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Naplex Drug Card > Asthma Drugs > Flashcards

Asthma Drugs Flashcards

1
Q

As needed
Reduces exacerbation risk compared SABA alone
Max dose of fast acting LABA component: 72 mcg

A

ICS + Formeterol

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2
Q

As needed
Quickly reverses bronchodilation

A

SABA

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3
Q

IV or PO used for exacerbation or asthma that is difficult to control

A

Systemic steroids

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4
Q

Reliever available OTC but not part of GINA guidelines

A

Inhaled epinephrine

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5
Q

Can be used in combination with SABA to control exacerbation

A

SAMA

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6
Q

Preferred anti-inflammatory and first line agent for all asthma patients

A

ICS

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7
Q

Preferred add-on to ICS but avoid as monotherapy

A

LABA

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8
Q

Can be used as add-on if LABA cannot be used
Can be added to an ICS-LABA
Preferred in children

A

Oral Leukotriene Receptor Antagonist

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9
Q

As add-on to ICS-LABA if history of excerbation

A

LAMA

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10
Q

For specific asthma type

A

Monoclonal antibodies

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11
Q

Not preferred agent due to increased ADR, DI and need for level monitoring

A

Theophylline

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12
Q

Monoclonal for severe allergic asthma

A

Omalizumab

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13
Q

For severe eosinophollic asthma

A

Mepolizumab
Reslizumab
Benralizumab
Dupilumab

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14
Q

Step 1 treatment

A

Prn ICS-Formoterol

Or

Prn SABA+ low-dose ICS

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15
Q

Step 2 treatment

A

Prn ICS-Formoterol

Or

SABA (reliever) and Low dose ICS (controller)

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16
Q

Step 3 treatment

A

Low dose ICS-Formoterol (R and C)

Or

SABA (R) and low dose ICS-LABA (C)

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17
Q

Step 4 treatment

A

Low dose ICS-Formoterol (R) and medium dose ICS-Formoterol (C)

Or

SABA (R) and medium dose ICS-LABA (C)

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18
Q

Step 5 treatment

A

Referral

Low dose ICS-Formoterol (R) and high dose ICS-Formoterol (C)

Or

SABA (R) and high dose ICS-LABA (C)

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19
Q

Maintain current regemen
Or
Step down if at least 3 months of control

A

Well-controlled

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20
Q

Step up 1 step

A

Partly controlled

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21
Q

Step up 1-2 steps +/- short course oral steroids

A

Uncontrolled

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22
Q

Proair (HFA, Respiclick, Digihaler)

Proventil HFA

Ventolin HFA

A

Albuterol

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23
Q

1-2 puffs every 4-6 hr prn

A

Albuterol

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24
Q

Available PO but not recommended

A

Albuterol

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25
Q

Albuterol dose/inhalation

A

90 mcg

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26
Q

R-isomer of albuterol

A

Levoalbuterol

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27
Q

Shake SABA HFA products

A

Yes

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28
Q

Xopenex (Concentrate, HFA)

Xopenex

A

Levoalbuterol

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29
Q

SABA not used due to non-selectivity for beta receptors

A

Inhaled epinephrine

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30
Q

Asthmaneferin

A

Inhaled epinephrine

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31
Q

Warning:

CVD
Glaucoma
Hyperthyroidism
Hyperglycemia
Seizures

A

Beta agonist

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32
Q

Serevent diskus (DPI)

A

Salmeterol

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33
Q

Increased risk of asthma related death and hospitalization

A

Slameterol

( use with ICS)

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34
Q

QVAR Redihaler (MDI)

A

Beclomethasone

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35
Q

Pulmicort (Flexhalers, Respule) DPI

A

Budesonide

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36
Q

Symbicort

A

Budesonide + Formoterol

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37
Q

Flovent (HFA, Diskus)

Arnuity Ellipta (DPI)

ArmonAir Digihaler (DPI)

A

Fluticasone

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38
Q

Advair (Diskus, HFA)

Airduo (Respiclick, Digihaler)

Wixela Inhub

A

Fluticasone + Salmeterol

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39
Q

Breo Ellipta

A

Fluticasone + Vilanterol

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40
Q

Asmanex

A

Mometasone

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41
Q

Dulera

A

Mometasone + Formoterol

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42
Q

Alvesco

A

Ciclesonide

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43
Q

Contraindicated in Status asthmaticus and acute asthma episodes

A

ICS

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44
Q

Immunosuppression
Growth retardation
Increase Fracture risk
Adrenal insufficiency
Oral thrush
Dystonia

