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Therapeutics > Asthma > Flashcards

Asthma Flashcards

1
Q

in what resp disorder is there a change in volume of air the lung can hold?

A

restrictive disorders

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2
Q

what is obstructive resp disorders?

A

asthma & copd

  • lead to a decrease in airflow
  • *no change in volume of air the lungs can hold
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3
Q

when are most cases of asthma diagnosed?

A

<10 years of age

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4
Q

what is the definition of asthma?

A

a chronic inflammatory disorder

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5
Q

what are the symptoms of asthma?

A

non-specific

-cough (may/may not be productive)

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6
Q

what does the inflammation in asthma cause?

A

recurrent episodes of coughing (particularly at night or early in the morning), wheezing, breathlessness, and chest tightness

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7
Q

do asthma symptoms come and go and what are they dependent on?

A

symptoms come and go and are dependent on environment (i.e. cats)
-COPD sx’s are always there

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8
Q

patients with asthma symptoms need to be referred to what?

A

spirometry

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9
Q

what is the hallmark feature of asthma?

A

Airflow obstruction that is at least partially <b>reversible</b>

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10
Q

what does spirometry show in asthma? (what is FEV1?)

A

FEV1 of >200ml <b>and</b>

≥12% increase from baseline measure after SABA (e.g., albuterol)

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11
Q

what risk factors do people with have?

A

atopic conditions (i.e. eczema, allergic rhinitis, etc.)

IgE is the antibody

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12
Q

what are inhaled allergens?

A

-pollen, cockroaches, animal dander, dust mites, damp rooms (mold)

<b>IgE antibodies - specific to the type of allergen</b>

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13
Q

what are inhaled irritants?

A

-perfumes, tobacco smoke, cleaning agents, airborne chemicals, wood burning stoves

universal triggers NOT associated w/IgE

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14
Q

what are the preferred agents to use for inflammatory/immune response of asthma?

A

inhaled corticosteroids

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15
Q

what are the monoclonal antibody medications for asthma?

A

Xolair (omalizumab), Cinqair (reslizumab), Nucala (mepolizumab)

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16
Q

what is the mechanism of Cinquair (reslizumab) and Nucala (mepolizumab)?

A

block IL-5 and prevent the activation of eosinophils

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17
Q

what is the mechanism of Xolair (omalizumab)?

A

specifically binds to IgE and reduces serum IgE to <5% to what it was at baseline and prevents cascade from occurring

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18
Q

are the monoclonal antibodies first or last line meds for asthma?

A

LAST LINE
-for patients that are not responding to their inhaled corticosteroids, using bronchodilator frequently, having frequent flare ups and have allergic asthma worst of the worst patients

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19
Q

what is the indication for Xolair (omalizumab)?

A
  • 6+ years
  • mod-severe asthma not controlled on ICS
    • skin test or perennial allergies (animal dander, cockroaches, indoor molds, dust mites)
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20
Q

what is the indication for Cinqair (reslizumab)?

A

18+ years w/severe asthma esoinophilic phenotype

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21
Q

what is the indication for Nucala (mepolizumab)?

A

12+ years severe asthma w/an eosinophilic phenotype

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22
Q

patients with asthma should be referred for what testing?

A

allergy testing

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23
Q

how do you reduce exposure to animal dander?

A
  • Keep animal(s) out of the bedroom
  • Seal (filter) air ducts leading to bedroom
  • HEPA Filters
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24
Q

how do you reduce exposure to dust mites?

A

<b>-Reduce humidity to <50% - dust mites can’t survive if it’s too dry</b>

  • Remove carpets if possible
  • Wash bedding weekly (≥130oF)
  • Encase mattress, pillow, and box springs in an allergen impermeable cover
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25
Q

how do you reduce exposure to cockroaches?

A
  • Use poison bait or traps

- Do not leave food or garbage exposed

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26
Q

how do you reduce exposure to pollens & outdoor molds?

