BNF for Children 2011-2012

140 3.1.1 Adrenoceptor agonists BNFC 2011–20123 Respiratory systemInhalationCounselling Advise children and carers not to exceed prescribeddose and to follow manufacturer’s directions; if apreviously effective dose of inhaled salbutamol fails toprovide at least 3 hours relief, a doctor’s advice should beobtained as soon as possible.Salbutamol (Non-proprietary) AAerosol inhalation, salbutamol (as sulphate)100 micrograms/metered inhalation, net price 200-dose unit = £3.19. Counselling, administrationBrands include Salamol c , Salbumalin cDry powder for inhalation, salbutamol 100 micrograms/meteredinhalation, net price 200-dose unit =£3.31; 200 micrograms/metered inhalation, 100-doseunit = £4.85, 200-dose unit = £6.63. Counselling,administrationBrands include Easyhaler c Salbutamol, Pulvinal c SalbutamolNebuliser solution, salbutamol (as sulphate) 1 mg/mL, net price 20 2.5 mL (2.5 mg) = £1.91; 2 mg/mL,20 2.5 mL (5 mg) = £3.82. May be diluted withsterile sodium chloride 0.9%Brands include Salamol Steri-Neb cAiromir c (IVAX) AAerosol inhalation, salbutamol (as sulphate)100 micrograms/metered inhalation, net price 200-dose unit = £1.97. Counselling, administrationAutohaler (breath-actuated aerosol inhalation), salbutamol(as sulphate) 100 micrograms/meteredinhalation, net price 200-dose unit = £6.02. Counselling,administrationAsmasal Clickhaler c (UCB Pharma) ADry powder for inhalation, salbutamol (as sulphate)95 micrograms/metered inhalation, net price 200-dose unit = £5.65. Counselling, administrationDoseAcute bronchospasm. By inhalation of powderChild 5–18 years 1–2 puffs; for persistent symptoms upto 4 times daily (but see also Management of ChronicAsthma, p. 135)Prophylaxis of allergen- or exercise-induced bronchospasm. By inhalation of powderChild 5–18 years 1–2 puffsSalamol Easi-Breathe c (IVAX) AAerosol inhalation, salbutamol 100 micrograms/metered inhalation, net price 200-dose breath-actuatedunit = £6.30. Counselling, administrationSalbulin Novolizer c (Meda) ADry powder for inhalation, salbutamol (as sulphate)100 micrograms/metered inhalation, net price refillable200-dose unit = £4.95; 200-dose refill = £2.75.Counselling, administrationDoseAcute bronchospasm. By inhalation of powderChild 6–12 years 100–200 micrograms; for persistentsymptoms up to 400 micrograms daily (but see alsoManagement of Chronic Asthma, p. 135)Child 12–18 years 100–200 micrograms; for persistentsymptoms up to 800 micrograms daily (but see alsoManagement of Chronic Asthma, p. 135)Prophylaxis of allergen- or exercise-induced bronchospasm. By inhalation of powderChild 6–12 years 100–200 microgramsChild 12–18 years 200 microgramsVentolin c (A&H) AAccuhaler c (dry powder for inhalation), disk containing60 blisters of salbutamol (as sulphate)200 micrograms/blister with Accuhaler c device, netprice = £4.92. Counselling, administrationDoseAcute bronchospasm. By inhalation of powderChild 5–18 years 200 micrograms; for persistentsymptoms up to 4 times daily but see also Managementof Chronic Asthma, p. 135Prophylaxis of allergen- or exercise-induced bronchospasm. By inhalation of powderChild 5–18 years 200 microgramsEvohaler c (aerosol inhalation), salbutamol (as sulphate)100 micrograms/metered inhalation, net price200-dose unit = £1.50. Counselling, administrationNebules c (for use with nebuliser), salbutamol (assulphate) 1 mg/mL, net price 20 2.5 mL (2.5 mg) =£1.68; 2 mg/mL, 20 2.5 mL (5 mg) = £2.83. May bediluted with sterile sodium chloride 0.9%Respirator solution (for use with a nebuliser orventilator), salbutamol (as sulphate) 5 mg/mL. Netprice 20 mL = £2.18 (hosp. only). May be diluted withsterile sodium chloride 0.9%SALMETEROLNote Not for immediate relief of acute attacks; for use inasthma only in children who regularly use an inhaledcorticosteroid, see notes aboveCautions see notes abovePregnancy see p. 133Breast-feeding see p. 133Side-effects see notes above; nausea, dizziness,arthralgia, and rash also reportedIndication and doseReversible airways obstruction (includingnocturnal asthma and prevention of exerciseinducedbronchospasm) in patients requiringlong-term regular bronchodilator therapy seealso Management of Chronic Asthma, p. 135. By inhalationChild 5–12 years 50 micrograms (2 puffs or 1blister) twice dailyChild 12–18 years 50 micrograms (2 puffs or 1blister) twice daily; up to 100 micrograms (4 puffsor 2 blisters) twice daily in more severe airwaysobstructionCounselling Advise children and carers that salmeterolshould not be used for relief of acute attacks, not toexceed prescribed dose, and to follow manufacturer’sdirections; if a previously effective dose of inhaled salmeterolfails to provide adequate relief, a doctor’s adviceshould be obtained as soon as possibleSerevent c (A&H) AAccuhaler c (dry powder for inhalation), disk containing60 blisters of salmeterol (as xinafoate)50 micrograms/blister with Accuhaler c device, netprice = £29.26. Counselling, administration