asthma

Question 0

What are the two LTRA’s available for use in treating asthma?

Answer 0

• zafirlukast (Accolate)

- montelukast (Singulair)

Question 1

Abreviation for leukotriene receptor agonist

Answer 1

What does LTRA stand for?

Question 2

Montelukast may also inhibit symptoms of allergic rhinitis becuase…

Answer 2

leukotrienes are also released from the nasal mucosa during allergen exposure.

Question 3

Methylxanthines have declined in the importance in the treatment of asthma, but some patients may still benefit from the use of…..

Answer 3

theophylline

Question 4

Leukotriene receptor agents work by…..

Answer 4

decreasing the inflammation in the lungs with people with asthma

Question 5

What is the most commonly prescribed beta2 receptor agonist?

Answer 5

-albuterol (Ventolin, Proventil)

Question 6

What is the trade name for levalbuterol?

Answer 6

What is the generic name for Xopenex?

Question 7

What is the trade name for salmeterol?

Answer 7

What is the generic name for Serevent?

Question 8

The perfect bronchodilator would work only on the beta2 recceptors in the lungs and have no other effects, however other systems affected include?

Answer 8

CV, skeletal muscles, and the CNS

Question 9

What is the approximate duration of a long acting beta agonist?

Answer 9

About 12 hours

Question 10

long acting beta agonists must be used in conjunction with?

Answer 10

A steroid because of the risk of adverse reactions, particularly in children.

Question 11

What are the long acting beta agonist drugs?

Answer 11

• salmeterol
• formoterol
• bambuterol

Question 12

Short acting beta agonists typically have an onset of 3-5 minutes and a duration of?

Answer 12

4-6 hours

Question 13

What is the route, dose, and frequency for levalbuterol (xopenex)?

Answer 13

liquid form in a nebulizer, 0.63-1.25 mg, q6-8 hours

Question 14

What is the trade name for salmeterol?

Answer 14

What is the generic name for Serevent?

Question 15

beta agonists can affect the muscles by…..

Answer 15

causing shakiness, and cramping of the hands legs and feet.

Question 16

For adults 12 years and older, what is the preferred treatment for intermittent asthma?

Answer 16

This is step 1 and it is a SABA PRN

Question 17

For adults 12 and older, what is the preferred treatment for mild persistent asthma?

Answer 17

This is step 2 and is a low dose ICS and a SABA PRN

Question 18

For adults 12 and older, what is the preferred treatment for step 3 moderate persistent asthma?

Answer 18

Either a medium-dose ICS or a low-dose ICS in conjunction with a LABA

Question 19

For adults 12 and older, what is the preferred treatment for step 4 moderate persistent asthma?

Answer 19

A medium dose ICS with a LABA

Question 20

When considering preferred versus alternative treatment plans in asthma, use of a LABA is not considered until?

Answer 20

beginning in step 3

Question 21

In adults 12 and older, what is the preferred method of treatment for step 5 severe persistent asthma?

Answer 21

A high dose ICS with a LABA

Question 22

In adults 12 and older, what is the preferred method of treatment for step 6 severe persistent asthma?

Answer 22

A high dose ICS, LABA, and an oral corticosteroid

Question 23

What is a leukotriene agonist?

Answer 23

A leukotriene antagonist (sometimes referred to as a leukast) is a drug that inhibits leukotrienes, which are fatty compounds produced by the immune system that cause inflammation in asthma and bronchitis, and constrict airways.

Question 24

LTRA’s have been shown to….

Answer 24

improve asthma symptoms, reduce asthma exacerbations and limit markers of inflammation such as eosinophil counts in the peripheral blood and bronchoalveolar lavage fluid. This demonstrates that they have anti-inflammatory properties.

Question 25

In adults 12 and older, what is the alternative treatment for step 2 mild persistent asthma?

Answer 25

A mast cell stabilizer, LTRA, or theophylline

Question 26

In adults 12 and older, what is the alternative treatment for step 3 moderate persistent asthma?

Answer 26

A low dose ICS and LTRA, theophylline, or zileuton

Question 27

In adults 12 and older, what is the alternative treatment for step 4 moderate persistent asthma?

Answer 27

A medium dose ICS and LTRA, theophylline, or zileuton

Question 28

What is the therapeutic action of a leukotriene receptor antagonist?

Answer 28

It selectively and competitively blocks the receptor that inhibits leukotriene formation, thus blocking many of the signs and symptoms of asthma - neutrophil and eosinophil migration, neutrophil and monocyte aggregation, leukocyte adhesion, increased capillary permeability, and smooth muscle contraction. These actions contribute to inflammation, edema, mucus secrretion, and bronchoconstriction associated with the sighs and symptoms of asthma.

Question 29

For patients 15 years and older, what is the dosing of montelukast?

Answer 29

10mg po qHS w/o regard to food

Question 30

What is the trade name for montelukast?

Answer 30

What is the generic name for Singulair?

Question 31

LTRA’s have anti-inflammatory properties however are not…

Answer 31

steroids. They are a second line of therapy when ICS can not or will not be used, or if the ICS dose can not be increased to manage symptoms.

Question 32

What are the inhaled corticosteroids?

Answer 32

• beclomethasone HFA
• budesonide DPI
• flunisolide
• flunisolide HFA
• fluticasone HFA MDI (Flovent inhaler)
• fluticasone DPI (Flovent diskus)
• mometasone DPI

Question 33

What is the drug class, and available doses of Advair?

Answer 33

fluticasone (ICS) and salmeterol (LABA)

• 100/50
• 250/50
• 500/50