Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

COPD and Asthma > Controller Medications > Flashcards

Controller Medications Flashcards

1
Q

inhaled corticosteroids (ICS) - prevent and control inflammation

A

beclomethasone, budesonide, ciclesodine, fluticasone proprionate, fluticasone, furoate, mometasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

adverse effects and clinical pearls

A

AE: oral thrush (candidiasis), cough, dysphonia
Counseling tip: patients should rinse their mouth and spit after use to prevent oral thrush.
Inhaled corticosteroids (ICSs) are the most effective long-term control therapy for asthma (improve quality of life, increasing lung function, and reduce the risk of exacerbations)
ICSs may increase the risk of pneumonia in patients with COPD
Titrate to lowest effective dose
Pulmicort respules should use Jet Nebulizer and should not be mixed with other nebulizer medications
High doses increase the risk for systemic side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

beclomethasone

A

QVAR
dosage form: redihaler (MDI)
for 5-11 year olds and adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

budesonide

A

pulmicort
dosage form: flexhaler
for 5-11 year olds and adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

budesonide

A

pulmicort respules
dosage form: nebulizer solution
for 0-4 year olds and 5-11 year olds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ciclesonide

A

alvesco
dosage form: HFA
for 5-11 year olds and adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

fluticasone proprionate

A

flovent, armonAir digihaler
dosage form: HFA, DPI, aerosol powder inhaler
for 0-4 year olds (HFA and DPI), 5-11 year olds (HFA and DPI), and adults (HFA, DPI, MDPI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

fluticasone furoate

A

arnuity ellipta
dosage form: ellipta
for 5-11 year olds and adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

mometasone

A

asmanex
dosage form: HFA and twisthaler
for 5-11 year olds and adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

long acting beta agonists (LABA) - increase cAMP –> bronchial smooth muscle relaxation and inhibit hypersensitivity mediators from mast cells (histamines and leukotrienes)

A

arformoterol tartate, formoterol, indacaterol, olodaterol, salmeterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

adverse effects and clinical pearls

A

AE: tachycardia, headache, tremor, hypokalemia;
boxed warning for increased risk of asthma related death for all monotherapy LABA use - shouldn’t be used alone for asthma treatment; boxed warning for increasing hospitalizations in pediatric and adolescent patients
prolonged QT seen with intentional overdoses; not for acute symptoms
may be helpful for exercise induced bronchospasm
formoterol and indaceterol capsules should not be taken orally
pediatric considerations: most children <4 yo cannot provide sufficient inspiratory flow for adequate lung delivery with a DPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

arformoterol tartate

A

brovana
dosage form: nebulizer solution
for adults only and COPD only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

formoterol

A

perforomist
dosage form: nebulizer solution
for adults only; COPD only unless used in combo with ICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

indacaterol

A

arcapta neohaler
dosage form: neohaler
for adults only and COPD only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

olodaterol

A

striverdi respimat
dosage form: respimat
for adults only and COPD only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

salmeterol

A

serevent
dosage form: diskus
for 5-11 year olds and adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

long-acting antimuscarinics (LAMA) - block the bronchoconstrictor effects of ACh on M3 and M2 receptors

A

aclidinium, glycopyrrolate, revefenacin, tiotropium, umeclidinium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

adverse effects and clinical pearls

A

AE: dry mouth, dizziness, blurred vision, upper respiratory infections and paradoxical bronchospasms
tiotropium has been approved for use in asthma as an add-on option for children >/=12yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

aclidinium

A

turdorza pressair
dosage form: DPI
for adults and COPD only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

glycopyrrolate

A

seebri neohaler
dosage form: DPI and nebulization solution
for adults and COPD only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

revefenacin

A

yupelri
dosage form: nebulization solution
for adults and COPD only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

tiotropium

A

spiriva
dosage form: handiHaler and respimat
for 5-11 year olds (>/=6 yo respimat) and adults handiHaler (COPD only) and respimat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

umeclidinium

A

incruse ellipta
dosage form: DPI
for adults and COPD only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ICS/LABA combo products

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

adverse effects and clinical pearls

A

AE: see individual products
guidelines recommend combo LABA and ICS in asthma, as LABA shouldn’t be used as monotherapy
combo products developed to create convenient packaging and assist with patient adherence

26
Q

fluticasone/salmeterol

A

advair
dosage forms: DPI and HFA MDI
for 5-11 year olds (DPI) and adults (DPI and HFA)

27
Q

fluticasone/salmeterol

A

airDuo and airDuo digihaler
dosage form: respiclick (DPI)
for adults only

28
Q

budesonide/formoterol

A

symbicort
dosage form: HFA MDI
for 5-11 year olds and adults

29
Q

mometasone/formoterol

A

dulera
dosage form: MDI
for adults only

30
Q

fluticasone/vilanterol

A

breo ellipta
dosage form: DPI
for adults only

31
Q

LABA/LAMA combo products

A

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

32
Q

adverse effects and clinical pearls

A

AE: see individual products
not indicated for treatment of acute deteriorations

33
Q

olodaterol/tiotropium

A

stiolto respimat
dosage form: respimat
for adults and COPD only

34
Q

vilanterol/umeclidinium

A

anoro ellipta
dosage form: ellipta
for adults and COPD only

35
Q

indacaterol/glycopyrronium

A

utibron neohaler
dosage form: neohaler
for adults and COPD only

36
Q

formoterol/glycopyrronium

A

bevespi aerosphere
dosage form: aerosphere
for adults and COPD only

37
Q

formoterol/aclidinium

A

duaklir pressair
dosage form: DPI
for adults and COPD only

38
Q

LABA/LAMA/ICS combo products

A

fluticasone/umeclidinium/vilanterol, budesonide/glycopyrrolate/formoterol fumarate

