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1 File name: Respiratory System BNF Section 3 Original date of issue: 31/11/2005 Last Reviewed: 01/05/2012 Version:4 Page 1 of 7 Department: Pharmacy Review Date:01/05/2014 Authorised: Drug and Therapeutics ommittee 3: Respiratory system 3.1 Bronchodilators Adrenoceptor agonists Selective beta 2 agonists First line Second line Salbutamol Inhaler (100micrograms) Salbutamol Accuhaler (200micrograms) Salbutamol Nebuliser Solution (2.5mg/2.5ml, 5mg/2.5ml) Salbutamol Injection (500micrograms/1ml) Terbutaline Turbohaler 100 dose (500mcg) Terbutaline Injection (500mcg/ml, 2.5mg/5ml) Salmeterol Accuhaler (50micrograms) omments Formoterol 6micrograms, 12micrograms Turbohaler (60-dose) onsultant Respiratory / Paediatrician use only as an alternative to salmeterol Other adrenoceptor agonists NIL
2 Date of issue: 31/11/05 Review Date: 01/05/12 Version: 2 Page:2 of Antimuscarinic bronchodilators Ipratropium Inhaler (20micrograms) Ipratropium Nebuliser Solution (250micrograms/1ml, (500microgramsmicrograms/2ml) Tiotropium Handihaler and apsules (18micrograms) Tiotropium Respimat (2.5micrograms) omments NOTE: Different tiotropium devices have different doses. For patients unable to use Handihaler device. NOTE: Different tiotropium devices have different doses Theophylline Aminophylline MR Tablets (225mg Phyllocontin),(350mg Phyllocontin Forte) Aminophylline injection 250mg /10ml Theophylline MR Tablets (125mg Nuelin), (175mg Nuelin SA), (200mg Uniphyllin), (250mg Nuelin SA), (300mg, 400mg Uniphyllin ontinus) ompound bronchodilator preparations Ipratropium bromide 500mcg and salbutamol sulphate 2.5mg Nebuliser Solution (Ipramol) Peak flow meters, inhaler devices and nebulisers Spacer devices Aerochamber (infant with mask, standard) Volumatic Volumatic with paediatric mask ompliance aid Haleraid (120-dose, 200-dose) Nebuliser kit with adult mask Nebuliser kit with mouthpiece
3 Date of issue: 31/11/05 Review Date: 01/05/12 Version: 2 Page:3 of orticosteroids Beclometasone F-free Inhaler (Qvar) (50micrograms, 100micrograms) Beclometasone F-free inhaler (lenil Modulite) (50micrograms, 100micrograms, 200micrograms, 250micrograms) Beclometasone F-free Autohaler (Qvar) (50micrograms, 100micrograms) Beclometasone F-free Easi-Breathe (Qvar) (50micrograms, 100micrograms) Beclometasone Inhaler (250micrograms, 200micrograms, 50micrograms) Beclometasone (easibreath) Inhaler (100micrograms, 250micrograms, 50micrograms) Budesonide Turbohaler (100micrograms, 200microgram) Fluticasone Accuhaler (50micrograms, 100micrograms, 250micrograms, 500micrograms) Fluticasone Inhaler (50micrograms, 250micrograms) Fluticasone Inhaler F-free (125micrograms) Seretide Accuhaler 100 (fluticasone propionate 100mcg, salmeterol 50mcg) Seretide Accuhaler 250 (fluticasone propionate 250mcg, salmeterol 50mcg) Seretide Accuhaler 500 (fluticasone propionate 500mcg, salmeterol 50mcg) Seretide Evohaler 50 (fluticasone propionate 50mcg, salmeterol 25mcg) Seretide Evohaler 125 (fluticasone propionate 125mcg, salmeterol 25mcg) Seretide Evohaler 250 (fluticasone propionate 250mcg, salmeterol 25mcg) Symbicort Turbohaler (100/6, 200/6, 400/12) All Beclometasone F-free need to be prescribed by brand name. R R Budesonide Repsules (500micrograms/2ml, 1mg/2ml) iclesonide inhaler (80 micrograms, 160micrograms) Flutiform (fluticasone + formoterol) Metered Dose Inhaler (125mcg/5mcg,50mcg/5mcg,250mcg/10mcg) Reserved for patients in whom inhaled steroids are unsuitable or ineffective. Under recommendation of onsultant Paediatrician Respiratory onsultant use only. For patients who develop local adverse effects with other inhaled corticosteroids For use as an alternative to Seretide Evohaler for patients with chronic asthma in whom treatment with an inhaled corticosteroid and a long-acting beta-2 agonist in a combination device is considered appropriate.
