RT Drug Formulary

Name	Class	Indications	Forms Available	Onset/Duration	Typical Dose	Actions	Side effects/Toxicity
Albuterol(Proventil, Ventolin, Volmax) albuterol medical facts	Selective β₂-agonist	Asthma/Bronchospasm, COPD	MDI (90 µg/actuation) DPI (200 µg/actuation) Nebulized (0.083%, 0.5%) PO (2-,4-,8-mg tablets, 2-mg/5mL syrup)	5 minutes (inhaled), 30 minutes (oral)/4 to 6 hours	Outpatient MDI use: 2 puffs q4h prn Outpatient nebulizer use: 2.5 mg in 2 mL saline q4h prn Intubated patients: 4 to 8 puffs q1-4 h Emergency Treatment: 2 to 4 puffs q15 min, or continuous nebulized Oral maintenance: 4 mg PO tid		Tachycardia, palpitations, hypokalemia, lactic acidosis
Aminophylline(Phyllocontin, Truphylline) Methylxanthines for chronic obstructive pulmonary disease (COPD)	Methylxanthine	Asthma or other obstructive lung disease exacerbation, respiratory muscle weakness	PO (100-, 200-mg tablets; 225-mg sustained release, 105 mg/5mL elixir) Rectal (250,500 mg; 300-mg/5mL liquid) IV	Minutes (IV)/approx.6 hours	Emergency treatment: Load 6 mg/kg, then 0.5 -1.2 mg/kg/h infusion IV Maintenance adult: 400 mg PO daily, divided tid-qid Maintenance child: 16 mg/kg daily, divided tid-qid		Tachycardia and palpitations, nausea, agitation and seizures
Amphotericin B (Liposomal preparations Amphotec and AmBisome) amphotericin B medical facts	Antifungal antibiotic	Prevention and treatment of invasive pulmonary aspergillosis in immunocompromised patients	Nebulized IV	N/A	0.1 mg/kg/d, or 3 mL of 10-mg/mL solution or 10 mg by nebulizer bid		Bronchospasm; potential for nephrotoxicity and ototoxicity

arformoterol tartrate (Brovana) Brovana Official FDA information, side effects and uses.	Long acting selective β₂-adrenergic bronchodilator	Chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema	Nebulized 2 mL of arformoterol tartrate solution packaged in 2.1 mL unit-dose		15 mcg administered twice a day (morning and evening) by nebulization
Atropine Complete Atropine information	Anticholinergic	Reduction of excessive secretions, especially before procedures such as bronchoscopy and intubation	Oral (0.4, 0.6 mg) IV, IM	5 minutes/1 to 2 hours	0.4 to 0.6 mg PO/IV/IM q2h prn		Dry mouth, blurred vision, mydriasis, urinary retention, confusion
Beclomethasone Diproprionate )Beclovent, Vanceril, Beconase, Vancenase) Complete Beclomethasone Dipropionate information	Inhaled corticosteroid	Asthma and COPD maintenance therapy, rhinitis, sinusitis	MDI (42 µg/ actuation) Nasal (42 µg/actuation)	Duration: ~8 hours	2 to 3 puffs tid-qid (age > 12) 1 to 2 puffs tid-qid (children ages 6 to 12		Hoarseness, thrush, sore throat, possible growth retardation
Beractant (Survanta) Complete Beractant Information	Surfactant replacement	Treatment of neonatal respiratory distress syndrome (RDS), prophylaxis of RDS in neonates weighing less than 1250 g	Intratracheal liquid instillation (25 mg phospholipid/mL)	Minutes/12 hours	4 mL/kg; repeat doses q6h prn	Reduces surface tension	Mucous plugging, transient decrease in PaO2 and hemodynamic instability

Name	Class	Indications	Forms Available	Onset/Duration	Typical Dose	Actions	Side effects/Toxicity
