{
  "schema_version": 1,
  "kind": "condition",
  "id": "shortness-of-breath",
  "name": "Shortness of Breath (Dyspnoea)",
  "category": "acute",
  "sources": "Egyptian National Drug Formulary - cardiovascular.pdf, Furosemide monograph (chapter PDF p162) · Egyptian National Drug Formulary - respiratory-2026.pdf, Salbutamol monograph (chapter PDF p48) · Suha F, Modi P, Sharma S. Dyspnea. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-.",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary - cardiovascular.pdf, Furosemide monograph (chapter PDF p162) · Egyptian National Drug Formulary - respiratory-2026.pdf, Salbutamol monograph (chapter PDF p48)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1633,
      "generic": "Salbutamol",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.inhalation",
      "strength_mg": null,
      "adult_dose": "Inhaler: one inhalation (100 mcg) or two inhalations, up to 4 times a day for persistent symptoms; maximum 8 inhalations/day, not more often than every 4 hours.",
      "adult_duration": "As needed for symptomatic relief of bronchospasm; reassess if requiring frequent use.",
      "dose_source": "Egyptian National Drug Formulary - respiratory-2026.pdf, Salbutamol monograph (chapter PDF p48)",
      "rationale": "Salbutamol is the standard first-line reliever for breathlessness caused by bronchospasm in asthma or COPD, which are among the common causes of this symptom in primary care.",
      "cautions": [
        "Inhaled, not swallowed: the dose is the metered-dose inhaler's 100 mcg per actuation.",
        "Only appropriate when breathlessness is due to reversible airway obstruction (asthma/COPD) - not to breathlessness from heart failure, anaemia, or other causes.",
        "Sudden severe breathlessness with chest pain, stridor, inability to speak in full sentences, or low oxygen saturation/cyanosis are emergencies needing immediate referral, not routine inhaler treatment.",
        "Frequent need for the reliever inhaler signals poorly controlled disease and needs step-up therapy/referral.",
        "Can cause tremor, tachycardia, and hypokalaemia, especially at high or nebulised doses.",
        "RED FLAG - Sudden severe breathlessness with chest pain may be pulmonary embolism or heart attack, stridor or inability to speak in full sentences means severe airway obstruction, and breathlessness with leg swelling or worse when lying flat may be heart failure."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Different inhaler and nebuliser doses apply in children under 12; not reproduced here as this condition entry is being used for adult breathlessness.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "AEROLIN 100MCG/DOSE INHALER",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO > 3M HEALTH CARE-U.K.",
          "price_egp": 7.3,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 0.1,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "BUTALIN 100MCG/ACTUATION 200 DOSES",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "JULPHAR",
          "price_egp": 12.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 0.1,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "SALBOVENT RESPIRATOR 5MG/ML SOLN. 20 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ALEXANDRIA",
          "price_egp": 17.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 5.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "BRONCHOLIN S 0.5% RESPIRATOR SOLN. 30 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "price_egp": 37.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ALVEOTRACK 5 MG/ML INH. SOLN. 30 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MDI PHARMA",
          "price_egp": 49.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 5.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "VENTAL INHALER 100 MCG/DOSE 200 DOSES",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ARAB DRUG COMPANY (ADCO)",
          "price_egp": 72.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 0.1,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "VENTOLIN DISKUS 200MCG/DOSE ACCUHALER",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLAXO SMITHKLINE",
          "price_egp": 86.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 0.2,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "VENTOLIN EVOHALER 100MCG/ACTUATION INHALER",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLAXO SMITHKLINE",
          "price_egp": 86.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 0.1,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OPICHESTAL SYRUP 120ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EL-OBOUR",
          "price_egp": 2.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "SALBUTAMOL 2MG/5ML SYRUP 120ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SEDICO",
          "price_egp": 3.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 2.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "shortness-of-breath"
    },
    {
      "id": 1634,
      "generic": "Furosemide",
      "line": 2,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": null,
      "adult_dose": "20-50 mg by mouth as a single initial dose in a patient not already on a loop diuretic, then titrate as needed to the desired effect.",
      "adult_duration": "As directed; ongoing/repeated dosing guided by response (weight, oedema, breathlessness) once volume overload is confirmed.",
      "dose_source": "Egyptian National Drug Formulary - cardiovascular.pdf, Furosemide monograph (chapter PDF p162)",
      "rationale": "Furosemide is the standard diuretic for breathlessness caused by fluid overload from heart failure, one of the important causes of this symptom that a GP treats directly.",
      "cautions": [
        "Taken by mouth, not injected: the dose text reads '20-50 mg by mouth'.",
        "Only appropriate when breathlessness is due to fluid overload (e.g. heart failure) - confirm the diagnosis (e.g. leg swelling, orthopnoea) before starting.",
        "Monitor renal function and electrolytes (especially potassium and sodium), particularly with higher or repeated doses.",
        "Breathlessness with chest pain, stridor, inability to speak in sentences, or low oxygen saturation are emergencies needing urgent referral rather than routine outpatient diuretic dosing.",
        "Caution in dehydration and in combination with other nephrotoxic drugs or antihypertensives (risk of hypotension).",
        "Contraindicated in anuria, hepatic disease, severe electrolyte depletion, and hypersensitivity to sulfonamides."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "2 mg/kg single initial dose; if ineffective, may increase in 6-8 hours by 1-2 mg/kg increments to maximum 6 mg/kg/dose",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "ODEMENT 40MG 10 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EL NASR",
          "price_egp": 1.3,
          "pack_count": 10,
          "unit_price": 0.13,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FRUZEX 40MG 12 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MISR",
          "price_egp": 3.25,
          "pack_count": 12,
          "unit_price": 0.27,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FUROSEMIDE 40MG 20 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SEDICO",
          "price_egp": 7.5,
          "pack_count": 20,
          "unit_price": 0.38,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "LAFUREX 20MG 20 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "AMOUN",
          "price_egp": 8.5,
          "pack_count": 20,
          "unit_price": 0.42,
          "strength_mg": 20.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "LAFUREX 40MG 20 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "AMOUN",
          "price_egp": 9.5,
          "pack_count": 20,
          "unit_price": 0.47,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FUROSEMIDE-ALEX 40MG 20 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ALEXANDRIA",
          "price_egp": 19.0,
          "pack_count": 20,
          "unit_price": 0.95,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "LASIX 40 MG 24 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SANOFI",
          "price_egp": 30.0,
          "pack_count": 24,
          "unit_price": 1.25,
          "strength_mg": 40.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FURORETIC 500 MG 20 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "DEBEIKY > VETOPHARM-EGYPT",
          "price_egp": 93.0,
          "pack_count": 20,
          "unit_price": 4.65,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "GENESEMIDE 20MG/5ML SYRUP 120 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES > VODACHEM",
          "price_egp": 56.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 20.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "shortness-of-breath"
    }
  ]
}