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Asthma/COPD Meds > Asthma & COPD Meds - Clinical Pearls > Flashcards

Asthma & COPD Meds - Clinical Pearls Flashcards

1
Q

Albuterol (ProAir, Ventolin, Proventil)

A
  • Chronic use (>2 times daily) indicates poor control

- Correct use with a holding chamber is equally effective as mebulizer treatment for mild/moderate exacerbations

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2
Q

Levalbuterol (Xopenex)

A
  • Reserved for patients who do not respond to albuterol
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3
Q

Ipratropium (Atrovent HFA)

A
  • Should not be used as first line therapy
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4
Q

Albuterol/Ipratropium (DuoNeb)

A
  • May be used up for up to 3 hours for initial management of severe exacerbation
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5
Q

Methylprednisolone

A
  • Can be used in patients taking ICS before exacerbation

- Can be used as chronic therapy in COPD and Asthma for severe stages

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6
Q

Prednisolone

A
  • Can be used in patients taking ICS before exacerbation

- Can be used as chronic therapy in COPD and Asthma for severe stages

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7
Q

Prednisone

A
  • Can be used in patients taking ICS before exacerbation

- Can be used as chronic therapy in COPD and Asthma for severe stages

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8
Q

Dexamethasone

A
  • Can be used in patients taking ICS before exacerbation

- Can be used as chronic therapy in COPD and Asthma for severe stages

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9
Q

Methylprednisolone Acetate

A
  • Can be used in patients taking ICS before exacerbation
  • Can be used as chronic therapy in COPD and Asthma for severe stages
  • Repository injection for patients with vomiting or adherence issues
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10
Q

Epinephrine

A
  • No proven benefit of systemic use over aerosol

- Added to standard therapy for acute asthma if anaphylaxis/angioedema suspected

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11
Q

Tertbutaline

A
  • No proven benefit of systemic use over aerosol
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12
Q

Magnesium Sulfate IV

A
  • Can consider if patient in life-threatening exacerbation 1 hour after therapy
  • Given via IV infusion
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13
Q

Beclomethasone (QVAR)

A
  • Lowest effective dose should be used
  • Most effective long-term controller class
  • Increased risk of pneumonia in COPD patients
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14
Q

Budesonide (Pulmicort)

A
  • Lowest effective dose should be used
  • Most effective long-term controller class
  • Increased risk of pneumonia in COPD patients
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15
Q

Ciclesonide (Alvesco)

A
  • Lowest effective dose should be used
  • Most effective long-term controller class
  • Increased risk of pneumonia in COPD patients
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16
Q

Fluticasone Propionate (Flovent)

A
  • Lowest effective dose should be used
  • Most effective long-term controller class
  • Increased risk of pneumonia in COPD patients
17
Q

Fluticasone Furoate (Arnuity Ellipta)

A
  • Lowest effective dose should be used
  • Most effective long-term controller class
  • Increased risk of pneumonia in COPD patients
18
Q

Mometasone (Asmanex)

A
  • Lowest effective dose should be used
  • Most effective long-term controller class
  • Increased risk of pneumonia in COPD patients
19
Q

Arformoterol Tartrate (Brovana)

A
  • Increased risk of death as asthma monotherapy
  • Boxed warning: increased hospitalizations in pediatrics
  • Prolonged QT in overdose
  • Not for acute symptoms
20
Q

Formoterol (Perforomist)

A
  • Increased risk of death as asthma monotherapy
  • Boxed warning: increased hospitalizations in pediatrics
  • Prolonged QT in overdose
  • Not for acute symptoms
21
Q

Indacaterol (Arcapta Neohaler)

A
  • Increased risk of death as asthma monotherapy
  • Boxed warning: increased hospitalizations in pediatrics
  • Prolonged QT in overdose
  • Not for acute symptoms
  • Capsules should not be taken orally
22
Q

Olodaterol (Striverdi Respimat)

A
  • Increased risk of death as asthma monotherapy
  • Boxed warning: increased hospitalizations in pediatrics
  • Prolonged QT in overdose
  • Not for acute symptoms
  • Capsules should not be taken orally
23
Q

Salmeterol (Serevent Diskus)

A
    • Increased risk of death as asthma monotherapy
  • Boxed warning: increased hospitalizations in pediatrics
  • Prolonged QT in overdose
  • Not for acute symptoms
  • Capsules should not be taken orally
24
Q

Aclidinium (Turdorza Pressair)

A
  • COPD only
25
Q

Revefenacin (Yupelri)

A
  • COPD only
26
Q

Glycopyrrolate (Seebri Neohaler)

A
  • COPD only
27
Q

Tiotropium (Spiriva)

A
  • COPD only
28
Q

Umeclidinium (Incruse Ellipta)

A
  • COPD only
29
Q

Montekulast (Singulair)

A
  • Less effective than low dose ICS or ICS/LABA in asthma
  • Minor substrate of CYP2C8/9 and 3A4
  • Not for acute relief of symptoms
30
Q

Zafirlukast (Accolate)

A
  • Less effective than low dose ICS or ICS/LABA in asthma
  • Take at least 1 hour before or 2 hours after meals
  • Can increase INR
  • Major substrate/minor inhibitor of CYP2C9
31
Q

Zileution (Zyflo CR)

A
  • Less effective than low dose ICS/LABA in asthma
  • Weal CYPP1A2 inhibitor
  • Take with food
32
Q

Omalizumab (Xolair)

A
  • Boxed warning for anaphylaxis
  • Do not administer >150mg per injection site
  • Dosed by weight and serum IgE
33
Q

Mepolizumab (Nucala)

A
  • Precaution for anaphylaxis

- Available as an autoinjector

34
Q

Reslizumab (Cinqair)

A
  • Boxed warning for anaphylaxis & malignancy

- IV infusion

35
Q

Benralizumab (Fasenra)

A
  • Precaution for anaphylaxis
  • Available as an autoinjector
  • Acts on IL-5 receptors rather than IL-5
36
Q

Dupilumab (Dupixent)

A
  • Precaution for anaphylaxis

- Available as prefilled syringes

37
Q

Roflumilast (Daliresp)

A
  • Monitor LFTs and weight
  • Contraindicated in liver dysfunction
  • Major substrate of CYP3A4 and minor of CYP1A2
38
Q

Cromolyn (Intal)

A
  • Less effective than low dose ICS
39
Q

Theophylline (Theochron)

A
  • Dose related toxicity: seizures, arrhythmia, tachycardia, N/V, headache
  • Major substrate of CYP3A4, CYP1A2, and CYP2E1

Asthma/COPD Meds (7 decks)

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