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

American Association For Inhalation Therapy

Sujets

• Respiratory therapy

Informations

• Publié par: les_archives_du_savoir
• Nombre de lectures: 8
• Langue: English
• Poids de l'ouvrage: 11 Mo

Extrait

July 1990
Volume 35, Number 7
ISSN 00989142-RECACP
A MONTHLY SCIENCEJOURNAL
ESTABLISHED 195635TH YEAR—
EnergyMeasurement of
SPECIAL ISSUE Instrumentation,Expenditure:
NONINVASIVE MONITORING andPractical Considerations,
PART II Clinical Application
Monitoring LungMeasuring and
the LaboratoryVolumes Outside
DeterminationsLung Mechanics
Instrumentationat the Bedside:
and Clinical Application
MonitoringVentilatory Pattern
Noninvasive Hemodynamic
Monitoring
Respiratory Function of
HospitalOutside the
ManagementResource
Conference1989 Journal
SummarydimensionThe added
^therapyin asthma
r^
,^Hincidence ofss than1%
usingtachycardia in patients
]
Alupent Inhalation Aerosol'
effectsadverse cardiovascularNo
comparisons ofnoted in two clinical^
ionand albuterol InhalationAlupent
Solutions^-^
Adverse reactions similar to those ofother
sympathomimetic agents*
Alupent be used with caution in patients with*As with other sympathomimetic agents, should
arrhythmias, inincluding ischemic heart disease, hypertension or cardiaccardiovascular disorders,
mellitus, and in patients unusually sensitive to sympathomimeticpatients with hyperthyroidism or diabetes
diastolic blood pressurehave convulsive disorders. Significant changes in systolic andamines or who
of any beta-adrenergic bronchodilator.could be expected to occur in some patients after use
inAsthmaFastAction, Fast Relief
Alupent
(metaproterend sulfate)
Inhalation Aerosol Inhalation Solution
S%iii10mLand30
unilL bollles. dose
6". tSand
!£ eoennnger mgeltielm1 990, Boetiringer Ingelheim Pharmaceuticals, Inc. BoehringerAji ,
Inc.[JSt- Pharmaceuticals,
I iu.:_
v^:y Ingelheim Ridgeiiew. ct oes??Prescribing Information.Please see following page for brief summary of
Circle 134 on reader service cardFast Action, Fast Reliefin Asthma
Alupenf
metaproterenol sulfate^
Inhalation Inhalation Inhalation Syrup Tablets 10 mg
and20mgAerosol 10 ml* Solution 5% Solution Unit- 1 mg/Sn>g/5 mmL
1 mL and 30mL dose Vials 0.4%
and 0.6%
10 fuL; 1 5 mg per mL (each metered dose delivers 0.65 mg metaproterenol sulfate)
Bronchodilator Bound
Brief Summary of Prescribing Information
CONTRAINDICATIONS Use in patients with cardiac arrhythmias associated with tachycardia is
contraindicaled
Although rare, immediate hypersensitivity reactions can occui Therefore, Alupenf (metaproterenol Volumes
IS contraindicated in patients with history of hypersensitivity to any of its componentssulfate1)SP) a
Excessive of adrenergic aerosols is potentially dangerous Fatalities have beenWARNINGS use
reported follov\flng excessive use of Alupenf (metaproterenol sulfate LISP) as with other
sympathomimetic inhalation preparations, and the eKact cause is unknown. Cardiac arrest was
The 1989 bound volumes of RESPIRATORY
noted in several cases
cardiovascular effectmAlupent, like other beta adrenergic agonists, can produce a significant CARE are available. The 12 issues of Volume 34
some patients, as measured by pulse rate, blood pressure, symptoms, and/or EGG changes As
aerosols, Alupent produce paradoxical bronchospasm (which can are bound in a blue buckram cover and can bewith other beta adrenergic can
tie Irie-threalening) . If il occurs, the preparation should be discontinued immediately and alternative
imprinted with your name or the name of yourtherapy instrtutecT
should not more oHen than prescnbed Patients should be advised to contact theirAlupent be used institution at no extra charge. The cost per bound
physician in the event that they do not respond to their usual dose of a sympathomimetic amine
aerosol members validvolume is $40.00 for AARC (with
PRECAUTIONS General Extreme care must be exercised with respect to the administration of
membership number) and $80.00 for
additional sympathomimetic agents.
amine, i1 should with caution in patients withSince metaproterenol is a sympathomimetic be used nonmembers. Shipping is included for customers
cardiovascular disorders, including ischemic heart disease, hypertension or cardiac arrtiythmias. in
with hyperthyroidism or mellitus, and in patientswho are unusually responsive topatients diabetes within the U.S. and Canada.
sympathomimetic amines or who have convulsive disorders. Significant changes in systolic and
diastolic blood pressure could expected to occur m some patients after use of any betabe
For a limited time, you may also order the 1 987adrenergic bronchodilator