A
  • Use air conditioning

- Stay indoors when pollen counts are high

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27
Q

how do you reduce exposure to indoor molds?

A
  • Fix all water leaks
  • Clean moldy surface
  • Reduce humidity to <50%
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28
Q

what are common asthma triggers/exacerbating factors?

A
  • GERD
  • Rhinitis (use inhaled intranasal steroids)
  • Exercise
  • Sulfites
  • Beta-blockers (including eye drops)
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29
Q

according to the EPR 3, if you have intermittent asthma, what txt do you need?

A

Intermittent asthma – not very symptomatic (have occasional issue and need albuterol; exercise induced asthma)

<b>-don’t need to use controller therapy (only use bronchodilators)</b>

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30
Q

according to the EPR 3, if you have persistent asthma, what txt MUST you use?

A

MUST use controller therapy (preferred therapy is inhaled corticosteroid)

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31
Q

what 2 domains are assessed when staging severity?

A

impairment & risk

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32
Q

what is the impairment domain when staging severity?

A
  • Frequency & intensity of symptoms
  • Functional limitations
  • Effect on quality of life
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33
Q

what is the risk domain when staging severity?

A
  • Future exacerbations
  • Loss of pulmonary function
  • Risk of adverse effects from medication
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34
Q

what are the 2 treatment goals of asthma?

A
  • reduce impairment

- reduce risk

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35
Q

what is the rule of 2 for treatment of asthma?

A

<b>Factors that suggest asthma is not controlled:</b>

-Using SABA >2 days/week, or waking up >2x/month, or using >2 canisters of SABA/year

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36
Q

what txt goals are for reducing impairment of asthma?

A
  • Prevent asthma symptoms
  • Require infrequent use (<2 days a week) of inhaled SABA
  • Maintain (near normal pulmonary function
  • Maintain normal activity levels
  • Meet the patient’s expectations with asthma care
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37
Q

what txt goals are for reducing risk of asthma?

A
  • Prevent recurrent asthma exacerbations
  • Prevent loss of lung function
  • Provide optimal pharmacotherapy
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38
Q

what do peak flow meters measure?

A
  • Measures how well lungs are able to expel air (Peak expiratory flow rate or PEFR – L/min)
  • Not as sensitive as a spirometer, but pts can use it to measure their <i>lung fxn at home</i>

-pts set their personal best over 2-3 week period & record their highest value

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39
Q

what reading do pts record when using a peak flow meter?

A

their HIGHEST reading (not the avg.)

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40
Q

what the clinical utility of the peak flow meters?

A
  • Early indicator for loss of control
  • May help patients identify triggers
  • Determine how well regimen is working
  • May help indicate when to seek emergency care
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41
Q

after a personal best with the peak flow meter is established, what is the use?

A
  • Use at least every morning upon awakening
  • Use before taking any asthma medication
  • May use after taking a rescue medication to determine impact
  • Use as directed by PCP*** (i.e. action plan)
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42
Q

what are the 3 zones for asthma action plans?

A

80-100% of Personal Best = Green zone

50-80% of Personal Best = Yellow zone

<50% of Personal Best = Red zone

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43
Q

what does the green zone indicate?

A

80-100% of Personal Best

  • Continue with regular activities
  • Follow your maintenance medication plan (no changes)
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44
Q

what does the yellow zone indicate?

A

50-80% of Personal Best

  • May require medication adjustment
  • Contact health care provider
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45
Q

what does the red zone indicate?

A

<50% of Personal Best

-Emergency – Dial 911
Contact Health Care Provider -> <b>going to the hospital!!</b>

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46
Q

if peak flow reading increases 20% or more after using a SABA, what should you consider?

A

adjusting controller therapy

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47
Q

how frequently should you follow up for asthma?

A
  • Every 2-6 weeks while gaining control
  • Every 1-6 months once controlled
  • At 3 month intervals if a reduction in therapy is anticipated
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48
Q

what do you assess at <u>every</u> follow-up visit for asthma?

