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Therapeutics I - Spring 2023 > Controller Medication - Asthma and COPD > Flashcards

Controller Medication - Asthma and COPD Flashcards

1
Q

ICS - Meds

A

beclomethasone, budesonide, ciclesonide, fluticasone propionate, fluticasone furoate, mometasone

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2
Q

LABA - Meds

A

arformoterol tartrate, formoterol, indacaterol, olodaterol, salmeterol

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3
Q

LAMA - Meds

A

aclidinium, glycopyrrolate, revefenacin, tiotropium, umeclidinium

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4
Q

ICS/LABA - Meds

A

fluticasone/salmeterol, budesonide/formoterol, mometasone/formoterol, fluticasone/vilanterol

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5
Q

LABA/LAMA - Meds

A

olodaterol/tiotropium, vilanterol/umeclidinium, indacaterol/glycopyrronium, formoterol/glycopyrronium, formoterol aclidinium

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6
Q

LABA/LAMA/ICS - Meds

A

fluticasone/umeclidinium/vilanterol
budesonide/glycopyrrolate/formoterol fumarate

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7
Q

Mast cell stabilizer - Meds

A

cromolyn

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8
Q

Leukotriene Modifiers - Meds

A

montelukast, zafirlukast, zileuton

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9
Q

Methylxanthine - Meds

A

theophylline

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10
Q

Anti-IgE - Meds

A

omalizumab

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11
Q

Anti-IL5 - Meds

A

mepolizumab, reslizumab, benralizumab

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12
Q

Anti-IL4/IL13 - Meds

A

dupilumab

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13
Q

Phosphodiaesterase-4 Inhibitors - Meds

A

roflumilast

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14
Q

ICS - Adverse Effects

A

Oral thrush (candidiasis), cough, dysphonia

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15
Q

ICS - Clinical Pearls

A
  • Pts should rinse their mouth and spit after use to prevent oral thrush
  • Most effective long-term control therapy for asthma (improve quality of life, increase lung function, and reduce the risk of exacerbations)
  • May increase the risk of pneumonia in pts w/ COPD
  • Titrate to lowest effective dose - see low, medium and high dose conversion table
  • High doses increase the risk for systemic side effects
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16
Q

LABA - Adverse Effects

A

tachycardia, headache, tremor, hypokalemia

17
Q

LABA - Clinical Pearls

A
  • Boxed warning for increased risk of asthma related death w/ monotherapy use & increasing hospitalizations in pediatric and adolescent pts
  • Prolonged QT seen w/ intentional overdoses
  • Not for acute symptoms
  • May be helpful for exercise induced bronchospasm
  • Pediatric considerations: most children <4 yo cannot provide sufficient inspiratory flow for adequate lung delivery w/ a DPI
18
Q

LAMA - Adverse Effects

A

dry mouth, dizziness, blurred vision, upper respiratory infections and paradoxical bronchospasms

19
Q

LAMA - Clinical Pearls

A

Combination products developed to create convenient packaging and assist w/ pt adherence

20
Q

LABA/LAMA - Clinical Pearls

A

Not indicated for treatment of acute deteriorations

21
Q

Mast Cell Stabilizer - Adverse Effects

A

high incidence of unpleasant taste in mouth, rare cardiac arrythmias, coughing, dyspnea, sore throat, nausea, vomiting, diarrhea if absorbed systemically

22
Q

Mast Cell Stabilizer - Clinical Pearls

A
  • Less effective than low-dose ICS
  • Prevents increase in bronchial hyperreactivity seen in allergy season
23
Q

Leukotriene Modifiers - Adverse Effects

A

neuropsychiatric events (agitation, anxiety, abnormal dreams, hallucinations, depression, suicidal thinking), Churh-Strauss syndrome, increased hepatic transaminases

24
Q

Leukotriene Modifiers - Clinical Pearls

A
  • Less effective than low dose ICE and ICS/LABA in asthma
  • Used for asthma only; has not bee adequately trialed in COPD
25
Q

Methylxanthines - Adverse Effects

A

insomnia, GI upset, hyperactivity, hypotension, tremor

26
Q

Methylxanthines - Dose related toxicity

A

tachycardia, nausea, vomiting, headache, seizures, arrythmias

27
Q

Methylxanthines - Contraindications

A

peptic ulcer disease, arrythmias, seizure disorders

28
Q

Methylxanthines - Drug Interactions

A

Major substrate of CYP3A4, 1A2, 2E1
Inducers: cimetidine, erythromycin, clarithromycin, ciprofloxacin, ticlopidine
Inhibitors: phenobarbital, phenytoin, carbamazepine, rifampin, smoking
- PDE III inhibition likely cause for hypotension, tachycardia and nausea

29
Q

Anti-IgE - Adverse Effects

A

headache, injection site reactions, arthralgias, thrombocytopenia, pharyngitis, sinusitis, upper respiratory tract infections

30
Q

Anti-IgE - Clinical Pearls

A
  • Boxed warning: anaphylaxis
  • Do not give more than 150mg per injection site
  • Monitor for anaphylaxis before and after injection
  • FDA approved for moderate to severe persistent asthma in pts w/ a positive skin test or reactivity to a perennial aeroallergen and symptoms that are inadequately controlled w/ ICS

Therapeutics I - Spring 2023 (3 decks)

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