Information for Patients Extreme care must be exercised with respect to the administration of and 1988 bound volumes at the discount price of
additional sympathomimetic agents A sufficient interval of time should elapse pnor to
administration of another sympathomimetic agent $35.00 for AARC members and $75.00 for
Drug Interactions Other beta adrenergic aerosol bronchodtlators should not be used nonmembers.
concomitantly with Alupent' (metaproterenol sulfate USP) because they may have additve effects.
patients being treated withBeta adrenergic agonists should be administered with caution to
monoamine oxidase inhibitors or tricyclic antidepressants, since the action of beta adrenergic
Orders must be prepaid or include an
vascular system may potentiated,agonists on the be
CarcinogoiesiSi'Mutagenesis/Impairment of Fertility In an 18-month study in mice, Alupent institutional purchase order.
produced an increase in benign ovanan tumors in 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
volumePlease send bound of RESPIRATORYnonsignificant incidence ot benign leiomyomata ol the mesovanum was noted at 640 times the
maximum recommended dose The relevance of these findings to man is not known. Mutagenic
CARE for 1989at $40/$80.
studies with Alupent have not been conducted Reproduction studies in rats revealed no evidence
of impaired fertility
Pregnancy.Teratogenic Effects PREGNANCVCATEGORYC Alupent has been shown to be Please send bound volume of
emoryotoxc in rabbits when given orally m times the human inhalationteratogenic and doses 620
dose and 62 times the human oral dose There are no adequate and well-controlled studies in CARE for 1 988 at $35/$75.
women. Alupent should be dunng pregnancy only if the potential benefit justifies thepregnant used
potential nsk to the fetus
Please send bound volume of RESPIRATORY
Oral reproduction studies in mice, rats and rabbits showed no teratogenic or embryocidal effects at
50 mgAtg corresponding to 310 times the human inhalation dose and 31 limes the human oral CARE for 1 987 at $35/$75.
dose. Teratogenic effects in the rabbit included skeletal abnormalties and hydrocephalus with bone
separation
Check Enclosed
Nursing Mothers It is not known whether this dnjg is excreted in human milk Because many
is administereddrugs are excreted in human milk, caution should be exercised when Alupenl to a
nursing woman Order EnclosedPurchase No.
Pediatric Use Consult package insert for age limit,
other sympathomimeticADVERSE REACTIONS Adverse reactions are similar to those noted with AARC Member Number
agents Adverse reactions such as tachycardia, hypertension, palpitations, nervousness, tremor,
nausea and vomtting have been reported
most frequent adverse reaction Alupent" (metaproterenol sulfate USP) administered NameThe to by
metered-dose inhaler among 251 patients in 90-day controlled clinical trials was nervousness This
reported in 8% ot patients frequent adverse experiences, occumng in 1% to 4% ofwas 6 Less
patients, were headache, dizziness, palpitations, gastiointestmai distress, tremor, throat irritation,
vomiting, cough and asthma exacerbation Tachycardia occurred in less than 1% ofnausea,
Institutionpatients
HOW SUPPLIED Inhalation Aerosol Each Alupenf (metaproterenol sulfate USP) Inhalation
Aerosol contains 1 50 mg of metaproterenol sulfate as a micronized powder in inert propellants.
Addressdelivers through the mouthpiece 0.65 metaproterenol sulfate (^each mLEach metered dose mg _
contains I5mg) Alupent Inhalation Aerosol witn Mouthpiece, net contents 14 (10 ml), equippedq
with blue protecln/e cap Alupenl Inhalation Aerosol Refill, net contents 14 (10 mL)g
City
Inhalation Solution Alupent Inhalation Solution is supplied 5% solution in bottles of 10 mL oras a
30 mL with accompanying calibrated dropper
Alupent Inhalation Solution Unit-dose Vial is supplied as a 4% or 6% clear colorless or nearly
State .Zipcolorless solution containing 2 5mU with 25 vials per box.
available cherry-flavored syrup,Syrup Alupent is as a 10 mg per teaspoonful (5 mL), in 16 fl oz.
bottles.
Tablets Alupenl is supplied in 2 dosage strengths as scored, round white tablets in bottles ol 100. ol 10 mg coded 81/74 Tablets of mg Bl/72. Name to be imprinted20 coded
Consult package Insert before prescribing. AL-BS-10/89
References:
1. Alupenf (metaproterenol sulfate) Inhalation Aerosol full Prescribing
Information
Krainson JP Metaproterenol and albuterol nebulizer solutions double-blind2. a
crossover study Presented at the 46th Annual Meeting of the Amencan College Daedalus Enterprises, Inc.
of Allergy and rmmunoloqy, November 13, 1989, Orlando, Fla
3. Habib MP, Campbell SC, Shon BY, Pinnas JL A comparison of albuterol and P.O. Box 29686 Dallas, TX 75229
metaproteren