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Inhaler Indentification Guide - 1310 PDF
Inhaler Indentification Guide - 1310 PDF
Identification Guide
Version 2
This booklet has been produced by NHS Greater Glasgow and Clyde together with the following companies,
Almirall, AstraZeneca, Boehringer Ingelheim Ltd, Chiesi, GSK, Napp and Novartis as a service to medicine.
Endorsed by NHSGGC Respiratory Managed Clinical Network, September 2013
230801 Designed by Medical Illustration Services
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
CONTENTS
Example Costs of Respiratory Inhaler Devices
Recommendations for Inhaler Supply
Respiratory Inhaler Identification
• Short-acting beta2 agonist inhalers (SABAs) Salbutamol
Terbutaline
• Long-acting beta2 agonist inhalers (LABAs) Salmeterol
Formoterol
Indacaterol
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Recommendations for Inhaler Supply
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Respiratory Inhaler Identification
There are many different inhaler devices available. Examples of the different types of inhaler devices
are illustrated to aid identification. Please note however, that different strengths of inhalers may be
slightly different colours than those shown. The manufacturer’s packaging may also differ from time
to time.The following images are for illustrative purposes only. If the patient does not have any of the
inhaler devices illustrated, and you are unsure what device the patient normally uses, please speak to
a pharmacist or respiratory nurse specialist for further advice.
This booklet is not intended to be a prescribing guide. Although dosage information is provided for
some preparations, always refer to the BNF or manufacturer’s Summary of Product Characteristics
(SPC) for current dosage advice and further information.
The examples of the medicine prescription forms (kardexes) are for illustrative purposes only and do
not reflect all doses available for each inhaler preparation.
The Asthma UK website has useful information on how to use spacers and different inhaler devices.
Refer to the link below to access videos on inhaler technique:
http://www.asthma.org.uk/knowledge-bank-treatment-and-medicines-using-your-inhalers
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Bronchodilator – short-acting beta2 agonist (blue/reliever) Inhalers (SABAs)
SALBUTAMOL
Adult Dose
By aerosol inhalation
100-200 micrograms; for persistent
symptoms up to 4 times daily. Refer
to manufacturer’s dosing instructions
or BNF for further advice.
Ventolin evohaler®)
day
Ventolin evohaler
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Bronchodilator – short-acting beta2 agonist (blue/reliever) Inhalers (SABAs)
SALBUTAMOL
advice. √
1 puff Inhal SOB/wheeze
4x 01/02/13
A N Other (A N OTHER) day
Ventolin accuhaler
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Bronchodilator – short-acting beta2 agonist (blue/reliever) Inhalers (SABAs)
TERBUTALINE SULPHATE
Adult Dose
By inhalation of powder
500 micrograms; for persistent symptoms
up to 4 times daily. Refer to manufacturer’s
dosing instructions or BNF for further advice.
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Long-acting beta2 agonist Inhalers (LABAs)
SALMETEROL
Salmeterol 50 micrograms
Salmeterol 25 micrograms
√ √ √ √
1 puff Inhal 01/02/13 2 puffs Inhal 01/02/13
Serevent accuhaler
√ Serevent evohaler
√
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Long-acting beta2 agonist Inhalers (LABAs)
FORMOTEROL FUMARATE
Formoterol 12 micrograms
^Refer to manufacturer’s dosing √ √
1 puff Inhal
instructions or BNF for further advice.
01/02/13
A N Other (A N OTHER)
Oxis turbohaler
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Long-acting beta2 agonist Inhalers (LABAs)
INDACATEROL
Adult Dose:
By inhalation of dry powder
150 micrograms once daily,
increased to max. 300
Indacaterol
micrograms once daily. √ √
Refer to manufacturer’s 150 micrograms Inhal 01/02/13
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Antimuscarinic Bronchodilator Inhalers – short-acting muscarinic antagonists (SAMAs)
IPRATROPIUM BROMIDE
Adult Dose
By aerosol inhalation
20-40 micrograms 3-4
times daily. Refer to Ipratropium bromide 20 micrograms
manufacturer’s dosing √
2 puffs Inhal √
√
01/02/13
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Antimuscarinic Bronchodilator Inhalers – long-acting muscarinic antagonists (LAMAs)
TIOTROPIUM
Adult Dose
By inhalation of powder
18 micrograms once daily. Tiotropium
√ √
Refer to manufacturer’s 18 micrograms Inhal 01/02/13
Spiriva
®
Example of medicine prescription form
(inhalation powder, hard capsule
for use with HandiHaler® device)
Strength: 18 microgram cap
Adult dose
By inhalation
5 micrograms (2 puffs)
once daily. Refer to Tiotropium 2.5 micrograms
√
manufacturer’s dosing 2 puffs Inhal 01/02/13 √
instructions or BNF for A N Other (A N OTHER)
further advice. Spiriva Respimat
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Antimuscarinic Bronchodilator Inhalers – long-acting muscarinic antagonists (LAMAs)
ACLIDINIUM BROMIDE
Adult Dose
By inhalation of dry powder Aclidinium 322 micrograms
1 inhalation twice daily. √
1 puff Inhal
√
01/02/13
Eklira Genuair®
(dry powder)
Strength: 400 micrograms/metered inhalation
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Antimuscarinic Bronchodilator Inhalers – long-acting muscarinic antagonists (LAMAs)
GLYCOPYRRONIUM
Adult Dose
By inhalation of powder
50 micrograms
once daily. Refer to
manufacturer’s dosing Glycopyrronium
√ √
instructions or BNF for 50 micrograms Inhal 01/02/13
Seebri Breezhaler
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Corticosteroid (brown/preventer) Inhalers
BECLOMETASONE DIPROPIONATE
** NOTE:
BECLOMETASONE CFC-FREE AEROSOL INHALERS ARE NOT INTERCHANGEABLE AND MUST BE PRESCRIBED BY BRAND NAME **
Adult Dose
By aerosol inhalation
200-400 micrograms twice
daily (up to 1mg twice daily) Clenil modulite 100 micrograms
√ √
Refer to manufacturer’s 2 puffs Inhal 01/02/13
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Corticosteroid (brown/preventer) Inhalers
BECLOMETASONE DIPROPIONATE
** NOTE:
BECLOMETASONE CFC-FREE AEROSOL INHALERS ARE NOT INTERCHANGEABLE AND MUST BE PRESCRIBED BY BRAND NAME **
Adult Dose
By aerosol inhalation
50-200 micrograms twice
daily (up to 400 micro-
grams twice daily). Refer
to manufacturer’s dosing
instructions or BNF for
Qvar® Qvar Autohaler® Qvar Easi-Breathe® further advice.
