Asthma/COPD

Question 1

SABA’s

Answer 1

Albuterol
- Proair, Proventil, Ventolin HFA (MDI)
- RespiClick (DPI)
Levalbuterol 
- Xopenex (Nebs)
- Xopenex HFA (MDI)

Question 2

LABA

Answer 2

Salmeterol (Serevent Diskus)- DPI

BID dosing

Question 3

LAMA

Answer 3

Tiotropium (Spiriva Respimat, Handihaler

Respimat only: approved in Asthma
Handihaler (requires 2 puff) + Respimat: approved in COPD

Question 4

ICS (3)

Note: BID dosing

Answer 4

Beclomethasone (Qvar)- MDI

Fluticasone

• Flovent HFA (MDI)
• Flovent Diskus (DPI)
• Arnuity Ellipta (DPI)

Budesonide

• Pulmicort Flexhaler (DPI)
• Pulmicort Respules (Nebs)

Question 5

What are the only 2 MDI’s that don’t need to be shaken?

Answer 5

Qvar and Alvesco

Question 6

ICS class effects?

Answer 6

• Oral candidiasis (thrush), difficulty speaking (dysphonia), cough
• no single ICS product is approved for COPD

Question 7

Omalizumab (Xolair) caveats

Answer 7

• SC dosing every 2 or 4 weeks
• must be given in the hospital
• indicated for moderate-severe persistent allergic asthma at least 6 years old
• use when positive perennial allergen test
• steps 5 to 6

Question 8

Exercise induced bronchospasm treatment

Answer 8

SABA: 5 to 15 minutes before exercise
LABA: 30 minutes before exercise w/ NO ADDITIONAL doses

Question 9

Pregnancy treatment pregnancy

Answer 9

SABA + ICS (budesonide~preferred)

Question 10

Theophylline Caveats

MOA: non-selective phosphodiesterase inhibitor

Answer 10

Trough <2 mcg/mL
Goal therapeutic range: 5-15 mcg/mL
IBW unless TBW < IBW
Drugs that increase: Biaxin, cipro, zafliurast
Drugs that decrease: primidone and carbamazepine