Use of salmeterol is considered appropriate in the following:

1. Long-term maintenance treatment of asthma and in the prevention of bronchospasm in patients 12 years of age and older.

2. Patients with symptoms of nocturnal asthma, who require regular treatment with inhaled, short-acting b2 agonists.

3. Prevention of exercise-induced bronchospasm in patients 12 years old and older.

It is inappropriate to use Salmeterol in the following conditions:

1. Do not use for relief of acute asthma symptoms

2. Do not use in patients whose asthma can be managed by occasional use of short-acting, inhaled b2 agonists.

Dose:

1. For maintenance/prevention of asthma/nocturnal asthma the usual dose is 2 inhalations (42 mcg) twice daily (morning and evening).

2. For patients not currently on a scheduled salmeterol regimen, prevention of exercise-induced bronchospasms may be achieved by using 2 inhalations at least 60 minutes before exercise, however, short-acting b2 agonists should be available for rescue.

Monitor:

1. Pulmonary and liver function tests

2. Blood pressure & pulse

3. CNS stimulation.

4. Drug/drug interactions with beta-adrenergic blockers, MAO inhibitors, and tricyclic antidepressants.

5. Side effects of palpations, tachycardia, tremor, dizziness/vertigo, shakiness/nervousness/tension, headache, nausea/vomiting, heartburn, diarrhea, cough, and throat dryness/irritation.

6. Signs of deteriorating asthma, which include increasing use of short-acting inhaled beta2-agaonists.

Outcome:

1. Prevention of bronchoconstriction and/or improvement in pulmonary function testing.

2. Increased patient knowledge of precautions and proper utilization of medication.