Asthma & COPD Flashcards
What symptoms differentiate asthma from COPD?
Asthma is characterized by chronic inflammation, and is reversible with beta-agonists by greater than 12%.
(COPD is irreversible)
What does the term “airway remodeling” suggest?
Fibrosis (formation of rigid scar tissue)
Increase in goblet cells (more mucus)
Hypertrophy of smooth muscle cells ( bigger cells)
What is the purpose of a pulmonary function test?
Measures the rate at which the lungs are capable of changing volume.
What are MDIs and DPIs and how do their administrations differ?
MDI: Metered dose inhaler
DPI: Dry Powder Inhaler
Don’t have to touch lips to MDI. With MDIs you administer during large slow breath. They can also be used with a spacer. DPIs require quicker forceful breaths to administer.
With which type of inhaler is priming used, and what is its purpose?
Used on MDIs.
Prime on first use or after long period of disuse.
Shake the inhaler and spray once to ensure medication is activating.
Who would use an nebulizer
Someone who is too old or young to use hand-held device, someone on medicare (medicare pays for nebulizers).
SABA: What does it stand for, how long does it last, what does it do?
What are some common ADRs of SABAs?
SABA: Short-Acting-Beta2-Agonist.
Lasts 4-6 hours
Relaxes smooth muscle, no anti-inflammatory properties.
ADRs:
Tachycardia, shakiness, tachyphylaxis with overuse
LABA: What does it stand for, how long does it last, what does it do?
LABA: Long-acting-Beta2-Agonist.
Lasts 12 hours.
Stimulates B2 receptors, no anti-inflammatory properties.
ICS: What does it stand for, how long does it take to work, what does it do?
ICS: Inhaled Corticosteroid. Preferred long-term therapy. Anti-inflammatory. Start improving after 1-2 weeks, max improvement 4-8 weeks.
SABAs, LABAs, ICSs. Provide a use case for each medication, when should it and should it not be used?
SABAs: Everyone with asthma should have one, no one should use it for long term therapy. Use for acute exacerbation in conjunction with long term solution.
LABAs: Don’t use for acute exacerbation, don’t use on its own. LABAs are strictly adjunct therapy with ICSs.
ICS: Preferred long-term therapy, can be used alone, concomitantly with LABAs, or supplemented by SABAs
“Um, can I speak to the pharmacist? I’ve been taking this ICS for 6 months, but the internet told me not to take a corticosteroid for more than 4 weeks. am I going to grow a hump!?
If not, what ADRs can I expect?”
Don’t worry, adverse reactions from corticosteroids are significantly reduced when inhaled as compared to systemic administration. You don’t need to worry about those scary side effects with ICSs.
Common ADRs with ICSs are oropharyngeal candidiasis (thrush) and Dysphonia (different sounding voice)
Your regional manager has decided to stock medications according to class. What medications do you put on the SABA shelf?
Albuterol: (ProAir, Ventolin, Proventil)
Levalbuterol (Xopenex)
What medications do you stock the LABA shelf with?
Salmeterol (Serevent)
Formoterol (Foradil)
What medications go on the ICS shelf?
Which one also comes in a nebulizer solution?
Beclomethasone (QVAR)
Budesonide (Pulmicort)
Fluticasone (Flovent)
Budesonide is the only nebulizer solution ICS.
You also have a shelf for combination asthma meds. Which ones go here?
Advair (fluticasone + salmeterol)
Symbicort (budesonide + formoterol)
Dulera (mometasone + formoterol)
