Kerala State Drug Formulary.pdf

Drugs for Tuberculosis
Drugs available are : Salbutamol, terbutaline, salmeterol,
beclomethasone, budesonide, fluticasone, ipratropium
andcromoglycate.
Precautions : Good hand mouth coordination is required and good
inhaler technique is also a must. The success of inhalation therapy depends
upon perfecting the technique of inhalation so as to deliver the maximum
amount into the tracheobroncheal tree. This should be taught to the
patient and the physician should satisfy himself that the technique is
mastered. So also inhalation should be takenat the earliest warning of
asthma since inhalation will be ineffective if the paroxysm sets in. One of
the frequent causes of failure if inhaled medication is improper technique.ln
patients with poor hand mouth coordination, a spacer device is advisable
in which the drug is delivered into a spacer and the patient inhales from
this.
Dry Powder Inhalers
Here the drug is loaded as a capsule containing micronized particles
in a lactose carrier called the rotacap. The apparatus used is called a
rotahaler.Drugs available are : Salbutamol, salmeterol, beclomethasone,
budesonide and fluticasone.
Nebulizers
Nebulized drugs are delivered by a gas flow driving a jet nebulizer
unit, which produces the aerosol, or by an electric ultrasonic
nebulizer.Drugs that are used with nebulizer : Salbutamol,
terbutaline,ipratropium, budesonide and acetyl cystine. The advantage of
nebulizer is that the aerosol reaches the respiratory tract alongwith inhaled
air or oxygen without extra effort by the patient.Therefore this is the
method of choice when asthma is severe.Aminophylline is reserved for
those unresponsive to the maximal dose of beta 2 agonists. Dose is initially,
5 mg/ kg., then 0.5 mg/kg/h as i.v. drip.
Respiratory Stimulant
Doxapram
I: Acute respiratory failure, post—operative respiratory
failure,laryngospasm following intubation, drug
induced CNSdepression
C/ I: Heart disease, epilepsy, cerebral oedema,
phaeochromocytoma,recent cerebro vascular
accidents.
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