A

-Asthma control
-Medication technique
-Asthma action plan
<b>-Medication adherence</b>
-Patient related concerns

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49
Q

what are the top 3 risk factors for death to refer a pt for?

A
  • Prior severe exacerbation (Intubation or ICU Admission)
  • 2+ Hospitalizations or 3+ ED visits past year
  • > 2 canisters of SABA per month
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50
Q

when do you consider an asthma specialist?

A

-Hospitalized
-Difficulties achieving or maintaining control
(Step 4 care+ is required;
Step 3 care+ for kids 0-4 years)
-If immunotherapy is considered
-If additional testing is indicated
-If >2 oral steroid bursts in past year

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51
Q

what are the criteria for stepping down a pts therapy?

A
  • Must be “well controlled” for at least 3 months
  • Reduction should be gradual (i.e. decrease ICS by 25-50%)
  • Must monitor closely (e.g. 2-6 weeks)
  • Consider history of prior exacerbations
  • Remember use the least amount of medication needed for control
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52
Q

what should you provide to all asthma patients?

A

asthma action plans

-Tells patient what to do if they are starting to lose control

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53
Q

what is in an asthma action plan?

A
  1. Daily management
    - Controller medication
    - Environmental control measures
  2. Managing worsening asthma
    - How to adjust medication
    - When to see medical care
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54
Q

what are the 2 asthma medication regimens?

A

maintenance and rescue

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55
Q

what is the maintenance regimen for asthma?

A

<b>control inflammation to some extent</b>

  • inhaled corticosteroids
  • long acting B2-agonsts
  • long acting anticholinergics
  • leukotriene antagonists
  • theophylline
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56
Q

what 2 medication categories in the asthma maintenance regimen, don’t target inflammation but are in combo products?

A

Long acting B2-agonists (help w/bronchodilation but not inflammation)

Long acting anticholinergics (help w/bronchodilation but not inflammation)

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57
Q

what is the rescue regimen for asthma?

A

<b>quick acting agents to get out of bronchoconstricted state</b>

-Short acting B2-agonists
-***Short acting anticholinergics
(NOT approved or recommended for rescue in asthma)

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58
Q

what do MDIs have that DPIs don’t have?

A

a propellant (HFA) that helps push medicine out

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59
Q

what are the advantages of MDIs?

A
  • Less time (<1 min)
  • Small/portable
  • No drug preparation
  • Mechanical ventilation
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60
Q

what are the disadvantages of MDIs?

A

<b>-Technique/timing essential</b>

  • Freon effect (< w/HFA)
  • Requires breath hold
  • Oropharyngeal deposition
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61
Q

what are the advantages of DPIs?

A

-Less time (<1 min)
<b>-Less technique/timing</b>
-Small/portable
-Usually less money than MDI counterpart

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62
Q

what are the disadvantages of DPIs?

A
  • Some dose preparation
  • Requires breath hold
  • Requires fast inhalation
  • Oropharyngeal deposition
  • No mechanical ventilation
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63
Q

what are the advantages of nebulizers?

A
  • Minimal technique/timing
  • No breath hold required
  • Mechanical ventilation
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64
Q

what are the disadvantages of nebulizers?

A
  • More expensive
  • Drug preparation required
  • Admin time (5-15min)
  • Bulky and less portable
  • Requires power source
  • Must clean regularly
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65
Q

what is important when using an MDI?

A

how the pt holds it
-must hold in an “L” position (mouth piece down)

exhaling completely

breathing in deeply and slowly for 3-5 secs while depressing canister

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66
Q

who are valve holding chambers good for?

A

for pts w/problems coordinating and inhaling easier for patients

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67
Q

what do the valve holding chambers do?

A

Valves hold the medication in there, so gives you a little extra time to inhale
(vs spacers, just gives you space and doesn’t hold anything)

<b>valves are better</b>

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68
Q

are MDIs & DPIs compatible with valve holding chambers & spacers?

