Asthma Flashcards
Intermittant asthma signs and tx
less than 2 days per week and can treat intermittently with ICS + LABA/SABA
Mild asthma signs and tx
greater than 2 days per week but not daily. want to tx daily with ICS
moderate asthma
daily exacerbations, would do daily low dose ICS/LABA
severe asthma
increase ics dose until controlled, still ICS + LABA daily
proair/ventolin
albuterol, a SABA
salmeterol
LABA
QVAR
betamethasone, ICS
Pulmicort
Budosenide, ICS
symbicort
bucosenids (ICS) + formetalol (LABA)
advair
fluticasone (ICS) + salmetarol (LABA)
breo
fluticasone (ICS) + vilanterol (LABA)
dulera
mometasone (ICS) + formoterol (LABA)
ICS s/e
thrush, dysphonia, cough
saba s/e
nervousness, tremor, tachycardia, palpitations, cough, hyperglycemia, decreased potassium
laba boxed warning
increased risk of asthma related deaths if used alone
spiriva
tiotropium (LAMA)
flovent
fluticasone (1/2), ICS
Arnuity
fluticasone (2/2), ICS
Which ICS/LABA can be used for rescue due to its shorter onset of action
symbicort (budosenide + formeterol) and dulera (mometasone + formetorol)
**formetarol
What kind of inhaler is DPI?
diskus, ellipta, pressair, handihaler, flexhaler, neohaler, respiclock
HFA and Respomat is what kind of inheper
MDI
singulair
monteleukast
zileuton moa
inhibits leukotriene formation
boxed warning montelukast
a leukotriene modifying agent, boxed warning neuropsychiatric effects
monteleukast granual administration
can be administered directly in the mouth or dissolved in a small amount of breast milk or formula or mixed with applesauce, carrots, rice, or ice cream. use within 15 min of opening.
theophyline dosing weight
IBW
converting between aminophyline to theophyline
ATM -> multiply by .8 and vice versa
theophyline theraputic range
5-15 mcg/mL
theophyline moa
blocks PDE resulting in an increase in cAMP and bronchodilation
kinetics of theophyline
small increase in dose may result in massive increase in concentration and is metabolized (a substrate of) by CYP1A2 and Cyp3A4, also affected by CHF/liver dz and high protein diet/low carb
theophyline tox
vomiting, arrhythmias, seizures
xolair
omalizumab
what drug is indicatd for allergic asthma in patients with a positive skin test
xolair/omalizumab which is a monocolonial antibody that inhibits IgE binding
boxed warning for omalizumab
anaphylaxis
which ics is preferred in pregnancy
budosenide (pulmicort)
how to administer xolair
omilizuman, sQ in a healthcare setting under supervision due to risk of anaphalaxzis
dupillusumab, mepolizumab, resilizumab, and benralizumab
il receptor antagonsts indicated for eisinophillic phenotype (all il5 except dupilizumab)
resilizumab administration
iv with boxed warning for anaphylaxis
benralizumab
sc every 8 weeks
dupolumab
sc (il4/il3)
order of inhalers
SABA1st, then LABA or LAMA, then ICS (60 seconds in between)
red zone percent
less than 50% of personal best
how to administer MDI
shake for 5 seconds before each spray, prime, breathe in slowly and deeply and hold for 10 seconds. Clean mouthpiece with rinsing once weekly. (for dulera and symbacort just wipe)
Respiclick administration
Do not shake. No button. opening cap loads dose, do not open and close, breathe in deeply (a dpi) and hold for 10 seconds
pulmacort flexhaler administration
Twisting loads dose. a dpi so breathe in deeply and forcefully and no need to prime. An ICS so rinse with water.
advair discus counseling
hold like a hamburger. lever loads dose. a dpi so breathe in quickly and deeply. rinse and spit because ics.
how long should ampules be used after opening
2 weeks