Asthma Overview + Drugs (Class/Brand/Generic) Flashcards
montelukast
Class: Leukotriene Modifying Agents
Brand: Singular
Dosing:
▪︎ Age 1-5 yrs: 4 mg daily PM
▪︎ Age 6-14 yrs: 5 mg daily PM
▪︎ Age > 15 yrs: 10 mg daily PM
Granules can be mixed in breast milk or formula, applesauce, carrots, rice or ice cream & MUST be taken with 15 minutes
Preferred drug class combinations in asthma for maintenance
ICS and ICS/LABA
beclomethasone
Class: ICS
Brand: QVAR RediHaler
Counseling: do not shake or no need for spacer since it’s breath-activated & rinse mouth
Dulera
Class: ICS + LABA
Generic: mometasone + formoterol
Counseling: rinse mouth after use
fluticasone
Class: ICS
Brands: Flovent HFA/Diskus, Arnuity Ellipta
+ salmeterol (Advair HFA/Diskus)
+ vilanterol (Breo Ellipta)
albuterol
Class: SABA
Brands: Ventolin/Proventil/ProAir)
Dose: 90 mcg/inh 1-2 puffs Q4-6h prn
SE: nervousness, tachycardia, tremor, palpitations, cough hyperglycemia, hypokalemia
Xopenex
Class: SABA
Generic: levalbuterol (R-isomer)
Primary features that indicated an increase risk of asthma-related deaths:
-hx of near-fatal asthma req. ventilation
-hospitalization or emergency needs within the past yr
-psychosocial issues
-psychiatric disorders
-confirmed food allergies
-lack of written action plan
-not using ICS or poor adherence w/ ICS
-SABA overuse
-recent PO corticosteroid use
-domestic dispute
=generalized anxiety disorder
Preferred therapy to initiate in asthma
ICS
example: fluticasone
MOA & Brand name of mepolizumab
MOA: interleukin-5 (IL-5), reduces production and survival of eosinophils
Brand: Nucala
albuterol vs ipratropium
albuterol has an earlier onset of action but shorter duration of action compared to ipratropium
zafirlukast
Brand: Accolate
Class: leukotriene receptor antagonist
Dosing: BID on empty stomach
Agents that increase asthma exacerbations
NSAIDs
aspirin
beta-blockers (including ophthalmic timolol)
Vitamin D insufficiency in children