A

only MDIs are

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69
Q

if a kid uses a facemask, what should the parents make sure to do?

A

make sure kids wash around their mouth b/c it will lead to atrophy of skin around mouth

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70
Q

what is it about valve holding chambers (VHC)?

A
  • Requires less coordination to use
  • Improves drug deposition into lungs
  • Decreases oropharyngeal deposition
  • Consider a face mask in child < 4 years old
  • Use one actuation per inhalation!!!!!
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71
Q

what should every patient with asthma have?

A

a SABA

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72
Q

what is quick relief medication for asthma?

A

a SABA

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73
Q

what is the mechanism for SABAs?

A

increases adenyl cyclase -> increases cAMP which activates PKA -> Ca++ leaves the cell -> smooth muscle relaxes

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74
Q

when do pts use SABAs?

A

-Acute symptoms and exacerbations

<b>-Treatment of choice for exercise induced asthma</b>

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75
Q

what medication is the treatment of choice for exercise induced asthma?

A

SABAs

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76
Q

what is recommended for cleaning of SABAs?

A

Weekly cleaning is recommended

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77
Q

what is NOT recommended when using SABAs?

A

Regularly scheduled, daily, chronic use is NOT recommended

78
Q

what is albuterol?

A

a SABA

79
Q

what is levalbuterol?

A

SABA

brand name = Xopenex HFA

80
Q

what is the respiclick device?

A

a DPI

81
Q

what is the indication for the respiclick device?

A
  • Treatment or prevention of bronchospasm in 4 years+

- Prevention of exercise-induced bronchospasm in 4 years+

82
Q

what are the features of the respiclick device?

A
  • Dose counter (even numbers only)
  • “Click” open ~ loads dose
  • No priming or cleaning required
  • Breath activated device (Dry Powder)
83
Q

are nebulizers preferred in a conscious pt?

A

NO! they are NEVER preferred in a conscious pt (no added benefit)

-will lean towards MDI & VHCs more w/outpatient/discharging pts

84
Q

what percentage of albuterol is pre-mixed w/saline?

A

albuterol sulfate 0.083% (2.5mg/3ml)

-for albuterol sulfa 0.5% you must co-prescribe saline with it

85
Q

what is beclomethasone HFA?

A

ICS

86
Q

what is budesonide DPI?

A

ICS

87
Q

what is budesonide Neb?

A

ICS

88
Q

what is flunisolide HFA?

A

ICS

89
Q

what is fluticasone HFA?

A

ICS

90
Q

what is mometasone DPI?

A

ICS

91
Q

what is ciclesonide HFA?

A

ICS

92
Q

when are inhaled corticosteroids (ICS) used?

A

Preferred long-term control therapy for all ages

93
Q

how often should you clean ICS?

A

weekly cleaning

94
Q

what should a pt do after using an ICS?

A

rinse mouth and expectorate after using

  • use prior to brushing teeth
  • wash around child’s mouth if using a mask!
95
Q

mild-mod asthma is managed with what dose of ICS?

A

low-medium ICS doses

96
Q

what do ICS improve and provide reduced need of?

A

Improves lung function and reduced need for quick relief medications

97
Q

what is fluticasone propionate?

A

ICS

98
Q

what is fluticasone furoate?

A

ICS

99
Q

what are the adrs of ICS?

A

<b>-oral candidiasis</b>
<b>-dysphonia</b>
<b>-reflex cough and bronchospasm</b>
-growth rates are variable in children

100
Q

how do you reduce the oral candidiasis and dysphonia - adrs of ICS?

A

spacer, rinsing mouth, decrease dose/freq (if possible)

101
Q

how do you reduce the reflex cough and bronchospasm air of ICS?

A

Spacer, decrease rate of inspiration, pre-treat with albuterol

102
Q

what is the only pregnancy category B ICS? when should you use it?