Budesonide (Pulmicort, Rhinocort) Complete Budesonide Info	Inhaled corticosteroid	Asthma and COPD maintenance therapy, rhinitis, sinusitis	DPI (200 µg/actuation) Nasal (32 µg/actuation)	Duration:~12 hours	1 to 4 puffs bid		Hoarseness, thrush, sore throat, possible growth retardation
Budesonide/Formoterol (Symbicort) Complete Budesonide/Formoterol Fumarate Dihydrate information	Long acting selective β₂-agonist with inhaled corticosteroid	Asthma, COPD	Budesonide 80 µg and formoterol 4.5 µg/actuation Budesonide 160 µg and formoterol 4.5 µg/actuation	15 minutes/~12 hours	2 puffs bid
Colfosceril Palmitate, Cetyl Alcohol, Tyloxapol (Exosurf)	Surfactant replacement	Treatment of neonatal respiratory distress syndrome (RDS), prophylaxis of RDS in neonates weighing less than 1350 g	Intratracheal liquid instillation (13.5 mg/mL when reconstituted)	Minutes/12 hours	5 mL/kg q12h, three doses	Reduces surface tension	Pulmonary hemorrhage, mucous plugging, transient decrease in PaO2
Colistimethate (Colistin, Coly-Mycin) Complete Colistin info	Polypeptide antibiotic	Gram-negative pneumonia, especially Pseudomonas species	Nebulized (75 mg/mL) IV	N/A	150 mg by nebulizer bid	Binds phospholipids, dirupting bacterial cell membranes	Nephrotoxicity, neurotoxicity including neuromuscular blockade
Cromolyn Sodium (Intal, Nasalcrom) Cromolyn Aerosol Solution facts and comparsions	Cromone	Asthma, allergic rhinitis, conjunctivitis, mastocytosis	MDI (800 µg/actuation) DPI (20 mg/actuation) Nebulized (20 mg/2 mL) Nasal (5.2 mg/actuation) Oral (100 mg) Ophthalmic	10 minutes/2 to 6 hours	MDI: 2 puffs qid DPI: 20 mg qid Nebulized: 20 mg qid	Mast cell stabilization	Bronchospasm, arthralgia, angioedema, eosinophilic pneumonia, pulmonary infiltrates, mucosal irritation
Dexamethasone (Decadron, Dexacort) Dexamethasone Official FDA information, side effects and uses.	Systemic (or inhaled) corticosteroid	Multiple	MDI (dexamethasone sodium phosphate, 100 µg/actuation) Nasal (dexamethasone sodium phosphate, 100 µg/actuation) PO (0.25-,0.5-,0.75-,1-,1.5-,2-,4-,6-mg tablets; 0.5 mg/mL elixir and solution; 0.5-mg/0.5-mL solution) IV, Topical, ophthalmic	Duration: more than 48 hours	Systemic: varies Inhaled maintenance therapy: 3 puffs tid-qid		Multiple

Name	Class	Indications	Forms Available	Onset/Duration	Typical Dose	Actions	Side effects/Toxicity
Dornase Alfa (DNAase, Pulmozyme) Complete Dornase Alfa (Recombinant Human Deoxyribonuclease; DNase) information	Enzyme/secretion thinner	CF and other conditions with thick purulent secretions	Nebulized (1 mg/mL)	15 minutes/2 hours	2.5 mg qd-bid	Digests DNA in purulent secretions	Tachycardia and palpitations, nausea, agitation, and seizures
Ephedrine Complete Ephedrine information	Nonselective adrenergic agonist	Asthma/bronchospasm	Nasal (0.25% spray, 0.5% drops, 1% jelly) PO (25, 50 mg) SC/IM/IV (25, 50 mg/mL)	15 minutes/4 hours	Maintenance bronchodilator: 25 to 50 mg PO q4h prn Severe bronchospasm: 12.5 to 25 mg SC, IM, or IV		Tachycardia, palpitations, cardiac ischemia, hypertension, tremor