A

ICS

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45
Q

ICS does not require shaking

A

QVAR and Alvesco

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46
Q

Only ICS nebulizer

A

Budesonide

Use jet nebulizer

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47
Q

Records and stores its own data

A

Armonair and Airduo digihalers

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48
Q

LAMA indicated for asthma use

A

Tiotropium

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49
Q

Spirivia respimat

A

Tiotropium

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50
Q

LAMA-LABA-ICS for asthma use

A

Trelegy ellipta

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51
Q

Trelegy ellipta

A

Umeclidinuim/Vilanterol/Flutocasone

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52
Q

Inhibits LTD4

A

Montelukast

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53
Q

Singulair

A

Montelukast

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54
Q

Inhibit LTD4 and LTE4

A

Zafirlukast

55
Q

Accolate

A

Zafirlukast

56
Q

5-lipooxygenase inhibitor. Inhibits leukotriene formation

A

Zileuton

57
Q

Zyflo

A

Zileuton

58
Q

Tablet, Chew, Packet

A

Montelukast

59
Q

Approved for allergic rhinitis and EIB

A

Montelukast

60
Q

Use 2hrs before exercise

A

Montelukast

61
Q

> 14yrs: 10mg daily

6-14yrs: 5 mg daily

1-5yrs: 4mg daily

A

Montelukast

62
Q

20mg BID

5-11yrs: 10mg BID

A

Zafirlukast

63
Q

1hr before or 2hr after a meal

A

Zafirlukast

64
Q

Not recommended for < 12yrs

A

Zileuton

65
Q

Warning: Neuropsychiatric disorders

A

Montelukast

66
Q

Hepatotoxicity

A

Zafirlukast

Zileuton

67
Q

Granules can be mixed with soft food and used within 15 mins of opened

A

Montelukast

68
Q

Dispense in original container

A

Zafirlukast

69
Q

2C8/9 and 3A4 substrate

2C8/9 inhibitors

Gemfibrozil increases level

Lumefactor decreases level

A

Montelukast

70
Q

2C9 substrate

2C8/9 inhibitors

Increase theophylline level

Erythromycin and theophylline increase level

A

Zafirlukast

71
Q

1A2, 2C9, 3A4 substrate

1A2 inhibitors

Increase theophylline, propranolol and warfarin levels

A

Zileuton

72
Q

Phosphodiesterase inhibitors= increased cAMP = release of epinephrine from adrenal medulla

A

Theophylline

73
Q

Elixophyllin, Theo-24

A

Theophylline

74
Q

Caffeine and 3-methylxanthine are active metabolites

A

Theophylline

75
Q

Toxicity: persistent vomiting, arrhythmias, seizures

A

Theophylline

76
Q

Therapeutic level: 5-15 mcg/ml

Drawn with peak at steady state or after 3 days if oral dosing

A

Theophylline

77
Q

Requires loading dose at 5mg/kg of IBW

A

Theophylline

78
Q

Aminophylline x 0.8

A

Aminophylline to Theophylline dose conversion

79
Q

Theophylline/0.8

A

Theophylline to Aminophylline conversion

80
Q

Major 1A2 and Minor 2E1 and 3A4 substrate

A

Theophylline

81
Q

1A2 inhibitors will increase level

Cimetidine
Cipro
Fluvixamine
Propranolol
Zileuton

A

Theophylline

82
Q

Drugs will increase theophylline level

A

Zafirlukast
Allopurinol
Alcohol
Estrogen
Methotrexate
Verapamil

83
Q

Condition/Food will increase theophylline levels

A

CHF
Liver disease
High carb
Low protein

84
Q

Condition/Food will decrease theophylline levels

A

Cystic fibrosis
Hyperthyroidism
Low carb
High protein

85
Q

Inhibits muscarinic cholinergic receptors = reduction in vagal tone = bronchodilation

A

Anticholinergic

86
Q

LAMA approved in asthmatic patients 6yrs or older with exacerbation history despite ICS-LABA

A

Tiotropium

87
Q

Inhibits IgE binding to receptors of mast cell and basophil

A

Omalizumab

88
Q

Xolair

A

Omalizumab

89
Q

SC injections q2-4 weeks

A

Omalizumab

90
Q

Approved for 6 yrs and older with severe asthma defined as a positive skin test of perennial aeroallergen or inadequate sx control at step 5

