Asthma Flashcards
How do you classify asthma?
What vaccines should an asthma patient get?
What to know about the SABA’s?
intermittent <2 days per week rescue inhaler, >2 days/week but not daily or >1x day mild, moderate is daily, severe is several times per day.
Annual influenza vaccine, Pneumovax 23.
Albuterol(pro air, ventolin, proventil). Levalbuterol(Xopenex) MDI/DPI 1-2 inhalations q4-6h prn, proair respiclick has BBW to milk proteins. Watch for nervousness, tremor, tachycardia, palpitations, cough, hyperglycemia, Low K. MDI, shake well, Levalbuterol is R isomer of albuterol, 200 inhalations/canister except for ventolin HFA which is 60. EIB use 2 inhalations 5 minutes prior to use. Racepinephrine should not be used because it is non selective.
What to know about your LABA?
What to know about the inhaled corticosteroids?
What are your maintenance inhalers?
Salmeterol(Serevent), Increased risk of asthma related deaths, currently receiving but not adequately controlled, long-term asthma control medication, not for acute bronchospasm.
Beclomethasone(QVAR), Budesonide (pulmicort), Fluticasone(Flovent, Arnuity). Can cause dysphonia(difficulty speaking), oral candidiasis(thrush), cough, rinse mouth and throat with warm water, or use a spacer device, QVAR and Alvesco do not need to be shaken, Budesonide is a nebulized solution, Pulmicort Respules with a jet nebulizer.
QVAR(Beclomethasone), Budesonide(Pulmicort flexhaler), Fluticasone(Flovent HFA), Salmeterol, Tiotropium(Spiriva), Budesonide/Formoterol(Symbicort), Fluticasone/Salmeterol(Advair, Airduo), Mometasone/Formoterol(Dulera), Fluticasone/Vilanterol(Breo Ellipta). For COPD only use Salmeterol, Tiotropium(Spiriva handihaler and respimat), Symbicort, Advair diskus, Breo Ellipta).
What to know about LTRA’s?
What to know about Theophylline?
What drugs/conditions can increase theophylline levels?
inhibits Leukotriene 4, Montelukast(Singulair). 10 mg daily in the evening, 1-5 is 4 mg in the evening and 6-14 is 5 mg daily in the evening. Watch for Neuropsychiatric events, Montelukast granules can be put right into the mouth, breast milk or formula or anything else to mix. Use within 15 minutes. Dispense in original container.
Blocks phosphodiesterase. Convert aminophylline to theophylline multiply by 0.8, divide the other way, Therapeutic range is 5-15 mcg/mL, peak. Caffeine. Signs of toxicity are persistent vomiting, arrhythmias, seizures. use IBW.
Cipro, Zafirlukast, Zileuton. CHF or liver disease.
What drugs/conditions can decrease theophylline levels?
What to know about Xolair?
What are the IL-5 receptor antagonists?
Carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone, rifampin, ritonavir, high-protein diet and charbroiled meats.
Omalizumab, Given SC every 2-4 weeks, administer in a healthcare setting, IgE binding so used for allergic asthma. Anaphylaxis BBW.
Used in an eosinophilic phenotype. Mepolizumab(Nucala) SC, Reslizumab(Cinqair) boxed warning for anaphylaxis and given IV, Benralizumab (Fasenra) given SC every 8 weeks.
What is typically used in pregnancy?
What are your asthma zones?
Budesonide.
Green is >80-100% of personal best, Yellow is 50-80%, Red is <50%.