Flunisolide (AeroBid, Nasalide) Complete Flunisolide information	Low-potency inhaled corticosteroid	Asthma and COPD maintenance therapy, rhinitis, sinusitis	MDI (250 µg/actuation) Nasal (25 µg/actuation)	Duration:~12 hours	2 to 4 puffs bid		Hoarseness, thrush, sore throat, possible growth retardation
Fluticasone (Flovent, Flonase) fluticasone inhalation medical facts	High-potency inhaled corticosteroid	Asthma and COPD maintenance therapy, rhinitis, sinusitis	MDI (44, 110,220 µg/actuation) DPI (50, 110, 250 µg/actuation) Nasal (50 µg/actuation) Topical	Duration: ~12 hours	MDI: 220-880 ug (1 to 4 puffs) bid DPI: 100-500 ug (1 to 2 doses) bid Nasal: 1 spray per nostril bid		Hoarseness, thrush, sore throat, possible growth retardation
Fluticasone/Salmeterol (Advair) Advair Diskus medical facts	Long acting selective β₂-agonist with inhaled corticosteroid	Asthma, COPD	Advair Diskus 100/50, Advair Diskus 250/50, and Advair Diskus 500/50	Duration: ~12 hours	1 puff bid
Formoterol (Foradil) Foradil Aerolizer (formoterol) medical facts	Long acting selective β₂-agonist	Asthma, COPD	Aerolizer (12µg capsule)	~12 hours	Aerolizer: 1 capsule bid		Tachycardia, palpitations (less than short-acting agents), paradoxic bronchospasm
Glycopyrrolate (Robinul) Robinul (glycopyrrolate) medical facts	Anticholinergic	Reduction of excessive secretions, especially before procedures such as bronchoscopy and intubation	Oral (1, 2 mg) IV, IM	5 minutes/1 to 2 hours	Oral: 1 to 2 mg q4-6h IV/IM: 0.1 to 0.2 mg prn	Reduces secretion of the liquid component of mucous	Dry mouth, blurred vision, urinary retention, confusion
Heparin heparin medical facts	Anticoagulant	Prophylaxis and treatment of deep venous thrombosis and pulmonary embolism	IV, SC	Minutes/~2 hours	DVT prophylaxis: 5000 units SC q12h	Activates antithrombin III	Excessive bleeding and bruising, contraindicated in active hemorrhage, recent intracranial hemorrhage, active pericarditis
Hydrocortisone (A-HydroCort, Cortef, Hydrocortone, Solu-Cortef, Cortisol) hydrocortisone medical facts	Systemic corticosteroid	Multiple	PO (5, 10, 20 mg; 10-mg/5-mL suspension) Rectal (10% foam = 90 mg/application; 100 mg/60mL) IV	Duration:~8 hours	Adrenal insufficiency: 100 mg IV q6h Asthma/COPD exacerbation: 100 to 200 mg PO/IV q6h Pediatric: 1 mg/kg PO bid		Multiple
Ibuprofen (Advil, Motrin, Nuprin, Rufen) ibuprofen medical facts	Nonsteroidal antiinflammatory drug (NSAID)	Diverse inflammatory processes; pain; fever	Oral (200-,800-mg tablet) Rectal (120-,200-,300-,600-mg suppository)	Duration:~6 hours	Antiinflammatory/analgesic: 600 PO q4-6h		Peptic ulcer, increased bleeding, bronchospasm, nephropathy, nausea
Indomethacin (Indameth, Indocin) indomethacin medical facts	Nonsteroidal antiinflammatory drug (NSAID)	Diverse inflammatory processes; pain; fever	Oral (25-, 50-mg tablet, 25 mg/5 mL suspension) Rectal (50 mg suppository) IV	Duration:~6 hours	Antiinflammatory/analgesic: 50 PO q6h		Peptic ulcer, increased bleeding, bronchospasm, nephropathy, nausea
