Anti-IL5, Anti-IL4/IL13, and PDE4 Inhibitors Flashcards
anti-IL5
blocks binding of IL-5 to the alpha chain of the IL-5 receptor complex
results in reduced production and survival of eosinophils
anti-IL5 drugs
mepolizumab (nucala)
reslizumab (cinqair)
benralizumab (fasenra)
mepolizumab brand
nucala
mepolizumab (nucala) dosage forms
100mg/1mL auto-injector for home administration
100mg/1.2 mL after reconstituted with 1.2mL sterile water for injection
reslizumab brand
cinqair
reslizumab (cinqair) dosage form
100mg/10mL solution for dilution in normal saline
benralizumab brand
fasenra
benralizumab (fasenra) dosage forms
30mg/mL auto-injector for home administration
30mg/mL prefilled syringe
mepolizumab (nucala) dosing for 5-11 yos
approved for 6 and up
40mg sq every 4 weeks
mepolizumab (nucala) dosing for adults
100mg sq every 4 weeks
reslizumab (cinqair) dosing for adults
approved for 18 yos and up
3mg/kg IV once every 4 weeks
benralizumab (fasenra) dosing for adults
30 mg sq every 4 weeks for 3 doses then 30mg sq every 8 weeks
adverse effects of mepolizumab (nucala)
headache
injection site reactions
joint pain
herpes zoster infection
adverse effects of reslizumab (cinqair)
injection site reactions
muscle pain
increased creatinine phosphokinase
adverse effects of benralizumab (fasenra)
injection site reactions
antibody development
headache
pharyngitis
fever
clinical pearls of mepolizumab (nucala)
precaution - anaphylaxis
available as an in-clinic or at-home injection
monitor for anaphylaxis before and after injection
indicated for add-on maintenance treatment of patients with severe asthma with an eosinophilic phenotype
clinical pearls of reslizumab (cinqair)
boxed warning - anaphylaxis, malignancies
monitor for anaphylaxis before and after injection
indicated for add-on maintenance treatment of patients with severe asthma with an eosinophilic phenotype
clinical pearls of benralizumab (fasenra)
precaution - anaphylaxis
available as in-clinic or at-home injection
indicated for add-on maintenance treatment of severe asthma in adults and children over 12 yos with an eosinophilic phenotype
acts on IL-5 receptor while others on IL-5
Anti-IL4/IL13
blocks binding of IL-4 to reduce eosinophil trafficking and IgE reactions
also blocks IL-13 to reduce mucus secretion and airway remodeling
dupilumab (dupixent)
dupilumab brand
dupixent
dupilumab (dupixent) dosage forms
200mg/1.14 mL injection
300mg/2mL injection
dupliumab (dupixent) dosing in adults
400 to 600mg sq initial dose followed by 200 to 300 mg every other week for maintenance
600 mg initial then 300 mg dosing used in patients with corticosteroid dependent asthma or atopic dermatitis
adverse effects of dupliumab (dupixent)
injection site reactions
antibody development
joint pain
conjunctivitis
clinical pearls of dupliumab (dupixent)
precaution - anaphylaxis
available in prefilled syringe for in-office or at-home administration
indicated as an add-on maintenance treatment in patients with moderate to severe asthma aged 12 yos and older with an eosinophilic phenotype or with oral corticosteroid dependent asthma
phosphodiaesterase-4 inhibitors
inhibits PDE4 leading to increased cAMP
roflumilast (daliresp)
roflumilast brand
daliresp
roflumilast (daliresp) dosage form
tablets
250 mcg
500 mcg
roflumilast (daliresp) dosing in adults
250 mcg qd for 4 weeks then 500 mcg qd
COPD only
adverse effects of roflumilast (daliresp)
headache
weight loss
diarrhea
nausea
monitor in roflumilast (daliresp)
liver function test
weight
drug interactions in roflumilast (daliresp)
cyp3a4 (major)
cyp1a2 (minor)
contraindications of roflumilast (daliresp)
child-pugh class B or C