A

Omalizumab

91
Q

First 3 doses administered under healthcare supervision

Self administration if no anaphylaxis after 3 doses and can properly treat anaphylaxis reactions with right injection techniques

A

Omalizumab

92
Q

Warning includes: increase risk of CV and CNS ADR and malignancy

A

Omalizumab

93
Q

Monitor baseline IgE level, s/sx of anaphylaxis

A

Omalizumab

94
Q

Anaphylaxis reaction like with first dose or 1 year after initiation

A

Omalizumab

95
Q

Cytokine responsible for eosinophilic activation in asthma patients

A

Interleukin

96
Q

Interleukin 5 inhibitors

A

Mepolizumab
Reslizumab
Benralizumab

97
Q

Nucala

A

Mepolizumab

98
Q

Cinqair

A

Reslizumab

99
Q

Fasenra

Fasenra pen

A

Benralizumab

100
Q

Interleukin 3&4 inhibitors

A

Dupilumab

101
Q

Dupixent

A

Dupilumab

102
Q

Indicated for management of severe asthma with an eosinophillic phenotype

A

Mepolizumab
Reslizumab
Benralizumab
Dupilumab

103
Q

6yrs and older

Once monthly SC injection

A

Mepolizumab

104
Q

Adults

Once monthly IV injection

Warning: anaphylaxis

A

Reslizumab

105
Q

12yrs and older

Once monthly SC for three doses then once every 2 montht

A

Benralizumab

106
Q

12yrs and older

SC injection every other week

A

Dupilumab

107
Q

Tezspire

A

Tezepelumab
(For asthma)

108
Q

Take 5-15 mins before exercise

Duration 2-3h or 12hrs

A

SABA or ICS-Formoterol

109
Q

Alternative to SABA in EIB

Take 30mins before

A

Salmeterol

110
Q

2hrs before exercise

Duration 24hrs

A

Montelukast

111
Q

Should be continued during pregnancy and preferred controller

A

ICS

112
Q

Should last 30 days with a total of 60 inhalation

A

Advair diskus

Asmanex

113
Q

Should last 30 days with a total of 120 inhalation

A

QVAR Redihaler

114
Q

Should last 12 months with total of 200 inhalation

A

Albuterol MDI

115
Q

Should last 3-4 months with total of 60 inhalation

A

Ventolin HFA

116
Q

Time between each inhalation

A

60 seconds

117
Q

Sequence of administration if more than one inhaler

A

Bronchodilator before ICS
(SABA —> LABA/LAMA —> ICS)

Wait 60 seconds before the next inhalation

118
Q

Albuterol nebulizer concentration needs dilution in NS prior to use

A

0.5%

0.083% is ready to use no dilution necessary

119
Q

Types of nebulizers

A

Jet

Ultrasound

Mesh

120
Q

Do not use with spacers

A

DPI

MDI can be used with spacers

121
Q

How often a spacer should be cleaned

A

Weekly

122
Q

Personal best of a peak expiratory flow rate is measured with what device

A

Spirometry

123
Q

Peak expiratory flow rate takes in account what factors

A

Age
Gender
Height

PEFR is muscle dependent

124
Q

Developed for patient to manage asthma at home and minimize the risk of hospitalization due excerbation

A

Asthma action plan

125
Q

When is peak flow best measured

A

In the morning with awakenings before inhaler administration

126
Q

How is the peak flow meter cleaned

A

With warm water and soap only

At least weekly

127
Q

What is green zone on peak flow meter

A

Within 80-100% of personal best

Indicates good control

Continue maintenance therapy as indicated

128
Q

What is indicated by yellow zone on peak flow meter

A

Within 50-80% of personal best

Worsening lung function

Increase dose or add-on therapy

129
Q

What is indicted by the red zone on a peak flow meter

A

< 50% of personal best

Medical emergency

Use rescue +/- steroids or ED admissions

130
Q

When is steroids indicated in yellow zone

A

If sx persists and do not return to green zone after 1hr of rescue use

131
Q

When should a patient seek medical emergency if in red zone

A

Still in red zone 15 minutes after rescue and oral steroids

132
Q

Should not be cleaned by putting into water

A

Symbicort
Dulera

133
Q

Budesonide ampules should be used within what timeframe of opening the aluminum package

A

2 weeks

Naplex Drug Card (6 decks)

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