Infrasurf	Surfactant replacement	Treatment of neonatal respiratory distress syndrome (RDS), prophylaxis of RDS in neonates weighing less than 1250 g	Intratracheal liquid installation	Minutes/12 hours	3 mL/kg q12h	Reduces surface tension	Mucous plugging, transient decrease in PaO2 and hemodynamic instability

Name	Class	Indications	Forms Available	Onset/Duration	Typical Dose	Actions	Side effects/Toxicity
Ipratropium (Atrovent) ipratropium inhalation medical facts	Anticholinergic bronchodilator	COPD, asthma, and other obstructive lung diseases; rhinorrhea	MDI (18 µg/actuation) Nebulized (0.02%) Nasal Spray (0.03%, 0.06%)	1 minute/6 hours	MDI: 2 puffs q6h prn Nebulized: 2.5 mL (0.5 mg) q6h prn Nasal: 2 sprays per nostril q6h prn		Palpitations, dry mouth, blurred vision, acute exacerbation of narrow-angle glaucoma, urinary retention
Isoproterenol (Isuprel) isoproterenol inhalation medical facts	β-Adrenergic agonist	Asthma/bronchospasm	MDI (80, 120, 131 µg/actuation) Nebulized (0.25%, 0.5%, 1%) Sublingual (10, 15 mg) IV (200 µg/mL)	2 minutes/2 hours	MDI: 1 to 2 puffs q4h prn Nebulized: 2 mL of 0.25% solution in 2-mL saline q4h prn Sublingual: 10 to 20 mg PO qd IV: 0.01 to 0.02 mg IV q2h prn		Tachycardia, palpitations, tremor, hypo- or hypertension, flushing
Ketorolac (Toradol) Toradol (ketorolac) medical facts	Nonsteroidal antiinflammatory drug (NSAID)	Diverse inflammatory processes; pain; fever	Oral (10-mg tablet) IV, IM	30 minutes/6 hours	Antiinflammatory/analgesic: 60 mg IM May repeat q6h x 1		Peptic ulcer, increased bleeding, bronchospasm, nephropathy, nausea
Levalbuterol (Xopenex) levalbuterol medical facts	Selective β₂-agonist	Asthma/bronchospasm, COPD, especially in patients bothered by side effects of racemic albuterol	Nebulized (0.625- and 1.25-mg unit doses)	5 minutes/6 hours	0.625 to 1.25 mg q4h prn		Tachycardia, palpitations, tremor
Lidocaine lidocaine and prilocaine topical medical facts	Topical anesthetic	Cough, before bronchoscopy	Nebulized Intratracheal instillation	10 seconds/30 minutes	Nebulized: 2 mL of 4% solution Intratracheal instillation: 2 mL of 1% solution	Local anesthesia	Cardiac arrhythmia, decreased level of consciousness, increased risk of aspiration
Metaproterenol (Alupent, Metaprel) metaproterenol medical facts	β-adrenergic agonist (some β₂-selectivity	Asthma/bronchospasm, COPD	MDI (650 µg/actuation) Nebulized (0.4%, 0.6%, 5%) PO (10-, 20-mg tablets, 10-mg/5mL syrup)	5 to 30 minutes/4 hours	MDI: 2 to 3 puffs q3-4 h prn Nebulized: 2.5 mL of 0.6% solution q6h prn Oral, adult: 20 mg q6h prn Oral, children >27 kg: 10 mL q6h prn Oral, children <27 kg: 5 mL q6h prn		Tachycardia, palpitations, cardiac ischemia, tremor
Methylprednisolone (Medrol, Solu-Medrol) methylprednisolone medical facts	Systemic corticosteroid	Multiple	PO (2-, 4-,8-,16-,24-,32-mg) IV (injection and slowly absorbed suspension)	Duration: 12 to 24 hours	Asthma or COPD exacerbation: 125 mg IV, then 60 mg q6h Pediatric: 1 to 2 mg/kg/day IV q6h Systemic: varies		Multiple
Montelukast (Singulair) montelukast medical facts	Leukotriene synthesis inhibitor	Asthma, allergic rhinitis	PO (5-mg chewable, 10-mg tablet)	3 hours/24 hours	10 mg qd (adults) 5 mg qd (children)		Churg-Strauss syndrome?