A

<b>budesonide</b> (Pulmicort Flexhaler)

-if initiating therapy & pt is pregnant then may use budesonide, but don’t change if pt is on budesonide and then becomes pregnant

103
Q

what is the exception for cleaning MDI weekly?

A

Aerospan (flunisolide) b/c has spacer

104
Q

what is annuity ellipta? chemical name? clinical pearls?

A

DPI
Chemical name: fluticasone furoate

Clinical pearls:

  • 1st once daily ICS
  • cleaning not required
  • unable to double load dose
  • discard 6 wks after opening tray
105
Q

what are the drawbacks of annuity ellipta?

A
  • See DPI limitations

- Dosing may be less flexible

106
Q

what is armonair respiclick?

A

DPI
Chemical Name: Fluticasone propionate (ICS)

Clinical Pearls:

  • 12+ Asthma maintenance
  • Not interchangeable with Flovent!
  • Unable to double load dose
  • Discard 30 days after opening
107
Q

what are the oral corticosteroids?

A
  • methylprednisolone
  • prednisolone
  • prednisone
108
Q

when should you burst a patient?

A

when a patient is losing control & in the yellow zone

109
Q

what does to burst a patient mean?

A

a temporary increase in anti-inflammatory therapy -> to reestablish asthma control

110
Q

what MUST long acting B2-agonists be used with?

A

MUST BE used with anti-inflammatory medications (ICS) for long-term control of asthma symptoms

111
Q

what can long acting B2-agonist be used to prevent?

A

Can be used to prevent exercise-induced bronchospasm (30min-1hr before activity)

-but PREFERRED for exercise-induced bronchospasm is SABA

112
Q

what should long acting B2-agonists NOT be used to treat?

A

Not to be used to treat acute symptoms or exacerbations

113
Q

what is a long acting B2-agonist (LABA)?

A

salmeterol (Servant Diskus)

114
Q

what is Breo Ellipta? Chemical name? Clinical pearls? drawbacks?

A

DPI
<b>ONE INHALATION A DAY!!!</b>
Chemical Name: fluticasone furoate + vilanterol

Clinical Pearls:
<b>-1st once daily</b>/ICS/LABA Combo
-Cleaning not required
-Unable to double load dose
-Discard 6 weeks after opening tray

Potential Drawbacks:
-See DPI limitations

**Only strength FDA approved for COPD

115
Q

how often do you inhale bro ellipta?

A

ONE INHALATION A DAY

116
Q

what is Airduo Respiclick? Chemical name? Clinical pearls?

A

DPI

Chemical Name: fluticasone propionate + salmeterol
(ICS + LABA)

Clinical Pearls:

  • 12+ Asthma maintenance not controlled on ICS alone
  • Not interchangeable with Advair!
  • Unable to double load dose
  • Discard 30 days after opening
117
Q

what is a long acting antimuscarinic (LAMA)?

A

Spiriva Respimat (tiotropium)

118
Q

when do you use Spiriva Respimat (tiotropium) (long acting antimuscarinic?

A

<b><u>Add on txt for pts with a history of exacerbations (need ICS onboard also)</u></b>
-Good for patients that are on LABA and ICS and aren’t responding then add on Spiriva

<b>Once-daily, maintenance txt of asthma in pts 6+ years</b>

119
Q

what are the clinical pearls of Spiriva Respimat (tiotropium) (long acting antimuscarinic)?

A
  • EXPENSIVE
  • Expires 90 days after loading
  • Dose = Two half turns once daily
  • Spiriva (tiotropium) Respimat is only LAMA approved for asthma
120
Q

what are drawbacks of Spiriva Respimat (tiotropium) (long acting antimuscarinic)?

A
  • Initial load and priming

- Coordination b/w dose release and inhalation

121
Q

is theophylline used a lot?

A

Not used must – many DDIs, monitoring, narrow therapeutic index

122
Q

when do you use theophylline?

