Asthma & COPD Drug Ref

IMPORTANT: This app is intended for use by qualified healthcare professionals only. Always seek the advice of a qualified clinician before making any medical or prescribing decisions. Asthma & COPD Drug Ref is a comprehensive evidence-based respiratory pharmacology reference for doctors, nurses, pharmacists and respiratory specialist nurses. Built for the clinic, ward and emergency department. DRUG CLASSES REFERENCE Complete inhaled and oral drug reference across 6 classes: - SABA: salbutamol, terbutaline — doses, acute and routine use - LABA: salmeterol, formoterol, indacaterol, vilanterol, olodaterol - LAMA: tiotropium, umeclidinium, glycopyrronium, aclidinium, ipratropium - ICS: beclometasone, budesonide, fluticasone propionate and furoate, ciclesonide - Combination inhalers: ICS/LABA, LABA/LAMA, and triple therapy (ICS/LABA/LAMA) - Other agents: montelukast, theophylline, roflumilast, cromones STEP THERAPY - GINA 2024: 5-step asthma treatment ladder with as-needed ICS/formoterol guidance - GOLD 2024: ABCE group framework and pharmacological escalation strategy - Step-up and step-down criteria with review intervals BIOLOGIC THERAPY 7 approved biologics with eligibility criteria, NICE TA references and dosing: - Omalizumab (NICE TA278) — anti-IgE, allergic asthma - Mepolizumab (NICE TA431) — anti-IL-5, eosinophilic asthma - Benralizumab (NICE TA565) — anti-IL-5 receptor - Dupilumab (NICE TA751) — anti-IL-4/IL-13, broadest T2 indication - Tezepelumab (NICE TA878) — anti-TSLP, effective in T2-low asthma - Reslizumab — IV anti-IL-5 - Dupilumab for COPD (2024) — BOREAS/NOTUS trials ACUTE MANAGEMENT - Acute severe asthma: severity classification (moderate/severe/life-threatening/near-fatal) - 7-step treatment protocol including IV magnesium, IV salbutamol, ICU referral criteria - COPD exacerbation: controlled oxygen, NIV (BIPAP) criteria and settings - Antibiotic guidance — evidence-based indications INHALER GUIDE - pMDI, DPI, soft mist inhaler (Respimat) and nebuliser technique - Spacer devices — indications, cleaning, replacement - Device selection guide including environmental considerations (NICE NG80) OXYGEN THERAPY - SpO2 targets by condition — including COPD controlled oxygen 88–92% - Delivery devices: nasal cannula, Venturi mask, non-rebreather, HFNO, NIV - Long-term oxygen therapy (LTOT) criteria — NICE NG115 GINA & GOLD 2024 GUIDELINES - Asthma diagnosis, control assessment (ACQ/ACT), key GINA 2024 recommendations - GOLD ABCD groups, spirometric grading, non-pharmacological management - Asthma vs COPD comparison table SPECIAL SITUATIONS - Pregnancy: safe and unsafe drugs, acute asthma management in pregnancy - Elderly: device considerations, polypharmacy interactions, spirometry - Occupational asthma: causes, diagnosis, RIDDOR reporting - Difficult/severe asthma: distinguishing difficult-to-treat from true severe asthma SOURCES AND REFERENCES Full tappable reference list: GINA 2024, GOLD 2024, BTS/SIGN 2019, NICE NG115, NICE TA278/431/565/751/878, NAVIGATOR trial, UPLIFT, IMPACT, BOREAS, BTS oxygen guidelines and BNF. DISCLAIMER This app is intended for use by qualified healthcare professionals only as a clinical decision-support and educational reference tool. It is not a medical device and does not replace individual clinical assessment, local guidelines, or official prescribing information. Dr Atif Elnil MBBS MRCP UK, St Georges Hospital London