N-acetylcysteine (Mucomyst, Mucosil, NAC) acetylcysteine medical facts	Secretion thinner	Cystic fibrosis and other conditions with thick secretions, acetaminophen overdose	Nebulized or oral solution (10%, 20%)	5 minutes/1 to 2 hours	3 to 10 mL of 20 % solution tid-qid	Cleaves disulfide bonds in mucous	Bronchospasm (usually administered with a bronchodilator), rhinitis, nausea, mild elevation in liver enzymes with oral administration
Nedocromil (Tilade) nedocromil inhalation medical facts	Cromone	Asthma, allergic rhinitis	MDI (1.75 mg/actuation)	30 minutes/6 to 12 hours	2 puffs qid, then reduce to bid as tolerated	Mast cell stabilization	Bronchospasm, eosinophilic pneumonia
Omalizumab (Xolair) Xolair (omalizumab) medical facts	IgE Blocker	moderate-to-severe persistent asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen	SC	2 to 4 weeks	150 to 375 mg is administered SC every 2 or 4 weeks.	inhibits the binding of IgE to the high-affinity IgE receptor (FcåRI) on the surface of mast cells and basophils.	Anaphylaxis, presenting as bronchospasm, hypotension, syncope, urticaria, and/or angioedema of the throat or tongue,
Pentamidine (NebuPent) pentamidine medical facts	Antibiotic	Prophylaxis against (nebulized) or treatment of (IV) PCP in sulfa-allergic patients	Nebulized IV	N/A	PCP prophylaxis: 300 mg in 5 mL saline, nebulized monthly PCP treatment: 4 mg/kg IV qd	Unknown	Cough, bronchospasm
Pirbuterol (Maxair) pirbuterol inhalation medical facts	Selective β₂-agonist	Bronchospasm/asthma, COPD	MDI (200 µg/actuation)	5 minutes/5 hours	1 to 2 puffs q4h prn		Tachycardia, palpitations, tremor
Prednisolone (Delta-Cortef, Hydeltrasol, Prelone, Pedipred, Predicort) prednisolone medical facts	Systemic corticosteroid	Multiple	PO (5-mg tablet; 15-mg/5mL, 5-mg/5-mL liquid) Ophthalmic	12 to 24 hours	Varies		Multiple
Prednisone (Deltasone, Meticorten, Orasone, Sterapred) prednisone medical facts	Systemic corticosteroid	Multiple	PO (1, 2.5, 5, 10, 20, 25, 50 mg; 5-mg/1mL solution) IV	12 to 24 hours	Varies		Multiple
Racemic Epinephrine (Adrenalin, AsthmaHaler, AsthmaNefrin, Bronkaid, Epinal, Primatene Mist, Vaponephrine) Complete Epinephrine information	Nonselective adrenergic agonist	Anaphylaxis; asthma/bronchospasm; upper airway edema and laryngospasm	MDI (160, 200, 250 µg/actuation) Nebulized (1%, 1.25%, 2.25% solution) SC (1:1000) IV (1:10,000 and 1:100,000)	1 minute/1 hour	MDI: 1 puff q4h prn Nebulized: 0.5 mL of 2.25% solution in 2 mL saline, q6h prn Anaphylaxis: 0.4 mg SC	Bronchodilation; blocks histamine release by mast cells; vasoconstriction	Tachycardia, palpitations, cardiac ischemia, hypertension, tremor
Ribavirin (Virazole) ribavirin medical facts	Antiviral	RSV and severe influenza infection	Nebulized	60 minutes/7 hours (children) to 24 hours (adults)	6 g in 300 mL saline, continuous nebulization 18/24 hr for 3 to 7 days	Unknown	Bronchospasm, pulmonary edema, hypoxia, hypotension, cardiac arrhythmia (drug contraindicated in pregnancy; should be used with extreme caution with mechanical ventilators.
