GENERIC NAME: METAPROTERENOL INHALER - ORAL (met-a-proe-TER-e-nol)
BRAND NAME(S): Alupent
USES: Metaproterenol is used to treat wheezing and shortness of breath that commonly occur with lung problems (e.g., asthma, chronic obstructive pulmonary disease). Controlling these symptoms can decrease time lost from work or school. Metaproterenol is a bronchodilator (beta-2 receptor agonist) that works by opening breathing passages to make breathing easier.
HOW TO USE: Read the Patient Information Leaflet for instructions on proper use of this medication and the proper cleaning of the mouthpiece. Consult your doctor or pharmacist if you have any questions.Shake the canister well before each inhalation and test spray. Follow the instructions for test sprays in the air if you are using a new canister or if you have not used it in a while. This is also called priming your inhaler. Avoid spraying the medication in your eyes. A fine mist is a sign that the inhaler is properly working.Use this medication exactly as prescribed. Inhale by mouth usually every 3 to 4 hours as needed or as directed by your doctor. Take the cap off the mouthpiece. Place the mouthpiece near your mouth and exhale. Place the mouthpiece fully into your mouth and press the inhaler as you breathe in deeply. Hold your breath for 10 seconds if possible to allow the drug to be absorbed. If more than one inhalation is prescribed, wait at least 1 full minute between inhalations. If you take other asthma drugs by mouth or with inhaling devices, ask your doctor about how to correctly take this medication with your other asthma medicines.Dosage is based on your medical condition and response to therapy. Take this medication exactly as directed to get the most benefit from it. Do not take more of this medication or take it more often than recommended by your doctor.If you find it difficult to use this inhaler correctly, it may help to use a spacer device with this inhaler. Ask your doctor or pharmacist for more information.Clean the mouthpiece at least once weekly as directed in the Patient Information Leaflet. It should also be cleaned at any time that it appears to be clogged or is not working correctly.If you notice less effect than usual from this medication, if your symptoms get worse, or if you feel you need to take any of your asthma medications more often than recommended, seek immediate medical attention.Keep track of the number of inhalations used from each canister. Discard the canister after you have used the number of inhalations marked on the manufacturer's package. Sprays used to prime the inhaler should also be counted. Do not float the metal canister in water to test if any more drug is left in the canister.
Quick GuideAsthma Symptoms, Causes, and Medications
SIDE EFFECTS: Headache, nausea, vomiting, nervousness, dizziness, shaking (tremor), trouble sleeping, stomach upset, dry mouth, bad taste, cough, sore throat, or runny nose may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: fast/pounding/irregular heartbeat, muscle cramps, weakness.Seek immediate medical attention if this unlikely but serious side effect occurs: chest pain.Rarely, this medication has caused severe (rarely fatal), sudden worsening of breathing problems/asthma (paradoxical bronchospasm). If you experience sudden wheezing, seek immediate medical attention.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking metaproterenol, tell your doctor or pharmacist if you are allergic to it; or to similar bronchodilators (e.g., albuterol, levalbuterol, salmeterol); or to sympathomimetic drugs (e.g., epinephrine, pseudoephedrine); or if you have any other allergies.Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease (e.g., high blood pressure, abnormal heart rhythm, coronary insufficiency), seizures, overactive thyroid (hyperthyroidism), diabetes, low blood potassium level (hypokalemia).This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially the effects on the heart.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) within 2 weeks before, during, and after treatment with this medication. In some cases a serious, possibly fatal drug interaction may occur.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: other asthma drugs (e.g., levalbuterol, salmeterol), some beta blockers (such as propranolol), inhaled anesthetics (e.g., halothane, isoflurane), other sympathomimetic drugs (e.g., ephedrine, epinephrine), tricyclic antidepressants (e.g., amitriptyline, nortriptyline), certain "water pills" (diuretics that cause potassium loss such as furosemide, hydrochlorothiazide).This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents should call the US National Poison Hotline at 1-800-222-1222. Canada residents should call a provincial poison control center. Symptoms of overdose may include: chest pain, fast/pounding/irregular heartbeat, headache, shaking (tremors), nervousness, weakness, severe dizziness, seizures.
NOTES: Do not share this medication with others.Avoid allergens, irritants, smoking, and other factors that make asthma worse.Laboratory and/or medical tests (e.g., blood pressure, heart rate, EKG, blood potassium levels) may be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details.Learn to use a peak flow meter, use it daily, and promptly report worsening asthma (such as readings in the yellow/red range or increased use of quick-relief inhalers).
