Bronchodilator therapy

For bronchodilator therapy in a child 1 to 5 years old with severe acute asthma, use:

salbutamol 100 micrograms per actuation, 6 actuations (1 at a time) via pMDI with spacer (and mask, if required); repeat every 20 minutes for the first hour (or sooner if needed) asthma, acute: severe (child 1 to 5 years) salbutamol

PLUS

ipratropium 21 micrograms per actuation, 4 actuations (1 at a time) via pMDI with spacer (and mask, if required); repeat every 20 minutes for the first hour (or sooner if needed). asthma, acute: severe (child 1 to 5 years) ipratropium

For bronchodilator therapy in an adult or child 6 years or older with severe acute asthma, use:

salbutamol 100 micrograms per actuation, 12 actuations (1 at a time) via pMDI with spacer; repeat every 20 minutes for the first hour (or sooner if needed) asthma, acute: severe (adult, child 6 years or older) salbutamol    

PLUS

ipratropium 21 micrograms per actuation, 8 actuations (1 at a time) via pMDI with spacer; repeat every 20 minutes for the first hour (or sooner if needed). asthma, acute: severe (adult, child 6 years or older) ipratropium    

Bronchodilator therapy can be administered by intermittent nebulisation if the patient can’t breathe through a spacer. Mix the nebuliser solutions and drive the nebuliser with air unless oxygen is required.

For a child 1 to 5 years old, use:

salbutamol 2.5 mg via intermittent nebulisation every 20 minutes for the first hour (or sooner if needed) salbutamol

PLUS

ipratropium 250 micrograms via intermittent nebulisation every 20 minutes for the first hour (or sooner if needed). ipratropium

For an adult or child 6 years or older, use:

salbutamol 5 mg via intermittent nebulisation every 20 minutes for the first hour (or sooner if needed) salbutamol    

PLUS

ipratropium 500 micrograms via intermittent nebulisation every 20 minutes for the first hour (or sooner if needed). ipratropium