What are the effects of starting a patient on prednisone, Tessalon Perles (Benzonatate), doxycycline, and albuterol inhaler?

From the Guidelines

Starting the patient on prednisone, Tessalon Perles, doxycycline, and an albuterol inhaler is a suitable treatment plan for managing an acute respiratory condition with both inflammatory and infectious components, as suggested by the guidelines for COPD treatment 1.

Treatment Plan Details

• Prednisone is a corticosteroid that reduces inflammation in the airways, and according to the guidelines, it should be dosed at 30–40 mg orally per day for 10–14 days 1.
• Tessalon Perles (benzonatate) is a non-narcotic cough suppressant that works by numbing stretch receptors in the lungs, usually given as 100-200mg capsules three times daily.
• Doxycycline is an antibiotic, commonly prescribed at 100mg twice daily for 7-10 days to treat potential bacterial infections, and its choice should be based on local bacteria resistance patterns 1.
• The albuterol inhaler provides quick bronchodilation for symptom relief, used as 1-2 puffs every 4-6 hours as needed, and it is recommended to use a short-acting b-agonist (salbutamol or albuterol) and/or ipratropium MDI with spacer or hand-held nebuliser as needed 1.

Patient Advice

• The patient should be advised to complete the full course of antibiotics.
• The patient should taper the prednisone as directed.
• The patient should use the inhaler before physical activity if needed.
• The patient should report worsening symptoms or side effects promptly.
• Adequate hydration and rest will support recovery alongside this medication regimen.

Key Considerations

• The treatment plan should be based on the patient's specific condition and medical history.
• The patient's response to the treatment should be closely monitored, and adjustments should be made as needed.
• The patient should be educated on the proper use of the inhaler and the importance of completing the full course of antibiotics.

From the FDA Drug Label

As with other inhaled beta-adrenergic agonists, albuterol sulfate inhalation solution can produce paradoxical bronchospasm, which can be life threatening. Cases of urticaria, angioedema, rash, bronchospasm, hoarseness, oropharyngeal edema, arrhythmias (including atrial fibrillations, supraventricular tachycardia, extrasystoles) have been reported after the use of albuterol sulfate inhalation solution. The patient should be monitored for signs of paradoxical bronchospasm and hypersensitivity reactions when starting albuterol inhaler, and the physician should instruct the patient on the need for further evaluation if their asthma worsens 2, 2.

• Key considerations include:
  • Monitoring for cardiac effects
  • Instructing the patient on the proper use of the inhaler and the importance of seeking medical attention if symptoms worsen.

From the Research

Medication Overview

• The patient is being started on prednisone, Tessalon Perles, doxycycline, and an albuterol inhaler.
• Prednisone is a corticosteroid used to reduce inflammation in the body 3, 4.
• Tessalon Perles is a cough suppressant used to relieve coughing 5, 6.
• Doxycycline is an antibiotic used to treat bacterial infections, including those that cause respiratory symptoms 5, 6.
• Albuterol inhaler is a bronchodilator used to open airways and improve breathing in patients with respiratory conditions such as COPD or asthma.

Treatment of Respiratory Conditions

• The use of prophylactic antibiotics, such as doxycycline, may reduce the frequency of exacerbations in patients with COPD 5, 6.
• Corticosteroids, such as prednisone, may be used to reduce inflammation in the airways, but their use should be minimized due to potential side effects 3, 4.
• The combination of antibiotics and corticosteroids may be used to treat severe respiratory infections, such as pneumonia or acute exacerbations of COPD 5, 6, 4.

Potential Side Effects and Interactions

• The use of corticosteroids, such as prednisone, may suppress the hypothalamic-pituitary-adrenal (HPA) axis, predisposing to adrenal insufficiency 4.
• Antibiotics, such as doxycycline, may contribute to the development of antimicrobial resistance 5, 6.
• The combination of multiple medications, including prednisone, Tessalon Perles, doxycycline, and an albuterol inhaler, may increase the risk of potential side effects and interactions, and should be closely monitored by a healthcare professional.