Respiratory care : the official journal of the American Association for Respiratory Therapy

American Association For Inhalation Therapy

Description

June 1990 Volume 35, Number 6 ISSN00989142-RECACP A MONTHLY SCIENCE JOURNAL 35TH YEAR—ESTABLISHED 1956 Overview SPECIAL ISSUE A Review of Basic Engineering NONINVASIVE MONITORING Principles PARTI Fundamentals of Metrology: Instrument Error and Method Agreement Respiratory Monitoring without Machinery Capnometry and Capnography: Aspects and Applications Transcutaneous Monitoring: Instrumentation and Clinical Applications InstrumentationPulse Oximetry: and Clinical Applications The added dimension in asthma ^therapy ^ ifs^^iiYnmii^ usingin patientstachycardia " Inhalation Aerosol'Alupent effectscardiovascularadverseNo ofclinical comparisonsnoted in two albuterol InhalationAlupentand Solutions^' othersimilar to those ofAdverse reactions sympathomimetic agents* with caution in patients with agents. Alupent should be used*As with other cardiac arrhythmias, inheart disease, hypertension orcardiovascular disorders, including ischemic sympathomimeticunusually sensitive toor diabetes mellitus. and in patientspatients with hyperthyroidism diastolic blood pressureSignificant changes in systolic andwho have convulsive disorders.amines or bronchodilator.in some patients after use of any beta-adrenergiccould be expected to occur AsthmaFast ReliefinFastAction, Alupent sulfete)(metaproterend Aerosol Inhalation SolutionInhalation I (I .i>ui:t(lml nochinuioi iikil'Iih-Pharniaceulicnls. Iiic1990. Boehdiiget liigclheiin Boehrinqer Ingelneim ()««/g/5mL andZOmg 10mLand30mL dose Vials 0.

Sujets

• Respiratory therapy

Informations

• Publié par: les_archives_du_savoir
• Nombre de lectures: 7
• Langue: English
• Poids de l'ouvrage: 11 Mo

Extrait

ui:t(lml nochinuioi iikil'Iih-Pharniaceulicnls. Iiic1990. Boehdiiget liigclheiin Boehrinqer Ingelneim ()««/g/5mL andZOmg 10mLand30mL dose Vials 0." />

