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NAPLEX 2023 > Chapter 41: Asthma > Flashcards

Chapter 41: Asthma Flashcards

1
Q

ProAir HFA, ProAir RespiClick, Proventil HFA, Ventolin HFA generic

A

Albuterol

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2
Q

Levalbuterol brand name

A

Xopenex, Xopenex HFA

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3
Q

Primatene Mist generic

A

Epinephrine (OTC)

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4
Q

Salmeterol brand name

A

Severent Diskus

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5
Q

Beclomethasone brand name

A

QVAR RediHaler

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6
Q

Budesonide brand name

A

Pulmicort Flexhaler, Pulmicort Respules

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7
Q

Budesonide + Formoterol brand name

A

Symbicort

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8
Q

Fluticasone brand name

A

Flovent HFA, Flovent Diskus, Arnuity Ellipta

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9
Q

Fluticasone + salmeterol brand name

A

Advair Diskus, Advair HFA

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10
Q

Fluticasone + vilanterol brand name

A

Breo Ellipta

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11
Q

Mometasone + Formoterol brand name

A

Dulera

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12
Q

An asthma diagnosis is confirmed with

A

spirometry

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13
Q

Spirometry and pulmonary function tests test for reversibility (i.e, if the FEV1 increases by more than __% with the use of a bronchodilator)

A

12%

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14
Q

FEV1 measures

A

how much air can be forcefully exhaled in one second

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15
Q

FVC test

A

after taking a deep breath, the max volume of air that is exhaled (how much air is exhaled)

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16
Q

FEV1/FVC

A

the percentage of total air capacity (“vital capacity”) that can be forcefully exhaled in one second (the speed of the exhale)

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17
Q

Common asthma triggers

A

genetics, pollution, cigarettes, cold air/changes in weather, pets, dust/pollen/cockroaches, perfume & cosmetics, drugs (ASA, NSAIDs, non-selective BB - propranolol, nadolol, timolol, pindolol), infections (colds and viruses), allergic rhinitis, GERD, obesity, OSA, anxiety, stress, depression

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18
Q

Intermittent asthma is defined as daytime symptoms < / = __ days/week & SABA rescue inhaler use < / = __ days/week

A

2

2

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19
Q

Mild asthma is defined as daytime symptoms > __ days per week, but not daily & SABA rescue inhaler use > __ days/week, but not daily or > __ x/day

A

2
2
1

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20
Q

Moderate asthma is defined as daytime symptoms how many times per week & SABA rescue inhaler use ___

A

daily

daily

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21
Q

Severe asthma is defined as daytime symptoms ___ & SABA rescue inhaler use ___

A

throughout the day

several times per day

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22
Q

Which vaccines should people with asthma receive

A 
Annual influenza vaccine
Pneumovax 23 (age 2-64)
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23
Q

Which controller is first-line for all patients

A

ICS (need anti-inflammation in asthma)

