Serevent

Serevent Diskus Replaces Aerosol Inhalers

Nicole G. DeVita, RPh, MHP
Director of Pharmacy and Clinical Program Development
Partners Community HealthCare Inc.

Please note that Serevent (salmeterol) aerosol inhaler manufactured by GlaxoSmithKline is being phased out and will no longer be available. The Serevent® aerosol inhaler is being replaced by the Serevent® Diskus dry powder inhaler. PLEASE NOTE: THE SALMETEROL DOSE PER INHALATION USING THE DISKUS IS APPROXIMATELY TWICE THAT OF AN INHALATION USING THE MDI; THEREFORE THE DOSING IS NOT EQUIVALENT.

When using the diskus, please remember the following differences:

DOSING
	Serevent aerosol MDI	Serevent Diskus DPI
Asthma	2 puffs (42 mcg) Q12 (>12 y.o)	1 inhalation (50 mcg) Q12 (>4 y.o)
COPD	2 puffs (42 mcg) Q12	1 inhalation (50 mcg) Q12
Exercise-induced Bronchospasm	2 puffs 30-60 minutes prior to exercise	1 inhalation 30 minutes prior to exercise

General Differences
Aerosol Multi Dose Inhaler (MDI)	Dry Powder Inhaler (DPI)
1) 21 mcg salmeterol per puff	1) 50 mcg salmeterol per inhalation
2) Shake well before using	2) Do not shake, especially after dose is in chamber
3) May only estimate remaining dosages	3) Built in dose counter
4) Inhale slowly	4) Inhale deeply and steadily

Tips on Administering Serevent (salmeterol)

Dean Hess, PhD, RRT
Assistant Director, Respiratory Care Services, MGH

Remember that Serevent is a long-acting beta agonist. It is a controller medication, not a reliever. It should not be used for quick relief of acute bronchospasm. The patient should also have a prescription for a short-acting bronchodilator such as albuterol in addition to Serevent.

The usual dose of Serevent is one inhalation twice daily.

Patient instructions are basically as follows:

- Open: Hold the outer case in one hand and put the thumb of the other hand on the thumb grip. Push the thumb away as far as it will go until a click is heard.

- Click: Slide the lever away as far as it will go until a click is heard.

- Inhale: Hold the Diskus inhaler away from the mouth and exhale. With the mouthpiece held to the lips, inhale quickly and deeply through the Diskus inhaler. Remove the Diskus inhaler, hold your breath for about 10 seconds, and then breathe out slowly.

Powders are not compatible with administration to mechanically ventilated patients. Accordingly, Serevent can no longer be administered in the ventilator circuit.