Table 2.

Representative Therapies for the Chronic Management of a Plastic Bronchitis^*

Medications	Indication	Drug Class	Route of Administration	Typical Doses
Albuterol	Airway Clearance	Bronchodilator	Inhaled	2.5 mg q4-6h prn
Levalbuterol			Inhaled	0.63–1.25 mg q4-6h prn
Budesonide	Antiinflammatory	Corticosteroid	Inhaled	0.25–1 mg bid
Budesonide-formoterol	Airway Clearance	Corticosteroid-bronchodilator	Inhaled	2 puffs bid (strength dependent on age of patient)
Fluticosone-Salmeterol			Inhaled	1 puff bid (strength dependent on age of patient)
Hypertonic Saline (3% and 7%)	Airway Clearance		Inhaled	4 mL bid
Azithromycin	Antiinflammatory	Macrolide	Oral	250–500 mg three times per week
Montelukast	Antiinflammatory	Leukotriene Pathway	Oral	6 months to 5 years: 4 mg qd
		Inhibitor		6–14 years: 5 mg qd
				≥ 15 years: 10mg qd
N-Acetylcysteine	Airway Cast Reduction	Mucolytic	Inhaled	Infants: 10% solution: 1–2 mL tid-qid
				20% solution: 2–4 mL tid-qid
				Children: 10% solution: 3–5 mL tid-qid
				20%: 6–10 mL tid-qid
				Adolescents: 10% or 20%
				solution: 5–10 mL tid-qid
Dornase alfa			Inhaled	2.5 mg qd-bid
Alteplase (tPA)	Airway Cast Reduction	Fibrinolytic	Inhaled	Optional dose of 10–12 mg followed by 5 mg q4-6h
UFH		Anticoagulant	Inhaled	Various regimens: 5000 U q8h
			Subcutaneous	Variable Dosing

UFH: unfractionated heparin

tPA: tissue plasminogen activator

^*some of these medications may be used in a variety of combinations with the intent to reduce cast formation and facilitate cast expectoration.