Asthma and chronic lung disease (reversible airflow obstruction)
Asthma and chronic lung disease (reversible airflow obstruction) · ICD-10: J45.909
Symptoms
- • Wheezing (whistling sound when breathing)
- • Shortness of breath
- • Cough that sometimes wakes the child at night
- • Breathing faster than normal
- • Trouble breathing out
- • Tightness in the chest
- • Feeling tired
Drugs and regimens
Acute bronchospasm — ≥4 years: 2 inhalations every 4–6 h
Bronchospasm — >14 y: 2 or 4 mg three or four times daily
Bronchospasm — 6–14 y: 2 mg three or four times daily
Bronchospasm — 2–5 y: 0.1 mg/kg three times daily (max 2 mg)
Nebulised — 2–12 y: 0.63 or 1.25 mg 3–4 times daily as needed
Acute asthma/COPD — load 5.7 mg/kg (ideal body weight) IV over 30 min, only if no theophylline in the previous 24 h
Asthma maintenance — ≥12 y: start 40–80 mcg twice daily
Asthma maintenance — 4–11 y: 40 or 80 mcg twice daily
Severe eosinophilic asthma (≥12 y) — 30 mg SC every 4 weeks for 3 doses, then every 8 weeks
Severe asthma, children 6–11 y — <35 kg: 10 mg; ≥35 kg: 30 mg (every 4 weeks ×3, then every 8 weeks)
Asthma — initiation, 3 months–12 years: 0.5–1 mg twice daily
Asthma — maintenance, 3 months–12 years: 0.25–0.5 mg twice daily
Asthma — initiation, ≥12 years: 1–2 mg twice daily
Asthma 6 to <12 y — 2 puffs 80/4.5 twice daily
Asthma ≥12 y — 2 puffs (80/4.5 or 160/4.5) twice daily
Eosinophilic or steroid-dependent asthma — 400 or 600 mg, then 200 or 300 mg every 2 weeks
Asthma, adults — 1 inhalation of 100/25 or 200/25 mcg once daily
Asthma, 12–17 y — 1 inhalation of 100/25 mcg once daily
Asthma — ≥12 y: 1 inhalation twice daily
Asthma — 4–11 y: 1 inhalation of 100/50 twice daily
Bronchospasm during anaesthesia — 10–20 mcg IV
Severe eosinophilic asthma (≥12 y) — 100 mg SC every 4 weeks
Severe eosinophilic asthma, children 6–11 y — 40 mg every 4 weeks
Asthma — once daily
Moderate–severe allergic asthma (≥6 y) — 75–375 mg every 2 or 4 weeks by IgE and weight
Acute asthma attack in children — by age
Acute asthma, child already on maintenance steroids — 2 mg/kg (max 60 mg)
Bronchospasm — adult: 5 mg three times daily (about every 6 h while awake)
Bronchospasm — 12–15 y: 2.5 mg three times daily
Severe asthma (add-on, ≥12 y) — 210 mg SC every 4 weeks
Children 1–15 y, <45 kg — start: 12–14 mg/kg/day
Children <45 kg — after 3 days: 16 mg/kg/day
Children <45 kg — after 3 more days: 20 mg/kg/day
>45 kg and adults — start 300 mg/day
Infants under 1 year
Asthma with thick secretions
Asthma — ≥6 y: 2 puffs of 1.25 mcg once daily
Asthma prophylaxis and chronic treatment (≥12 y) — 20 mg twice daily
Children 5–11 y — 10 mg twice daily