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salmeterol xinafoate
Serevent, Serevent Diskus

Pregnancy Risk Category C

How supplied
Inhalation aerosol:
21 mcg/metered spray
Inhalation powder:
50 mcg/blister

Action
Not clearly defined. Selectively activates beta2 receptors, which results in bronchodilation. Also, blocks the release of allergic mediators from mast cells lining the respiratory tract.

Indications & dosage
Long-term maintenance treatment of asthma; prevention of bronchospasm in patients with nocturnal asthma or reversible obstructive airway disease who need regular treatment with short-acting beta agonists--

For inhalation aerosol--
Adults and children over age 12:
2 inhalations q 12 hours, in the morning and evening.
For inhalation powder--
Adults and children over age 4:
1 inhalation q 12 hours, in the morning and evening.
Prevention of exercise-induced bronchospasm
--
For inhalation aerosol--
Adults and children ages 12 and over:
2 inhalations at least 30 to 60 minutes before exercise.
For inhalation powder--
Adults and children ages 4 and older:
1 inhalation at least 30 minutes before exercise.
Maintenance treatment of bronchospasm associated with COPD (including emphysema and chronic bronchitis)--

Adults:
2 inhalations (42 mcg; inhalation aerosol) q 12 hours, in the morning and evening.

Adverse reactions
CNS:
headache, sinus headache, tremor, nervousness, giddiness, dizziness.
CV:
tachycardia, palpitations, ventricular arrhythmias.
EENT:
nasopharyngitis, pharyngitis, nasal cavity or sinus disorder.
GI:
nausea, vomiting, diarrhea, heartburn.
Musculoskeletal:
joint and back pain, myalgia.
Respiratory:
cough, lower respiratory infection, upper respiratory tract infection, bronchospasm.
Other:
hypersensitivity reactions (rash, urticaria).

Interactions
Drug-drug.
Beta agonists, other methylxanthines, theophylline: possible adverse cardiac effects with excessive use. Monitor closely.
MAO inhibitors:
risk of severe adverse CV effects. Avoid use within 14 days of MAO therapy.
Tricyclic antidepressants:
risk of moderate to severe adverse CV effects. Use with extreme caution.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug or its ingredients.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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