June 1990
Volume 35, Number 6
ISSN00989142-RECACP
A MONTHLY SCIENCE JOURNAL
35TH YEAR—ESTABLISHED 1956
Overview
SPECIAL ISSUE
A Review of Basic Engineering
NONINVASIVE MONITORING
Principles
PARTI
Fundamentals of Metrology:
Instrument Error and Method
Agreement
Respiratory Monitoring without
Machinery
Capnometry and Capnography:
Aspects and Applications
Transcutaneous Monitoring:
Instrumentation and Clinical
Applications
InstrumentationPulse Oximetry:
and Clinical ApplicationsThe added dimension
in asthma ^therapy
^ifs^^iiYnmii^
usingin patientstachycardia
" Inhalation Aerosol'Alupent
effectscardiovascularadverseNo
ofclinical comparisonsnoted in two
albuterol InhalationAlupentand
Solutions^'
othersimilar to those ofAdverse reactions
sympathomimetic agents*
with caution in patients with agents. Alupent should be used*As with other
cardiac arrhythmias, inheart disease, hypertension orcardiovascular disorders, including ischemic
sympathomimeticunusually sensitive toor diabetes mellitus. and in patientspatients with hyperthyroidism
diastolic blood pressureSignificant changes in systolic andwho have convulsive disorders.amines or
bronchodilator.in some patients after use of any beta-adrenergiccould be expected to occur
AsthmaFast ReliefinFastAction,
Alupent
sulfete)(metaproterend
Aerosol Inhalation SolutionInhalation
I (I .i>ui:t(lml
nochinuioi iikil'Iih-Pharniaceulicnls. Iiic1990. Boehdiiget liigclheiin Boehrinqer
Ingelneim ()««/<•Huicifin'id, i;i
suiiuiuity of Pruscrlbing liilorrnatioii'lc;isu sue lollowifig page lot bncl
reader service cardCircle 134 onFastFastAction, ReliefinAsthma
Alupenf
'metaproterenol sulfate^
Inhalation Inhalation Inhalation Synx) TabletstOmg
AerosoHOmL* Solution 5% Solution Unit- 10n>g/5mL andZOmg
10mLand30mL dose Vials 0.4%
and 0.6%
*10 mL; 15 mg per mL (each metered dose delivers 0.65mg metaproterenol sulfate) BoundBronchodllator
Brief Summary of Prescribing Information
COffTRAINDICATIONS in patients wrth cardiac arrtiythmiasUse associated with tachycardia is
contraindicated
Atthouqh rare, immediate Volumeshypersensitivity reactions can occur Therefore, Alupent' (metaproterenol
suffatellSP) IS contraindicated in patients with a history of hypersensitivity to any of its components.
WARNINGS Excessive use of adrenergic aerosols is potentially dangerous Fatalities have been
reported following excessive of AJupent"use (metaproterenol sulfateIJSP) as with other
sympathomimetic inhalation preparations, and the exact cause is unknown. Cardiac arrest was 1989The bound volumes of RESPIRATORY
noted in several cases
CARE are available. The 12 issues of Volume 34Alupent. like other beta adrenergic agonists, can produce significant cardiovascular effect ina
some patients, as measured by pulse rate, blood pressure, symptoms, and.'or ECG changes. As
are bound in a blue buckram cover and can be
with other beta adrenergic aerosols, Alupent can produce paraaoxical bronchospasm (which can
lite-threateninq) Ifbe it occurs, the preparation should be discontinued immediatety and aftemative
imprinted with your name or the name of your
therapy instituted
Alupent should not be used more often than prescnbed Patients should be advised to contact their institution at no extra charge. The cost per bound
physician m the event that they responddo not to their usual dose ofa sympathomimetic amine
volume is for AARC membersaerosol $40.00 (with valid
PRECAUTIONS General Extreme care must be exercised with respect to the administration of membership number) and $80.00 for
additional sympathomimetic agents
nonmembers. ShippingSince metaproterenol is a sympathomimetic amine, it should with caution in patients with is included for customersbe used
cardiovascular disorders, including ischemic heart disease, hypertension or cardiac arrhythmias, in
within the U.S. and Canada.patients with hyperthyroidism or diabetes meilitus, and in patients who are unusually responsive to
synipathomimetic amines orwho have convulsive disorders. Significant chianges in systolic and
diasiolic blood pressure could be expected to occur in some patients after use ofany beta
For a limited time, you may also order the 1987
adrenergic bronchodllator
Information for Patients Extreme care must be exercised with respect to the administrafton of and 1988 bound volumes at the discount price of
additional sympathomimetc agents. A sufficient mten/al of time should elapse prior to
administration of another sympathomimetic agent $35.00 for AARC members and $75.00 for
Drug Interactions Other beta adrenergic aerosol bronchodilatofs should not be used nonmembers.
