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Rx Prep > Asthma - Quiz 3 > Flashcards

Asthma - Quiz 3 Flashcards

1
Q

What is asthma?

A

Inflammation and bronchoconstriction cause airway obstruction causing expiratory airflow limitation

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2
Q

What are the common triggers for asthma?

A
  1. Pollution
  2. Cigarettes
  3. Cold air
  4. Pets
  5. Dust, pollen, roaches
  6. Perfume
  7. Drugs (Aspirin, NSAIDs, non-selective beta blockers)
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3
Q

What is FEV1?

A

How much air can be forcefully exhaled in one second

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4
Q

What is FVC?

A

The max volume of air exhaled after taking a deep breath

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5
Q

What is FEV1/FVC?

A

The percentage of total air capacity that can be forcefully exhaled in one second

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6
Q

What is the asthma diagnostic criteria?

A
  1. Measure baseline FEV1 with spirometry
  2. Give albuterol
  3. Measure post-bronchodilator FEV1

An FEV1 increase >12% post-bronchodilator is consistent with asthma diagnosis (reversible)

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7
Q

Guidelines for asthma tx?

A

GINA

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8
Q

Initial asthma tx step 1?

A

Daytime sx: <2/month
Night sx: none

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9
Q

Initial asthma tx step 2?

A

Daytime sx: <2/month but <4-5 d/wk
Night sx: none

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10
Q

Initial asthma tx step 3?

A

Daytime sx: Most days
Night sx: <1/wk

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11
Q

Initial asthma tx step 4?

A

Daytime sx: Daily
Night sx: ≥1/wk

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12
Q

How often are follow ups?

A

2-6 wks

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13
Q

How do you control RF?

A
  1. Avoid smoking
  2. Annual flu vaccine
  3. Pneumococcal and COVID vaccines
  4. Allergen test
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14
Q

What are relievers for ?

A

Acute sx

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15
Q

What are the preferred reliever regimens?

A

low dose ICS+formoterol
SABA

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16
Q

Types of relievers?

A
  1. low dose ICS+formoterol
  2. SABA
  3. Systemic steroids
  4. Inhaled epinephrine
  5. SAMA
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17
Q

Reliever that quickly reverses bronchoconstriction?

A

SABA

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18
Q

Agents that are used for exacerbations?

A

low dose ICS+formoterol
PO systemic steroids

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19
Q

What is first line controllers?

A

ICS

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20
Q

What agent is commonly used in children

A

LTRAs

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21
Q

Examples of SABA?

A
  1. Albuterol
  2. Levalbuterol
  3. Epinephrine
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22
Q

Albuterol

A

ProAir, Ventolin, Proventil

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23
Q

Levalbuterol

A

Xopenex

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24
Q

LABA example?

A

Salmeterol

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25
Q

Salmeterol

A

Serevent Diskus

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26
Q

ADRs of SABAs?

A
  1. Nervousness
  2. Tremor
  3. Tachycardia
  4. Palpitations
  5. Cough
  6. Hyperglycemia
  7. Low K
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27
Q

How many inhalations are in albuterol?

A

Albuterol: 200 inh/canister
Ventolin: 200 or 60 inh/canister

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28
Q

BBW of LABA?

A
  1. Increased asthma deaths without ICS
  2. Increased asthma hospitalization (pediatric and adolescents)
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29
Q

Beclomethasone

A

QVAR Redihaler

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30
Q

Budesonide

A

Pulmicort

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31
Q

Fluticasone

A

Flovent, Arnuity

32
Q

Mometasone

33
Q

Budesonide/Formoterol

A

Symbicort, Breyna

34
Q

Fluticasone/Salmeterol

35
Q

Fluticasone/Vilanterol

A

Breo Ellipta

36
Q

Mometasone/formoterol

37
Q

ADRs of ICS?

A
  1. Increased risk for fractures, growth, immunosuppression
  2. Dysphonia
  3. Oral candida
  4. Cough
38
Q

Counseling when using ICS

A

Rinse mouth with water and spit out to avoid thrush

39
Q

What ICS don’t need to be shaken?

A
  1. Ciclesonide (Alvesco)
  2. QVAR Redihaler
40
Q

ICS that is available as a neb solution?

A

Budesonide

41
Q

Tiotropium

42
Q

Umeclidinium/vilanterol/fluticasone

43
Q

What agents are preferred for maintanance asthma?

A

ICS
ICS/LABA

44
Q

What are the LTRAs?

A
  1. Montelukast
  2. Zafirlukast
  3. Zileuton
45
Q

Montelukast

46
Q

Zafirlukast

47
Q

Zileuton

48
Q

BBW of Singular

A

Neuropsychiatric events

49
Q

Indicatiosn for SIngulair?

A

ALlergic rhinitis, exercise-induced broncocontriction

50
Q

How do you adminsiter Singulair granuales?

A
  • Can be administered directly in the mouth
  • Dissolved in breast milk or formula
  • Applesauce, carrots, rice, or ice cream
51
Q

When do you administer Singulair?

A

In the evening

52
Q

MOA of theophylline?

A

Blocks PE -> increase in cAMP -> bronchodilation

53
Q

What are the active metabolites in theophylline?

A

Caffein and 3-methylxanthine

54
Q

Therapeutic range of theophylline?

A

5-15mcg/mL

55
Q

Drugs that increase theophylline levels?

A

Ciprofloxacin, zileuton, zafirlukast

56
Q

Conversion from aminophylline to theophilline
* Vice versa?

A

Aminophylline to theophylline multiply by 0.8

Vice versa: divide by 0.8

57
Q

Drugs that decrease theophylline levels?

A
  1. Carbamazepine
  2. Fosphenytoin
  3. Phenobarbital
  4. Phenytoin
  5. Primidone
  6. RIfampin
  7. Ritonavir
58
Q

When should anticholinergics be used for asthma?

A

Add on with ICS

59
Q

When are biologics used?

A

Severe asthma that remains uncontrolled

60
Q

MOA of Omalizumab?

A

Inhibits IgE binding

61
Q

How is Omalizzumab adminsitered?

A

SC
Iniitate in a healthcare setting under med supervision

62
Q

Omalizumab

63
Q

Indications for Xolair?

A

Severe allergic asthma

64
Q

BBW of Xolair?

A

Anaphylaxis

65
Q

Interleukin receptor antagonsits that are administered via SC?

A
  1. Mepolizumab (Nucala)
  2. Benralizumab (Fasenra)
  3. Dupilumab (Dupixent)
66
Q

Interleukin receptor antagonsits that are administered via IV?

A

Reslizumab (Cinqair)

67
Q

Indications of IRA?

A

Severe eosinophillic asthma

68
Q

BBW for reslizumab?

A

Anaphylaxis

69
Q

Indication for Tezepelumab?

A

Severe asthma (any type)

70
Q

Administration of Tezepelumab?

71
Q

What is the tx for EIBS?

A

SABA
Low dose ICS+formoterol

Taken 5-15 min before exercise

72
Q

Describe the timing and order of inhaler use?

A

Wait 60 seconds between each one:
1. SABA for rescue
2. Bronchodilators to open airways
3. ICS for maintenace and sx relief

73
Q

What is a neb?

A

Device that turns liquid medications into fine mist

74
Q

What are spacers for?

A

Children and anyone with dexterity issues

75
Q

Spacer brands?

A

AeroChamber
OptiHaler
OptiChamber

76
Q

Counseling for budesonide (pulmicort respules)

A

Ampules should be used within 2 weeks of opening the aluminum package

Rx Prep (15 decks)

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