1. Xopenexlevalbuterol By Danielle Gill UC PharmD Candidate Plateau Medical Center

2. Beta-2 agonist R-isomer of albuterol Fast-acting Used for the prevention of bronchiospasm Asthma and Chronic Obstructive Pulmonary Disease (COPD) Pharmacologic Category

3. Coughing Sneezing Chest tightening Shortness of breath Relaxes Tightened muscles around the airway Symptom relief

4. XOPENEX Inhalation Solution (nebulizer) ages 6-11: 0.31 mg up to 0.63 mg TID 12 or over: 0.63-1.25 mg TID This form is turns the medicine into a vapor like mist so it can be inhaled by the patient. Dosage

5. Tachycardia Increase in blood pressure Dyspepsia Leg cramps Dizziness Tremor Adverse Effects

6. heart disease (e.g., reduced heart circulation, high blood pressure, and irregular heartbeat) seizures high levels of thyroid hormone diabetes Precautions for patients

7. Store XOPENEX in the protective foil pouch at room temperature (68°F - 77°F). Protect from light and excessive heat. Keep unopened vials in the foil pouch. Once the pouch is opened, the vials should be used within two weeks. Vials removed from the pouch, if not used immediately, should be protected from light and used within one week. Discard any vial that is opaque Storage requirements

8. Albuterol is equivalent in effectiveness to Xopenex and it costs more ($0.42 vs. $5.61/day) Xopenex was shown to cause greater changes in heart rate and blood sugar then Albuterol Pharmacy is looking into discontinuing this drug on their formulary. Possible Problems

9. Orzali Peter. Xopenex. Pharmacy Proposal for Formulary Removal. Xopenex website available at www.xopenex.com Lexi-Comp. University of Charleston School of Pharmacy. Online. References