concomitantly with Alupent" (metaproterenol sulfate USP} because theymay have additive effects.
Beta adrenergic agonists should be administered wrth caution patients treatedto being v^
monoamine oxidase inhibitors or tricyclic antidepressants, since tne action ol beta adrenergic Orders must be prepaid or include an
agonists on the vascular system may be potentiated
institutional purchase order.
Carclnoganesis/Mutagenesis/lmpairment of Fertility In an 18-month study in mice. Alupent
produced an increasem benign ovanan intumors females at doses corresponding to 320 and 640
times the maximum recommended dose (based on a 50 kg individual) In a 2-year study in rats, a Please send bound volume of RESPIRATORY
nonsignificant incidence of benign leiomyomata of the mesovanum was notea at 640 times the
maximum recommended dose The relevance of these findings to man is not known Mutagenic CARE for 1 989 at $40/$80.
studies with Alupent have not been conducted Reproduction studies in rats revealed no evidence
of impaired fertility
Please send bound volume ofPregnancy/Teratogenlc Effects PREGNANCYCATEGORYC Alupent has been shown to be
teratogenic and emoryotoxic in rabbitswhen given orally in times the human mhalafiondoses 620 CARE for 1 988 at $35/$75.and timesdose 62 the human oral dose. There are no adequate and well-controlled studies in
pregnant women. Alupent should be used dunng pregnancy only if the potential benefit justifies the
potential nsk fetus.to the Please volume ofsend bound RESPIRATORY
Oral reproduction studies m mice, rats rabbitsand showed no teratogenic or embryocidal effects at
50 mgAg corresponding to 310 times the human inhalation dose and 31 times the human oral CARE for 1987 at $35/$75.
dose Teratogenic effects in the rabbit included skeletal abnomialities and hydrocephalus vflth bone
separation a Check Enclosed
Nursing Mothers It is not knovm whether this dnjq is excreted in human milk. Because many
drugs are excreted in human milk, caution should exercised w/henbe Alupent is administerecfto a
nursing woman Purchase Order No. Enclosed
Pediatric Use Consult package insert for liml.age
AARC Member NumberADVERSE REACTIONS Adverse reacfions are similar withto those noted other sympathomimetic
agents. Adverse reactions such as tachycardia, hypertension, palpitations, nervousness, tremor,
nausea and vomiting have been reported
Name
The most ft-equent adverse reacfion to Alupent' (metaproterenol sulfate USP) administered by
metered-dose inhaleramong 251 patents in 90-day controlled clinica! trials was nervousness Th;s
was reported in 68% of patents Less h'equent adverse expenences, occumng in 1% to 4% of
patients, were headache, dizziness, palpitations, gastrointestinal distress, tremor, throat imtation,
nausea, vomiting, cough and asthma exacerbation Tachycardia occured in less than 1% of
Institution
patients
HOW SUPPLIED Inhalation Aerosol Each Alupent" (metaproterenol sulfate USP) Inhalation
Aerosol contains
150 mg of metaproterenol sulfate as a micronized powder in inert propellants Address_Each metered dose delivers through the mouthpiece 0.65mg metaproterenol sulfate ml(each
contains mg) Alupent15 Inhialation Aerosol witn Mouthpiece, net contents 14g (10 ml), equipped
with blue proledp^e cap Alupent Inhalation Aerosol Refill, net contents 14 mL)(10g City
Inhalation Solution Alupent Inhalation Solution is supplied as a 5% solution in bottles of 10 mL or
30 mL with accompanying calibrated dropper
Alupent Inhalation Solution Und-dose Vial is supplied as a 4% or 0.6% clear colorless or nearly
State .Zip
colorless solution containing 2.5mU with 25 viafe per box.
Syrup Alupent is available as a cherry flavored syrup, 10 mg per teaspoonftjl (5 mL), in 16 tl. oz.
bottles
Tablets Alupent is supplied m 2 dosage strengths as scored, round white tablets in bottles ot 100, Name imprintedto be of 10 mg coded 81/74 Tablets of 20 mg coded BI/72.
Consult package insert before prescribing. AL-BS-10/89
References:
1. Alupent" (metaproterenol sulfate) Inhalation Aerosol full Prescribing
Information
2. Kramson JP Metaproterenol and albuterol nebulizer solutions-a double-blind
Daedalus Enterprises, Inc.crossover study Presented theat 46th Annual fvleeting of the American College
of Allergy and Immunology, November 13, 1989, Orlando, Fla
P.O. Box 29686 Dallas, TX 752293. Habib MP, Campbell SC, Shon BY, Pinnas AJL comparison of albuterol and
metaproterenol nebulizer solutions -Ann Allergy 1987,58 421-424
AL4432
Boehringer Boehringer Ingelheim
Pharmaceuticals. Inc.
Ingelheim
Ridgefield, 06877CTC^RERE/PIRATORy
Aysocialiun tor Respir