3.1. Bronchodilators
The British Thoracic Society and the Scottish Intercollegiate Guidelines Network jointly produce the British Guideline on the Management of Asthma which is available from the SIGN website (www.sign.ac.uk). The prescribing resources page contains useful resources for prescribing inhaler devices including device guides and patient information leaflets.
3.1.1. Adrenoceptor agonists
3.1.1.1. Selective beta2 agonists
3.1.1.1.1. Short-acting bronchodilators
Prescribing Notes:
Preferred devices:
- Salbutamol 100 microgram Easyhaler (DPI)
- Salbutamol 100 microgram CFC free inhaler (MDI)
Salbutamol inhalers generally should not be prescribed to be used regularly, but should be used on a when required basis.
Prescribing Notes:
Salbutamol inhalers generally should not be prescribed to be used regularly, but should be used on a when required basis.
Prescribing Notes:
Nebules should generally be used as an emergency back-up to other treatments rather than used routinely.
Prescribing Notes:
To prevent confusion, prescribe inhaler devices by brand name.
Nebules should generally only be used as an emergency back-up to other treatments rather than used routinely.
3.1.1.1.2. Long-acting bronchodilators
Long-acting beta agonist (LABA) inhalers are possible treatments for patients with COPD. They should be used with ICS in the treatment of asthma..
Prescribing Notes:
Preferred brands and devices:
- 1st Choice: Formoterol Easyhaler (dry powder inhaler)
- 2nd Choice: Atimos Modulite (aerosol inhaler)
To prevent confusion, prescribe inhaler devices by brand name.
3.1.1.1.3. Combination inhaled devices
3.1.1.2. Other adrenoceptor agonists
3.1.2. Antimuscarinic bronchodilators
3.1.2.1. Antimuscarinic combination inhalers
Restrictions:
For use as a maintenance bronchodilator in COPD. To prevent confusion, prescribe inhaler devices by brand name. Preferred List use of tiotropium only relates to use in COPD.
Prescribing Notes:
Preferred brand and device:
- Braltus® Zonda
To prevent confusion, prescribe inhaler devices by brand name.
Restrictions:
COPD
- Use as a maintenance bronchodilator in COPD.
Asthma
- Consider as add-on treatment in adults on medium to high dose ICS with a history of exacerbation (one course of oral steroids for a severe exacerbation in the last year) or persistent airflow obstruction.
Prescribing Notes:
To prevent confusion, prescribe inhaler devices by brand name.
Prescribing Notes:
For use as maintenance bronchodilator in COPD. To prevent confusion, prescribe inhaler devices by brand name.
Prescribing Notes:
To prevent confusion, prescribe inhaler devices by brand name.
For the relevant SMC advice click here