A
  • Alternative therapy for Step 2 care (not preferred)

- Adjunctive therapy with ICS in patients ≥ 5 years old

123
Q

what must you monitor with theophylline?

A

Monitor serum theophylline concentration (5-15mcg)

124
Q

what is theophylline similar to?

A

it’s similar to caffeine

125
Q

what CYP enzyme does Theophylline interact with? what about smoking?

A

DDIs with CYP1A2

<b>Smoking induces metabolism!</b>
-If pt stops smoking -> theophylline dose can go very high and then need to reduce their dose

126
Q

what are dose-related acute toxicities of theophylline?

A
  • Tachyarrhythmias
  • Central nervous system stimulation
  • Seizures
  • Hyperglycemia and hypokalemia
127
Q

what is the MOA of theophylline?

A

Bronchodilation smooth muscle relaxation from phosphodiesterase inhibition and possible adenosine antagonism

128
Q

what inhibitors does theophylline interact with and what happens to the levels of theophylline?

A

<b>Inhibitors will INCREASE theophylline levels</b>

  • ETOH
  • Zileuton
  • Cimetidine
  • Zafirlukast
  • Propranolol
  • Ciprofloxacin
129
Q

what inducers does theophylline interact with and what happens to the levels of theophylline?

A

<b>Inducers will DECREASE theophylline levels</b>

  • Smoking
  • Rifampin
  • Phenytoin
  • Omeprazole
  • Phenobarbital
  • Carbamazepine
130
Q

what are leukotrienes?

A
  • Produced and released from multiple sources
  • Contract smooth muscle (potent bronchoconstrictors – in asthma want to block leukotrienes)
  • Increase vascular permeability and mucus secretions
131
Q

when do you use leukotriene inhibitors?

A
  • Alternative therapy for Step 2 care (not preferred)

- Adjunctive therapy with ICS

132
Q

what are the names of the leukotriene inhibitors?

A
  • montelukast (Singulair) - preferred
  • zafirlukast (Accolate)
  • zileuton (Zyflo and Zyflo CR)
133
Q

where do montelukast (Singulair) & zafirlukast (Accolate) block leukotrienes?

A

<b>block at receptor level (LTRA)</b>

134
Q

where does zileuton (Zyflo) block leukotrienes?

A

<b>blocks production (5-lipoxygenase inhibitor)</b>

135
Q

when must you take zafirlukast (Accolate)? what is its MOA? what is CYP is it an inhibitor of & what does it increase?

A

-Selective competitive inhibitor of LTD4 and LTE4 receptors

<b>-Take at least 1 hour before or 2 hours after meals (b/c food can effect its bioavailability)</b>

<b>-Competitive inhibitor of the CYP2C9 (increases warfarin levels)</b>

136
Q

what is the preferred leukotriene inhibitor?

A

montelukast (Singulair)

137
Q

how often do you administer montelukast (Singulair)? what is it a selective competitive inhibitor of?

A

-Selective competitive leukotriene D4 inhibitor

<b>-Administer once daily at bedtime</b>

138
Q

what must you monitor for zileuton (Zyflo)?

A

liver fxn for liver toxicity!

139
Q

what is the name of the drug that’s a mast cell stabilizer?

A 
cromolyn sodium (Intal)
-Nebulizer formulation ONLY
140
Q

what formulation does cromolyn sodium (Intal) come in?

A

Nebulizer ONLY

141
Q

when is cromolyn sodium (Intal) used? how is it dosed?

A
  • Long-term prevention of symptoms in mild persistent asthma
  • Preventative treatment prior to exercise or known allergies

-Dosed 3-4x/day

142
Q

what are the adrs of cromolyn sodium?

A
  • Bad taste – metallic taste

- Cough/irritation

143
Q

what is an add of leukotriene inhibitors?

A

weird dreams - just monitor if occur

144
Q

what vaccines must everyone with asthma get?