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24
Q

Which drug classes are controllers

A 
ICS
LABA
LTRAs
LAMAs
Injectable MABs
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25
Which drug classes are relievers
ICS + formoterol | SABAs
26
LABAs are used in combination with:
ICS | NEVER use LABAs alone
27
Which MAB is used for severe allergic asthma
Omalizumab
28
Albuterol MDI/DPI dose
1-2 inhalations Q4-6H PRN
29
SABA SE
Nervousness, tremor, tachycardia, palpitations, cough, hyperglycemia, ↓ K
30
Levalbuterol contains __ isomer of albuterol
R
31
Most albuterol inhalers contain __ inhalations/canister, with the exception of ___ which also has __ inhalations/canister
200 inhalations/canister | Ventolin: 200 inhalations/canister AND 60 inhalations/canister
32
SABAs or low-dose ICS + formoterol should be used in exercise-induced bronchospasm ___ min prior to exercise. The effects of the SABA will last __-__ hours
5 2-3 hours
33
Which drugs are SABAs
Albuterol Levalbuterol Racepinepherine Epinephrine
34
Which drug is a LABA
Salmeterol
35
Salmeterol BW
↑ risk of asthma related deaths when used as monotherapy | ONLY use with ICS
36
ICS SE
Dysphonia (difficulty speaking), oral thrush, cough
37
Which ICS is the only one available as a nebulized solution
budesonide
38
Pulmicort Respules can only be used with
a jet nebulizer
39
Which MDIs should not be shaken
Alvesco (ciclesonide) Qvar RediHaler Respimat products
40
Which drugs are ICS
Beclomethasone (QVAR RediHaler) Budesonide (Pulmicort Flexhaler) Fluticasone (Flovent HFA, Flovent Diskus, Arnuity Ellipta)
41
Which drug is a LAMA for asthma
Tiotropium (Spirivia Respimat) | **for COPD - Respimat or HandiHaler
42
Brand name identifiers for MDIs
HFA, RespiMat
43
Brand name identifiers for DPIs
Diskus, Ellipta, Pressair, Handihaler, Neohaler, Respiclick, Flexhaler
44
Which DPI needs to be primed before first use
Flexhaler
45
Montelukast MOA
Inhibits leukotriene D4 (LTD4)
46
Zileuton MOA
Inhibits leukotriene formation
47
Montelukast formulations
tablet, chewable tab, packet
48
Montelukast dosing
10 mg daily in the evening Age 6-14 years: 5 mg daily in the evening Age 1-5 years: 4 mg daily in the evening
49
Montelukast BW
neuropsychiatric events
50
Which formulation of montelukast can be administered directly into the mouth, dissolved in breast milk or formula or mixed with applesauce, carrots, rice or ice cream; should be used within __ min
granules | 15
51
How must zafirlukast be administered
in original container
52
Theophylline MOA
Blocks phosphodiasterase, causing an increase in cAMP and release of epi from adrenal medulla cells, resulting in bronchodilation
53
Active metabolite of theophylline
caffeine
54
Theophylline therapeutic range
5-15 mcg/mL
55
Theophylline is dosed based on
IBW (or TBW if < IBW)
56
Theophylline toxicity can present as
persistent vomiting, arrhythmias, seizures
57
How to convert aminophylline to theophylline
ATM x 0.8
58
A small increase in theophylline dose can result in
large increase in Theophylline concentration
59
Which drugs can increase theophylline levels
cipro, zileuton, zafirlukast
60
Which drugs can decrease theophylline levels
carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone, rifampin, ritonavir
61
Which conditions can increase theophylline levels
CHF, liver disease
62
Which conditions/food can decrease theophylline levels
high-protein diet
63
Omalizumab MOA
Inhibits IgE binding to the IgE receptor on mast cells and basophils
64
Omalizumab indication
moderate-severe persistent, allergic asthma with a positive skin test to a perennial aeroallergen
65
Omalizumab brand name
Xolair
66
Omalizumab formulation & administration
SC injection; must be administered in a healthcare setting under medical supervision d/t BW of anaphylaxis
67
Which drugs are IL-5 receptor antagonists
Mepolizumab (SC), reslizumab (IV), and benralizumab (SC)
68
Which drug is an IL-4 & IL-3 receptor antagonists
Dupilumab (SC)
69
Which ICS is is preferred in asthma control in pregnant patients
Budesonide
70
For a patient with good asthma control, how long should their albuterol inhaler last
about 12 months
71
If a patient is prescribed > 1 inhalation of medication at a time, how long should the patient wait between each inhalation
60 seconds
72
If using more than 1 inhaler, what is the correct sequence of inhalers
SABA → Other Bronchodilators (LABA or LAMA) → ICS
73
Spacers should NEVER be used with
a DPI
74
How often must a spacer be cleaned
at least once a week
75
What are common spacer names
AeroChamber, OptiHaler, OptiChamber
76
Spacers reduce the risk of
thrush from steroid inhalers
77
The patient's best peak expiratory flow rate (PEFR) is called
personal best (PB)
78
The patient's personal best from a PEFR takes into account their:
height, gender and age
79
Peak flow meter technique
- Use every morning upon awakening and before the use of any asthma meds - Move indicator to bottom. Stand up straight and exhale - Inhale as deeply as possible. Place lips firmly around the mouthpiece - Blow out as hard & as fast as possible. Write down the PEFR - Repeat steps 2 more times, and record the highest value
80
Green zone of an asthma action plan (> 80-100% of PB) indicates
all clear - good control
81
Yellow zone of an asthma action plan (> 50-80% of PB) indicates
Caution - worsening lung fxn
82
Red zone of an asthma action plan (< 50% of PB) indicates
Medical alert - possibly needs to go to the emergency department
83
When using an MDI, the inhaler should be shaken for how long immediately before each spray
5 seconds
84
When using an MDI, how long should a patient hold their breath for after pressing down on the canister to deliver a dose
up to 10 seconds
85
Which inhalers should not be put into water
Symbicort, Dulera
86
What is an important counseling point for the ProAir RespiClick and AirDuo RespiClick
Opening and closing the cap without inhaling a dose will waste medication and can damage your inhaler
87
The ampules in Budesonide (Pulmicort Respules) should be used within __ weeks of opening the aluminum package
2

NAPLEX 2023 (88 decks)

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