formoterol fumarate

formoterol fumarate

(for moh' te rol)

Foradil Aerolizer

Pregnancy Category C

Drug classes

Beta₂ agonist

Antasthmatic

Therapeutic actions

Long-acting agonist that binds to beta₂ receptors in the lungs causing bronchodilation; may also inhibit the release of inflammatory mediators in the lung, blocking swelling and inflammation.

Indications

·        Long-term maintenance treatment of asthma in adults and children > 5 yr

·        Prevention of exercise-induced bronchospasm in adults and children > 12 yr when used on an occasional, as-needed basis

·        Long-term maintenance treatment of bronchoconstriction in patients with COPD

Contraindications and cautions

·        Contraindicated with hypersensitivity to adrenergics, amines, or to formoterol, acute asthma attack, acute airway obstruction.

·        Use cautiously in the elderly, with pregnancy, lactation.

Available forms

Inhalation powder in capsules—12 mcg

Dosages

ADULTS

·        Maintenance treatment of COPD: Oral inhalation of contents of 1 capsule (12 mcg) using Aerolizer Inhaler q 12 hr. Do not exceed a total daily dose of 24 mcg.

ADULTS AND PEDIATRIC PATIENTS > 12 YR

·        Prevention of exercise-induced bronchospasm: Oral inhalation of contents of one capsule (12 mcg) using the Aerolizer Inhaler 15 min before exercise. Use on an occasional, as-needed basis.

ADULTS AND PEDIATRIC PATIENTS > 5 YR

·        Maintenance treatment of asthma: Oral inhalation of contents of 1 capsule (12 mcg) using the Aerolizer Inhaler every 12 hr. Do not exceed 1 capsule every 12 hr.

Pharmacokinetics

Route	Onset	Peak	Duration
Inhalation	1–3 min	1–3 hr	8–20 hr

Metabolism: Hepatic; T_1/2: 10–14 hr

Distribution: Crosses placenta; may enter breast milk

Excretion: Feces, urine

Adverse effects

·        CNS: Tremor, dizziness, insomnia, dysphonia, headache, nervousness

·        CV: Hypertension, tachycardia, chest pain

·        GI: Nausea, dyspepsia, abdominal pain, irritation of the throat and mouth

·        Respiratory: Bronchitis, respiratory infection, dyspnea, tonsillitis

·        Other: Viral infection (most likely in children)

Nursing considerations

CLINICAL ALERT!

Name confusion has occurred between Foradil (formoterol) and Toradol (ketorolac); use extreme caution.

Assessment

·        History: Hypersensitivity to adrenergics, amines, or formoterol, acute asthma attack, acute airway obstruction, pregnancy, lactation

·        Physical: R, adventitious sounds, P, BP, ECG, orientation, reflexes

Interventions

·        Instruct patient in the proper use of Aerolizer Inhaler. Ensure that patient does not swallow the capsule.

·        Monitor use of inhaler. Patient should not wash the inhaler but should keep it dry; it should not be used for delivering any other medication. If a bronchodilator is needed between doses, consult with health care provider. Do not use more often than every 12 hr.

·        Encourage patient who experiences exercise-induced asthma to use drug 15 min before activity, and to reserve this drug for occasional, as-needed use.

·        Ensure that patient continues with appropriate use of corticosteroids or other drugs used to block bronchospasm, as appropriate.

·        Arrange for periodic evaluation of respiratory condition during therapy.

·        Arrange for analgesics as appropriate for headache.

·        Establish safety precautions if tremor becomes a problem.

Teaching points

·        Use the Aerolizer Inhaler as instructed. This is the only inhaler that can be used with this drug.

·        Use only twice a day. Do not wash the inhaler; keep it dry at all times. Do not use this inhaler to deliver any other drugs. Check the "use by" date on your drug and discard any capsules that have expired.

·        If drug is to be used periodically for exercise-induced asthma, use 15 minutes before activity.

·        Arrange for periodic evaluation of your respiratory problem while using this drug; continue to use any other therapies that have been prescribed to control your asthma.

·        You may experience these side effects: Headache (appropriate analgesics may be ordered); tremors (use care in performing dangerous tasks if this occurs); fast heartbeat, palpitations (monitor activity if this occurs, rest frequently).

·        Report severe headache, irregular heartbeat, worsening of asthma, difficulty breathing.

Adverse effects in Italic are most common; those in Bold are life-threatening.