MISSED DOSE: If you are using metaproterenol regularly and miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
STORAGE: Store at room temperature between 59-77 degrees F (15-25 degrees C) away from direct sunlight. It is best to store the inhaler with the mouthpiece down. Avoid freezing. Do not puncture the canister or expose it to high heat or open flame. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).
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Asthma OverviewAsthma is a condition in which hyperreactive airways constrict and result in symptoms like wheezing, coughing, and shortness of breath. Causes of asthma include genetics, environmental factors, personal history of allergies, and other factors. Asthma is diagnosed by a physician based on a patient's family history and results from lung function tests and other exams. Inhaled corticosteroids (ICS) and long-acting bronchodilators (LABAs) are used in the treatment of asthma. Generally, the prognosis for a patient with asthma is good. Exposure to allergens found on farms may protect against asthma symptoms.
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
COPD vs. Emphysema Differences Similarities
COPD (chronic obstructive pulmonary disease) is the term doctors and other health care professionals use to describe a group of serious, progressive (worsens over time), chronic lung diseases that include emphysema, chronic bronchitis, and sometimes asthma. The number one cause of COPD or emphysema, is smoking, and smoking is the third leading cause of death in the US. When a person first develops COPD, he or she may not have any symptoms. As the disease progresses, the symptoms worsen and become more severe and include:
- Difficulty breathing with exertion or physical activity, which in the advanced stages, eventually leads to breathlessness all of the time.
- Chronic cough
- Excessive phlegm production
- Upper respiratory infections like the flu or common cold.
- A barrel-shaped chest
- A bluish tint to the skin from lack of oxygen
- Chest tightness
- varenicline (Chantix) to quit smoking
- The antidepressant and bupropion (Zyban) to reduce nicotine withdrawals
- Drugs that are prescribed for another condition (off label), for example, nortriptyline (Pamelor) and clonidine (Catapres)
- Short-term bronchodilators, for example, albuterol (Ventolin, Proventil)
- Long-term bronchodilators, for example, salmeterol (Serevent) and formoterol (Foradil)
- Anticholinergic bronchodilators, for example, ipratropium (Atrovent) and tiotropium (Spiriva)
- Combined drugs using steroids and long acting bronchodilators
- Roflumilast (Daxas, Daliresp)
You can prevent getting COPD or emphysema if you:
- Quit smoking and making healthy lifestyle changes
- Avoid secondhand smoke
- Avoid home and workplace air pollutants
- Prevent upper respiratory tract infections
There is a genetic cause of COPD called alpha-1 antitrypsin.
CDC. "Chronic Obstructive Pulmonary Disease (COPD)." Updated: Sep 16, 2016.
NIH; National Heart, Lung, and Blood Institute. "COPD National Action Plan." Updated: May 15, 2017.
NIH; National Heart, Lung, and Blood Institute. "What is COPD?" Updated: Apr 28, 2017.
U.S. Department of Health and Human Services. "COPD (Chronic Obstructive Pulmonary Disease)." Updated: Oct 31, 2014.
Victoria State Government. "Emphysema." Updated: Nov 2014.
Sharafkhaneh, A. et al. Emphysema. Proc Am Thorac Soc. 2008 May 1; 5(4): 475–477. doi: 10.1513/pats.200708-126ET
Boka, K. "Emphysema." Medscape. Updated: Aug 31. 2016.
Kleinschmidt, P. "Chronic Obstructive Pulmonary Disease (COPD) and Emphysema in Emergency Medicine." Medscape. Updated: Jun 08, 2017.
Lungs Design And PurposeThe lungs are primarily responsible for the exchange of oxygen and carbon dioxide between the air we breathe and the blood. Eliminating carbon dioxide from the blood is important, because as it builds up in the blood, headaches, drowsiness, coma, and eventually death may occur. The air we breathe in (inhalation) is warmed, humidified, and cleaned by the nose and the lungs.
Neutropenia is a marked decrease in the number of neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled with neutrally-staining granules, tiny sacs of enzymes that help the cell to kill and digest microorganisms it has engulfed by phagocytosis.
Signs and symptoms of neutropenia include gum pain and swelling, skin abscesses, recurrent ear and sinus infections, sore mouth, low-grad fever, pneumonia-like symptoms, and pain and irritation around the rectal area.
Neutropenia has numerous causes, for example, infections (HIV, TB, mono); medications (chemotherapy); vitamin deficiencies (anemia); bone marrow diseases (leukemias), radiation therapy, autoimmune destruction of neutrophils, and hypersplenism.
Treatment of neutropenia depends upon the cause and the health of the patient.