Guidelines for the Diagnosis and Management of Asthma

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FIGURE 22. DOSAGES OF DRUGS FOR ASTHMA EXACERBATIONS Albuterol Nebulizer solution (0.63 mg/3 mL, 1.25 mg/3 mL, 2.5 mg/3 mL, 5.0 mg/mL) MDI (90 mcg/puff) Bitolterol Nebulizer solution (2 mg/mL) Medication Child Dose* Adult Dose Inhaled Short-Acting Beta 2 -Agonists (SABA) MDI (370 mcg/puff) Levalbuterol (R-albuterol) Nebulizer solution (0.63 mg/3 mL, 1.25 mg/0.5 mL 1.25 mg/3 mL) MDI (45 mcg/puff) 0.15 mg/kg (minimum dose 2.5 mg) every 20 minutes for 3 doses then 0.15–0.3 mg/kg up to 10 mg every 1–4 hours as needed, or 0.5 mg/kg/hour by continuous nebulization. 4–8 puffs every 20 minutes for 3 doses, then every 1–4 hours inhalation maneuver as needed. Use VHC; add mask in children
FIGURE 22. DOSAGES OF DRUGS FOR ASTHMA EXACERBATIONS (continued) Dosage Medication Child Dose* Adult Dose Comments (not all inclusive) Anticholinergics (continued) Ipratropium with albuterol Nebulizer solution (Each 3 mL vial contains 0.5 mg ipratropium bromide and 2.5 mg albuterol.) 1.5 mL every 20 minutes for 3 doses, then as needed 3 mL every 20 minutes for 3 doses, then as needed May be used for up to 3 hours in the initial management of severe exacerbations. The addition of ipratropium to albuterol has not been shown to provide further benefit once the patient is hospitalized. MDI (Each puff contains 18 mcg ipratropium bromide and 90 mcg of albuterol.) 4–8 puffs every 20 minutes as needed up to 3 hours 8 puffs every 20 minutes as needed up to 3 hours Should use with VHC and face mask for children
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SUMMARY REPORT 2007 National Asthma
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Contents Acknowledgments iii Prefac
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Acknowledgements National Asthma Ed
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Development of the guidelines was f
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Robert Zeiger, M.D. Kaiser Permanen
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Preface The Expert Panel Report 3 (
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Introduction More than 22 million A
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New emphasis on multifaceted approa
Page 17 and 18: Figure 1. SUMMARY OF RECOMMENDED KE
Page 19 and 20: Figure 1. SUMMARY OF RECOMMENDED KE
Page 21 and 22: Asthma Definition and Implications
Page 23 and 24: Diagnosis of Asthma To establish a
Page 25 and 26: FIGURE 3. SUGGESTED ITEMS FOR MEDIC
Page 27 and 28: Managing Asthma Long Term GOAL OF T
Page 29 and 30: FIGURE 4. SAMPLE PATIENT SELF-ASSES
Page 31 and 32: Develop an active partnership with
Page 33 and 34: FIGURE 6. SAMPLE ASTHMA ACTION PLAN
Page 35 and 36: FIGURE 7. DELIVERY OF ASTHMA EDUCAT
Page 37 and 38: these particles do not remain airbo
Page 39 and 40: Animal Dander Some people are aller
Page 41 and 42: Quick-relief medications are used t
Page 43 and 44: FIGURE 10. AEROSOL DELIVERY DEVICES
Page 45 and 46: The stepwise approach and recommend
Page 47 and 48: individual drug efficacy studies in
Page 49 and 50: of particular relevance (impairment
Page 51 and 52: ■ Albuterol is the preferred SABA
Page 53 and 54: FIGURE 12. ASSESSING ASTHMA CONTROL
Page 55 and 56: FIGURE 14. CLASSIFYING ASTHMA SEVER
Page 57 and 58: FIGURE 16. STEPWISE APPROACH FOR MA
Page 59 and 60: FIGURE 17. USUAL DOSAGES FOR LONG-T
Page 61 and 62: FIGURE 18. ESTIMATED COMPARATIVE DA
Page 63 and 64: FIGURE 19. USUAL DOSAGES FOR QUICK-
Page 65 and 66: Managing Exacerbations Asthma exace
Page 67: FIGURE 21. MANAGEMENT OF ASTHMA EXA
Page 71 and 72: FIGURE 23a. EMERGENCY DEPARTMENT—
Page 73: For More Information The National H
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Guidelines for the Diagnosis and Management of Asthma

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