Salmeterol (Serevent) salmeterol medical facts	Long acting selective β₂-agonist	Maintenance therapy of asthma, COPD and other obstructive diseases; especially useful in preventing overnight exacerbation	MDI (25 µg/actuation) DPI (50 µg/actuation)	10 minutes/12 hours	MDI: 2 to 4 puffs bid DPI: 1 inhalation bid		Tachycardia, palpitations (less than short-acting agents), paradoxic bronchospasm
Terbutaline (Brethine, Bricanyl, Brethaire) terbutaline medical facts	Selective β₂-agonist	Asthma/bronchospasm	MDI (200 µg/actuation) PO (2.5, 5 mg) IV (1 mg/mL)	5 to 30 minutes/4 hours	Emergency nebulized treatment: 1 mg in 2 mL saline q4h prn Emergency parenteral treatment: 0.25 to 0.5 mg SC or IV q4h prn Inhaled maintenance therapy: 2 puffs q4-6h prn Oral maintenance therapy: 5 to 15 mg PO tid		Tachycardia, palpitations, tremor, paradoxic bronchospasm
Tiotropium Bromide (Spiriva) tiotropium inhalation medical facts	Long-acting anticholinergic	Maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including chronic bronchitis, emphysema, or both	Handihaler (18µg capsules)	24 hours	Once daily		Dry mouth, constipation, increased heart rate, blurred vision, glaucoma, urinary difficulty, and urinary retention. Contraindicated in patients with a history of hypersensitivity to atropine or its derivatives, including ipratropium, or to any component of this product.
Theophylline theophylline medical facts	Methylxanthine	Asthma, especially for nocturnal symptoms and in children; COPD and respiratory muscle weakness	PO (100-,200-mg capsules; 100-, 125-, 200-, 250-, 300-mg tablet; 50-, 60-, 65-, 75-, 100-, 125-, 130-, 200-, 250-, 260-, 300-, 400-, 450-, 500-,mg extended release; 50-mg/5-mL, 80-mg/15-mL elixir; 50-mg/5mL, 80-, 150-mg/15 mL syrup) IV	30 minutes/ varies widely	Maintenance therapy: 13 to 24 mg/kg/day, divided q6-8h Emergency treatment: Load 4.7 mg/kg, then 0.24 to 0.55 mg/kg/h infusion IV		Tachycardia and palpitations, nausea, agitation and seizures
Thrombin	Coagulant	Hemorrhage	Topical	seconds/hours	1 mL reconstituted	Converts fibrinogen to fibrin clot	Large clot formation may cause airway obstruction
Tobramycin (TOBI) Tobramycin Official FDA information, side effects and uses.	Aminoglycoside antibiotic	Patients with cystic fibrosis, and possibly other forms of bronchiectasis, colonized with Pseudomonas species	Nebulized (300 mg/5 mL unit dose) IV Ophthalmic	Hours/Weeks	300 mg bid x 28 days, then off x 28 days	Interferes with bacterial protein translation; reduces pulmonary levels of Pseudomonas species and other gram-negative bacteria	Ototoxicity, nephrotoxicity
Triamcinolone Acetonide (Azmacort) Azmacort medical facts	Inhaled corticosteroid	Asthma and COPD maintenance (and rarely, exacerbation) therapy; rhinitis, sinusitis	MDI (100 µg/actuation) Nasal (55 µg/actuation) Oral (1-, 2-, 4-, 8-mg tablets; 2-mg/mL, 4-mg/mL suspension) IV	~8 hours	MDI: 2 to 4 puffs tid-qid, tapered to bid as tolerated Pediatric MDI: 1 to 2 puffs tid-qid, tapered to bid as tolerated Systemic: varies		Hoarseness, thrush, sore throat, possible growth retardation
Warfarin (Coumadin) Coumadin (warfarin) medical facts	Anticoagulant	Prophylaxis and treatment of deep venous thrombosis and pulmonary embolism	PO	2 to 3 days/approx. 1 week	2 to 8 mg PO qd	Inhibits production of vitamin K-dependent factors V, VII, IX, X	Excessive bleeding and bruising; contraindicated in active hemorrhage, recent intracranial hemorrhage, active pericarditis
Zafirlukast (Accolate) zafirlukast medical facts	Leukotriene receptor antagonist	Asthma, allergic rhinitis	PO (20-mg tablet)	3 hours/12 hours	20 mg PO bid		Churg-Strauss syndrome?
Zileuton (Zyflo) zileuton medical facts	5-Lipoxygenase inhibitor	Asthma, allergic rhinitis	PO (600 mg)	1.5 hours/6 hours	600 mg PO qid		Hepatotoxicity