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3. Respiratory System

NICE TA38 - Inhaler devices for routine treatment of chronic asthma in older children (aged 5–15 years)

NICE TA10 - Guidance on the use of inhaler systems (devices) in children under the age of 5 years with chronic asthma

NICE NG9 - Bronchiolitis in children

COPD guidelines - https://medicines.necsu.nhs.uk/guidelines/south-tyneside-guidelines/ 

Salbutamol
BNF | BNFC | SPC

Aerosol inhaler - 100micrograms/metered dose

Breath actuated inhaler - 100micrograms/metered inhalatio

Dry powder inhaler - 200micrograms/dose (Accuhaler) Nebuliser solution 2.5mg, 5mg 

2.5mg nebules recommended for COPD as 5mg have no additional benefit

Ipratropium
BNF | BNFC | SPC

Aerosol inhaler - 20microgram/metered dose

Nebuliser solution - 250micrograms/ml

Spiriva (Tiotropium)
BNF | BNFC | SPC

Solution for inhalation - 2.5micrograms/metered dose (Respimat)                                                              

Tiotropium is first line for COPD treatment in accordance with NICE guidance

Braltus (Tiotropium)
BNF | BNFC | SPC

Inhalation powder 10micrograms (for use with Zonda inhaler).

Respimat is first line device for inhalation of tiotropium. When not tolerated or unwilling to change Braltus is a more cost effective option than Spriva handihaler and is almost identical in use.

 

Spiolto Respimat (tiotropim/olodaterol)
BNF | BNFC | SPC

Solution for inhalation - .5micrograms/2.5 microgram per metered dose        

 

Anoro® Ellipta 55/22 (Umeclidinium bromide, Vilanterol (as Vilanterol trifenatate))
BNF | BNFC | SPC

Dry powder inhaler 65 microgram / 22 microgram per 1 dose

Theophylline
BNF | BNFC | SPC

MR Tablets - 175mg, 250mg (Neulin SA)

MR Tablets - 200mg, 300mg, 400mg (Uniphyllin Continus)

MR Capsules - 60mg, 125mg, 250mg (Slophyllin) 

Aminophylline
BNF | BNFC | SPC

MR Tablets - 225mg, 350mg (Phyllocontin Continus)

Trimbow® 87/5/9 (Beclometasone dipropionate, Formoterol fumarate dehydrate, Glycopyrronium (as Glycopyrronium bromide) )
BNF | BNFC | SPC

Metered Dose Inhaler87 microgram/ 5 microgram/ 9 microgram per 1 dose

Trelegy®Ellipta 92/55/22 (Fluticasone furoate, Umeclidinium bromide, Vilanterol (as Vilanterol trifenatate))
BNF | BNFC | SPC

Dry powder inhaler 92 microgram, 65 microgram, 22 microgram per 1 dose

Adults: NICE TA138, Children: NICE TA131

Beclometasone Dipropionate
BNF | BNFC | SPC

Aerosol inhaler - 50microgram/ 100microgram, 250microgram/ metered dose (Clenil Modulite, QVAR).

Breath actuated inhaler - 50micrograms/metered dose (Autohaler, Easibreathe)

Clenil modulite and QVAR are not interchangeablewith other CFC free inhalers and should be prescribed by brand

Fostair (beclometasone/formoterol)
BNF | BNFC | SPC

Aerosol Inhalation - 100/6micrograms

Powder breath actuated inhaler - 100/6micrograms

DuoResp Spiromax (formoterol/budesonide)
BNF | BNFC | SPC

Dry Powder Inhaler - 160 μg / 4.5 μg, 320 μg / 9 μg

Only For Adults aged 18years or older

Relvar Ellipta (fluticasone/vilanterol)
BNF | BNFC | SPC

Dry Powder Inhaler - 92microgram, 22microgram

Symbicort (formoterol/budesonide)
BNF | BNFC | SPC

Dry Powder Inhaler - 6/100microgram, 6/200microgram, 12/400microgram/metered dose (turbohaler)

Sodium cromoglicate
BNF | BNFC | SPC

Aerosol Inhaler - 5mg/metered dose

Montelukast
BNF | BNFC | SPC

Tablets - 10mg 

Chewable Tablets - 4mg, 5mg 

Granules - 4mg 

Zafirlukast
BNF | BNFC | SPC

Tablets - 20mg 

Roflumilast
BNF | BNFC | SPC

500mg tabs

Cetirizine
BNF | BNFC | SPC

Tablets - 10mg

Liquid - 5mg/5ml 

Loratadine
BNF | BNFC | SPC

Tablets - 10mg

Liquid - 5mg/5ml 

Fexofenadine
BNF | BNFC | SPC

Tablets - 120mg, 180mg

Chlorphenamine
BNF | BNFC | SPC

Tablets - 4mg

Liquid - 2mg/5ml

Alimemazine tartrate
BNF | BNFC | SPC

Hospital only for the following indications

    • Enteral sedation in paediatric ITU setting
    • Use in patients where promethazine has failed

Existing patients can continue to be prescribed in primary care until a treatment review has taken place  

Hydroxyzine hydrochloride
BNF | BNFC | SPC

Tablets - 10mg, 25mg

Liquid - 10mg/5ml

Sedating

Promethazine hydrochloride
BNF | BNFC | SPC

Tablets - 10mg,25mg

Liquid - 5mg/5ml

Sedating

Adrenaline auto-injection device
BNF | BNFC | SPC

Jext 150microgram

300microgram autoinjector

Carbocisteine
BNF | BNFC | SPC

Capsules - 375mg

Liquid - 125mg/5ml

Erdosteine
BNF | BNFC | SPC

Capsules - 300mg 

For short term use only

Codeine Phosphate
BNF | BNFC | SPC

Linctus-  15mg/5ml

Pholcodeine
BNF | BNFC | SPC

Linctus - 5mg/5ml, 10mg/5ml