symptoms up to 4 times daily.
• Adult, by inhalation of nebulised solution: 2.5–5 mg, repeated up to four times daily for persistent symptoms.
Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.
Moderate and severe acute asthma by inhalation of aerosol.
• Children and adults: 2–10 puffs, each puff to be inhaled separately, repeat every 10–20 minutes or when required. Each puff is equivalent to 100 mcg.
Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).
For non-infected inflammatory conditions of nose using Vistamethasone® by intranasal administration
Adult: Apply 2–3 drops twice daily, dose to be applied into each nostril.
The Vitalograph 4500 AIM™ (Aerosol Inhalation Monitor) is designed to assist medical practitioners in assessing inhaler use, whether MDI or DPI. Mastery of the correct technique will support more accurate drug delivery and good patient compliance, resulting in better disease management and fewer visits to medical professionals.
Stockists: Vitalograph, Williams Medical Supplies, Medisave, Mistry Medical Supplies.
This spirometer uses the highly acclaimed Fleisch Pneumotachograph technology for flow measurement. It has a touchscreen with an icon driven menu and a large bright high resolution colour display. It has an in-built printer and can store data for up to 10,000 patients. It has automatic two-way synchronisation to Vitalograph Spirotrac Software and can link to popular practice management systems. There are over 50 test parameters to choose from, pre- and post-bronchodilator comparisons can be made and there is a choice of incentives to use.
Stockists: Vitalograph, Primary Care Supplies, Medisave.
A simple respiratory monitor that measures PEF and forced expiratory volume in one second (FEV1).
FEV1 has less diurnal variability and is less effort dependent than PEF, so is a valuable measure. Suitable for home or clinic use, the device can be integrated with a smartphone or tablet for ePRO data collection. It offers greater accuracy than mechanical peak flow meters and eliminates the need for paper record cards.
It automatically stores best readings and displays each reading as a percentage of the personal best for both PEF and FEV1. The PEF and FEV1 zones can be personalised and 600 test sessions can be saved.
It has a large easy-to-read display and uses AAA batteries. It has an easy to clean mouthpiece and flowhead and can be used in conjunction with Vitalograph SafeTway mouthpieces in a clinic.