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Toronto Notes 2019 Common Medications Table 38. Common Medications for Respiratory Diseases (continued)
Respirology R37
CORTICOSTEROIDS
Inhaled
Systemic
ADJUNCT AGENTS
LEUKOTRIENE ANTAGONISTS
H/A, fever, N/V, MSK pain, URTI, throat irritation, growth velocity reduction
in children/adolescents, HPA axis suppression, increased pneumonia risk in COPD
Endocrine (hirsutism, DM/glucose intolerance, Cushing’s syndrome,
HPA axis suppression), GI (increased appetite, indigestion), ocular (cataracts, glaucoma), edema, AVN, osteoporosis, H/A, psychiatric (anxiety, insomnia), easy bruising
GI upset, diarrhea, N/V, anxiety, H/A, insomnia, muscle cramp, tremor, tachycardia, PVCs, arrhythmias Toxicity: persistent, repetitive vomiting, seizures
H/A, dizziness, fatigue, fever, rash, dyspepsia, cough, flu-like symptoms
H/A, sinusitis, pharyngitis, URTI, viral infection, thrombocytopenia, anaphylaxis
Weight loss, suicidal ideation
GI (abdominal pain, diarrhea, N/V), H/A, prolonged QT, ventricular arrhythmias, hepatic impairment
GI (diarrhea, N/V, abdominal pain), renal failure, deafness
H/A, rash, GI (diarrhea, N/V, abnormal taste, heartburn, abdominal pain), increased urea
Photosensitivity, rash, urticaria, anaphylaxis, diarrhea, entercolitis, tooth discolouration in children
CNS (dizziness, fever, H/A), GI (N/V, diarrhea, constipation), prolonged QT
Drug
fluticasone (Flovent®)
(orange/peach MDI or diskus) budesonide (Pulmicort®) (brown turbuhaler)
ciclesonide (Alvesco®) (red MDI) beclomethasone
(QVAR®, Vanceril®) (brown MDI), mometasone (Asmanex®) (pink/grey/ brown twisthaler)
fluticasone furoate (Arnuity(®) (orange ellipta)
prednisone (Apo-prednisone®, Deltasone®) methylprednisolone (Depo-Medrol®, Solu-Medrol®)
theophylline (Uniphyll®)
montelukast (Singular®) zafirlukast (Accolate®)
Typical Adult Dose
2-4 puffs bid 2 puffs bid
1 puff daily or bid 1-4 puffs bid
1 puff daily or bid 1 puff daily
Typically 40-60 mg per day PO
125 mg q8h
IV (sodium succinate) loading dose 2 mg/kg then 0.5-1 mg/kg q6h for 5 d
400-600 mg OD
10 mg PO qhs, now only available as once daily slow release 20 mg bid
150-375 mg SC q2-4wk
500 μg PO OD
250-500 mg PO tid x 7-10 d
500 mg PO x 1 dose, then
250 mg OD x 4
1,000 mg od or 500 mg PO bid x 7-10 d
100 mg PO bid x 7-10 d
500 mg PO OD x 7-10 d 400 mg PO OD x 7 d
Indications
Maintenance treatment of asthma
Acute exacerbation of COPD; severe, persistent asthma, PCP Status asthmaticus
Treatment of symptoms of reversible airway obstruction due to COPD
Prophylaxis and chronic treatment of asthma
Moderate-severe persistant asthma
Severe emphysema, with frequent exacerbations
Alternate to doxycycline or fluoroquinolone
Alternate to macrolide or fluoroquinolone
Alternate to macrolide or doxycycline
Side Effects
ANTI-IgE MONOCLONAL ANTIBODIES
PDE-4 INHIBITORS
omalizumab (Xolair®)
roflumilast (Daxas®)
ANTIBIOTICS – COMMUNITY ACQUIRED PNEUMONIA
Macrolide
Doxycycline
Fluoroquinolone
erythromycin azithromycin
clarithromycin
levofloxacin (Levaquin®) moxifloxacin (Avelox®)