(CFC-free) MDI (aerosol) (aerosol) (aerosol)
Strengths: 50, 100 micrograms/
Strengths: 50, 100 micrograms/ Strengths: 50, 100 micrograms/ metered inhalation
metered inhalation metered inhalation
A N Other (A N OTHER)
MDI
√
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Corticosteroid (brown/preventer) Inhalers
BECLOMETASONE DIPROPIONATE
Beclometasone 200 micrograms
√ √
1 puff Inhal 01/02/13
A N Other (A N OTHER)
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Corticosteroid (brown/preventer) Inhalers
FLUTICASONE PROPIONATE
Adult Dose
Adult Dose
By aerosol inhalation By inhalation of dry powder
100-500 micrograms twice 100-500 micrograms twice
daily (up to 1mg twice daily) daily (up to 1mg twice daily)
Refer to manufacturer’s Refer to manufacturer’s
dosing instructions or BNF dosing instructions or BNF
for further advice. for further advice.
Flixotide Flixotide
Evohaler® Accuhaler®
MDI (aerosol) (dry powder)
Strengths: 50, 125, 250 Strengths: 50, 100, 250, 500
micrograms/metered micrograms/metered
inhalation inhalation
Flixotide evohaler
√ Flixotide accuhaler
√
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Corticosteroid (brown/preventer) Inhalers
BUDESONIDE
Pulmicort Easyhaler ®
budesonide Budelin novolizer®
® (dry powder)
Turbohaler (dry powder)
(dry powder)
Strengths^: 100, 200, 400 micrograms/ Strength: 200 micrograms/metered inhalation^
metered inhalation
Strengths^: 100, 200, 400
micrograms/metered inhalation
^Refer to manufacturer’s dosing
Budesonide 200 micrograms
instructions or BNF for further advice. √ √
1 puff Inhal 01/02/13
A N Other (A N OTHER)
Pulmicort turbohaler
√
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Compound Preparations (Corticosteroid/ Long-acting beta2 agonist)
FLUTICASONE/SALMETEROL
Seretide Seretide
Accuhaler® Evohaler®
(dry powder) MDI (aerosol)
Strengths^: Strengths^:
100 Accuhaler® 50 Evohaler®
(fluticasone 100 micrograms/salmeterol 50micrograms) (fluticasone 50 micrograms/salmeterol 25micrograms)
250 Accuhaler® 125 Evohaler®
(fluticasone 250 micrograms/salmeterol 50micrograms) (fluticasone 125 micrograms/salmeterol 25micrograms)
500 Accuhaler® 250 Evohaler®
(fluticasone 500 micrograms/salmeterol 50micrograms) (fluticasone 250 micrograms/salmeterol 25micrograms)
^Refer to manufacturer’s
Seretide 500 accuhaler dosing instructions or BNF Seretide 250 evohaler
√ √ √ √
1 puff Inhal 01/02/13 for further advice. 2 puffs Inhal 01/02/13
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Compound Preparations (Corticosteroid/ Long-acting beta2 agonist)
BUDESONIDE/FORMOTEROL
Symbicort 200/6
Symbicort 200/6 turbohaler √
√ √ 1 puff Inhal SOB/wheeze
2 puffs Inhal 01/02/13
8x 01/02/13
A N Other (A N OTHER) A N Other (A N OTHER) day
√ Max. 6 puffs on any one occasion
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Compound Preparations (Corticosteroid/ Long-acting beta2 agonist)
BECLOMETASONE/FORMOTEROL
Fostair 100/6
Fostair 100/6 √
√ √ 1 puff Inhal SOB/wheeze
1 puff Inhal 01/02/13
6x 01/02/13
A N Other (A N OTHER) A N Other (A N OTHER) day
MDI
√
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Compound Preparations (Corticosteroid/ Long-acting beta2 agonist)
FLUTICASONE/FORMOTEROL
Flutiform 125/5
√ √
2 puffs Inhal 01/02/13
A N Other (A N OTHER)
MDI
√
NB. Different strengths of inhalers may be slightly different colours to those illustrated.
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Spacer Devices
Some patients use spacer devices which remove the need for coordination between actuation of a
pressurised metered-dose inhaler (MDI) and inhalation. Spacers reduce the velocity of the aerosol and
subsequent impaction on the oropharynx and allow more time for evaporation of the propellant so that a
larger proportion of the particles can be inhaled and deposited in the lungs.
Spacers should be cleaned once a month and replaced every 6 to 12 months. It is important to prescribe a
spacer device that is compatible with the MDI. Spacer devices should not be regarded as interchangeable;
patients should be advised not to switch between spacer devices.
Volumatic®
• Large-volume device
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.
Spacer Devices
AeroChamber® Plus Able Spacer® A2A Spacer®
Produced by NHSGGC Medicines Information, September 2013. Endorsed by Respiratory Managed Clinical Network.