A

Everyone needs yearly <b>influenza vaccination</b>

  • trivalent or quadrivalent inactivated influenza vaccine
  • Inactivated influenza vaccine, trivalent, High Dose ≥ 65 years

Everyone needs <b>Pneumococcal vaccine</b>

145
Q

what is Proventil HFA, ProAir RespiClick, ProAir HFA, Ventolin HFA?

A

Albuterol (SABA)

146
Q

what is QVAR?

A

ICS

147
Q

what is Pulmicort Flexhaler?

A

ICS

148
Q

what is Pulmicort Respules?

A

ICS

149
Q

what is Aerospan?

A

ICS

150
Q

what is Flovent HFA/Flowvent Diskus?

A

ICS

151
Q

what is Asmanex Twisthaler?

A

ICS

152
Q

what is Alvesco?

A

ICS

153
Q

what is Flovent?

A

ICS

154
Q

what is Arnuity?

A

ICS

155
Q

what is salmeterol?

A

LABA

156
Q

what is (Servant Diskus)?

A

LABA

157
Q

what is fluticasone + salmeterol

A

ICS + LABA

158
Q

what is Advair Diskus?

A

ICS + LABA

159
Q

what is Advair HFA?

A

ICS + LABA

160
Q

whites budesonide + formoterol?

A

ICS + LABA

161
Q

wat is Symbicort HFA?

A

ICS + LABA

162
Q

what is mometasone + formoterol?

A

ICS + LABA

163
Q

what is Dulera HFA?

A

ICS + LABA

164
Q

what is Spiriva Respimat?

A

LAMA

165
Q

what is tiotropium?

A

LAMA

166
Q

what is beclomethasone HFA generic name and drug?

A

QVAR (ICS)

167
Q

what is budesonide DPI generic name and drug?

A

Pulmicort flexhaler (ICS)

168
Q

what is QVAR generic name?

A

beclomethason (ICS)

169
Q

what is pulmicort flexhaler?

A

budesonide (ICS)

170
Q

what is budesonide Neb?

A

pulmicort respules (ICS)

171
Q

what is pulmicort respules?

A

budesonide Neb (ICS)

172
Q

what is flunisolide HFA?

A

Aerospan (ICS)

173
Q

what is Aerospan?

A

flunisolide (ICS)

174
Q

what is fluticasone HFA?

A

Flovent HFA/Flovent diskus

175
Q

what is Flovent HFA/Flovent diskus?

A

fluticasone HFA

176
Q

what is mometasone DPI?

A

Asmanex Twisthaler

177
Q

what is Asmanex Twisthaler?

A

mometasone DPI (ICS)

178
Q

what is ciclesonide HFA?

A

Alvesco (ICS)

179
Q

what is Alvesco?

A

ciclesonide HFA (ICS)

180
Q

what is serevant diskus?

A

salmeterol (LABA)

181
Q

what is salmeterol?

A

serevant diskus (LABA)

182
Q

what is advair diskus/HFA?

A

fluticasone + salmeterol (ICS + LABA)

183
Q

what is fluticasone + salmeterol?

A

advair diskus/HFA (ICS + LABA)

184
Q

what is symbicort HFA?

A

budesonside + formoterol (ICS + LABA)

185
Q

what is budesonide + formoterol?

A

symbicort HFA (ICS + LABA)

186
Q

what is dulera HFA?

A

mometasone + formoterol (ICS + LABA)

187
Q

what is mometasone + formoterol?

A

dulera HFA (ICS + LABA)

188
Q

what is breo ellipta?

A

fluticasone furoate + vilanterol (ICS + LABA)

189
Q

what is fluticasone furoate + vilanterol?

A

breo ellipta (ICS + LABA)

190
Q

what is spiriva respimat?

A

tiotropium (LAMA)

191
Q

what is tiotropium?

A

spiriva respimat (LAMA)

Therapeutics (6 decks)

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