4 Date of issue: 31/11/05 Review Date: 01/05/12 Version: 2 Page:4 of romoglicate, related therapy and leukotriene receptor antagonists romoglicate and related therapy S Sodium romoglicate Inhaler (5mg 112-dose) For paediatric patients only Leukotriene receptor antagonists Montelukast 4mg, 5mg hewable Tablets Montelukast 10mg Tablets Montelukast Granules (4mg) For Respiratory onsultant s patients only where other treatments have failed. For use by paediatricians in children with severe asthma. 3.4 Antihistamines, hyposensitisation, and allergic emergencies Antihistamines Non-sedating antihistamines First line Loratadine Syrup (5mg/5ml) Loratadine Tablets (10mg) etirizine SF Solution (5mg/5ml) etirizine Tablets (10mg) omments
5 Date of issue: 31/11/05 Review Date: 01/05/12 Version: 2 Page:5 of 7 Sedating antihistamines First line Second line hlorphenamine Injection (10mg/1ml) hlorphenamine Tablets (4mg) hlorphenamine Syrup (2mg/5ml) Alimemazine Syrup (7.5mg/5ml, 30mg/5ml) Alimemazine Tablets (10mg) Hydroxyzine Tablets (10mg, 25mg) Hydroxyzine Syrup (10mg/5ml) Promethazine Hydrochloride Elixir (5mg/5ml) Promethazine Hydrochloride Tablets (10mg, 25mg) Promethazine Hydrochloride Injection (25mg/1ml) omments Allergen Immunotherapy Omalizumab Injection (75mg, 150mg pre-filled syringes) For use by Respiratory onsultants for the treatment of severe persistent asthma for patients initiated on treatment in Leeds.Supported for use in-line with NIE TA133 Nov Allergic emergencies Adrenaline Injection (1:1,000) 1mg in 1ml ampoule Adrenaline Injection (1:1,000) 1mg in 1ml syringe (MINIJET) Adrenaline Injection 300microgram/0.3ml autoinjector for adults (EPIPEN) Adrenaline Injection 150microgram/0.3ml autoinjector for children (EPIPEN JR)
6 Date of issue: 31/11/05 Review Date: 01/05/12 Version: 2 Page:6 of Respiratory stimulants and pulmonary surfactants Respiratory stimulants affeine citrate Solution (50mg/5ml) affeine citrate Injection (10mg/ml) Doxapram Injection (100mg/5ml) Pulmonary surfactants Poractant Alfa Suspension (urosurf) (120mg/1.5ml, 240mg/3ml) onsultant Paediatrician use only Acetylcysteine apsules (600mg) Respiratory onsultants use only 3.6 Oxygen Size Volume omments D E F G PD 340L 680L 1360L 3400L 300L Require a regulator to be attached D ZX 460L 3040L 3.7 Mucolytics Include integral regulators arbocisteine apsules (375mg) arbocisteine Syrup (250mg/5ml) 3.8 Aromatic inhalers NIL
7 Date of issue: 31/11/05 Review Date: 01/05/12 Version: 2 Page:7 of ough preparations ough suppressants odeine Linctus (15mg/5ml) Expectorant and demulcent cough preparations Simple Linctus (SF) 3.10 Systemic nasal decongestants NIL
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