How to manage asthma symptoms at school with prescribed Levalbuterol Tartrate Aerosol?

School Asthma Management Note for Levalbuterol Tartrate Aerosol

The student requires immediate access to their prescribed Levalbuterol Tartrate Aerosol (45 mcg/actuation) at school for rescue treatment of acute asthma symptoms, with authorization to self-administer 1-2 puffs every 4-6 hours as needed for wheezing or shortness of breath. 1

Medication Authorization Details

Prescribed Medication:

• Levalbuterol Tartrate HFA Aerosol, 45 mcg per actuation
• Dosing: 1-2 puffs every 4-6 hours as needed for wheezing or shortness of breath 1
• Duration: 30 days supply with 3 refills authorized
• This is a rescue (quick-relief) bronchodilator medication 2

When to Administer

The student should use their inhaler when experiencing:

• Wheezing or audible breathing difficulty 1, 2
• Shortness of breath or chest tightness 2
• Cough associated with asthma symptoms 3
• Before physical activity if prescribed for exercise-induced symptoms 1

Dosing instructions:

• Administer 1-2 puffs (45-90 mcg total) as needed 1, 4
• May repeat every 4-6 hours if symptoms persist 1
• For acute symptoms, the dose may be doubled for mild exacerbations 1

Critical Warning Signs Requiring Emergency Care

Immediately contact emergency services (911) and parents if the student exhibits:

• Inability to speak in complete sentences due to breathlessness 1
• Respiratory rate >25 breaths/minute 1
• Heart rate >110 beats/minute 1
• No improvement or worsening symptoms 15-30 minutes after inhaler use 1
• Confusion, drowsiness, or altered mental status 1
• Blue lips or fingernails (cyanosis) 1
• Severe chest retractions or difficulty breathing 1

Monitoring Requirements

School staff should observe for:

• Frequency of inhaler use: Using the rescue inhaler more than twice weekly for symptom control indicates poor asthma control and requires medical follow-up 2
• Effectiveness: Lack of expected symptom relief within 15-30 minutes indicates need for emergency evaluation 1, 2
• Side effects: Tremor, rapid heartbeat, or nervousness are common but should be reported if severe 5, 2

Administration Guidelines

Proper inhaler technique:

• Prime the inhaler by releasing 4 actuations before first use 1
• Shake well before each use 5
• Use with a spacer device if available for optimal delivery 2, 4
• Wait 1 minute between puffs if taking 2 puffs 1

Storage:

• Store at room temperature (68-77°F) 5
• Protect from excessive heat 5
• Keep inhaler with student at all times, including during physical education, field trips, and transportation 1

Important Safety Information

This medication should be used with caution if the student has:

• Known heart conditions, as levalbuterol can cause cardiovascular effects 5
• History of seizures, hyperthyroidism, or diabetes 5

Common side effects to monitor (not requiring discontinuation unless severe):

• Tremor or shakiness 2, 5
• Rapid heartbeat or palpitations 5
• Headache or dizziness 5
• Nervousness 5

Authorization for Self-Administration

The student is authorized to:

• Carry their inhaler on their person at all times 1
• Self-administer medication without direct supervision when symptomatic 1
• Keep a backup inhaler in the school nurse's office if desired 1

Parent/Guardian and prescribing physician contact information should be readily available for any questions or concerns regarding medication administration or asthma symptoms.

This authorization aligns with current asthma management guidelines emphasizing immediate access to rescue medications for optimal symptom control and prevention of severe exacerbations 1, 2.