39
Q

AE

A

see individual products

40
Q

fluticasone/umeclidinium/vilanterol

A

trelegy ellipta
dosage form: ellipta
for adults, asthma, and COPD

41
Q

budesonide/glycopyrrolate/formoterol fumarate

A

breztri aerosphere
dosage form: aerosphere
for adults and COPD only

42
Q

mast cell stabilizer

A

cromolyn

43
Q

adverse effects and clinical pearls

A

AE: high incidence of unpleasant taste in mouth (>10%), rare cardiac arrhythmias, coughing, dyspnea, sore throat, N/V/D if absorbed systemically
less effective than low-dose ICS
prevents increase in bronchial hyperreactivity seen in allergy season

44
Q

cromolyn

A

intal
dosage form: nebulizer solution
for 0-4 year olds, 5-11 year olds, and adults

45
Q

leukotriene modifiers - block the production of leukotrienes

A

montelukast, zafirlukast, zileuton

46
Q

adverse effects and clinical pearls

A

neuropsychiatric events (agitation, anxiety, abnormal dreams, hallucinations, depression, suicidal thinking), Churg-Strauss syndrome (rare), increased hepatic transaminases (zafirlukast and zileuton)
less effective than low dose ICS and ICS/LABA in asthma
have not been adequately trialed in COPD

47
Q

montelukast

A

singulair
dosage form: tablets (chewable), granule packets
for 0-4 year olds, 5-11 year olds, and adults
minor substrate of CYP2C8/9 and 3A4, not for acute relief of symptoms, boxed warning: neuropsychiatric events

48
Q

zafirlukast

A

accolate
dosage form: tablets
for 5-11 year olds and adults
take at least 1 hour or 2 hours after meals, can increase INR, major substrate, minor inhibitor or CYP 2C9

49
Q

zileuton

A

zyflo
dosage form: IR tablets and ER tablets
for adults
weak CYP1A2 inhibitor, take with food

50
Q

methylxanthines - bronchodilation through inhibition of PDE III and PDE IV

A

theopylline

51
Q

adverse effects and clinical pearls

A

AE: insomnia, gastrointestinal upset, hyperactivity, hypotension, tremor
dose related toxicity: tachycardia, nausea, vomiting, headache, seizures, arrythmias
CI: peptic ulcer disease, arrhythmias, seizure disorders
DI: major substrate of CYP 3A4, 1A2, 2E1- increase concentration: cimetidine, eryhtromycin, clraithromycin, ciprofloxacin, ticlopidine; decrease concentration: phenobarbital, phenytoin, carbamazepine, rifampin, smoking
PDE III inhibition likely cause for hyptotension, tachycardia, and nausea

52
Q

theophylline

A

theochron
ER 12 hour tablets, ER 24 hour tablets, ER 24 hour capsules, liquid
for adults only
acute exacerbation: loading dose, typically given IV as aminophylline, followed maintenance IV fusion
chronic management: smokers: 16mg/kg/day divided; nonsmokers: 13mg/kg/day divided
doses based on serum concentrations, target range 5-15 mcg/mL, toxic > 20 mcg/mL

53
Q

anti-IgE: inhibit binding to receptors on mast cells and basophils, inhibit mediator release adn attenuation of early and late phase allergic response

A

omalizumab

54
Q

omalizumab

A

xolair
dosage form: syringe for injection
for 5-11 year olds and adults
AE: headache, injection site reactions, arthralgias, thrombocytopenia, pharyngitis, sinusitis, upper RTI
boxed warning: anaphylaxis
don’t give more than 150 mg per injection site
FDA approved for moderate to severe persistent asthma in patients with a positive skin test or reactivity to a perennial aeroallergen and symptoms that are inaqequately controlled with ICS

55
Q

anti-IL5: blocka binding of IL-5 to the alpha chain of the IL-5 receptor complex which results in reduced production and survival of eosinophils

A

mepolizumab, reslizumab, benralizumab

56
Q

mepolizumab

A

nucala
dosage form: auto-injector or injection
for 5-11 year olds and adults
AE: headache, injection site reactions, arthralgias, Herpes Zoster infection
precaution: anaphylaxis
available as in-clinic or at-home injection
indicated for add-on maintenance treatment of patients with severe asthma with an eosinophilic phenotype

57
Q

reslizumab

A

cinqair
dosage form: injection
for adults only
AE: injection site reactions, myalgias, increased creatinine phosphokinase
boxed warning: anaphylaxis, malignancies
indicated for add-on maintenance treatment of patients with severe asthma with an eosinophilic phenotype

58
Q

benralizumab

A

fasenra
dosage form: auto-injector or pre-filled syringe
for adults only
AE: injection site reactionsl antibody development, headache, pharyngitis, fever
precaution: anaphylaxis
available as an in-clinic or at-home injection
indicated for add-on maintenance treatment of severe asthma in adults and children >/= 12 years of age with an eosinophilic phenotype
acts on IL-5 receptors while others act on IL-5

59
Q

anti-IL4/IL13: blocks binding of IL/4 to reduce eosinophil trafficking and IgE reactions while also blocking IL-13 to reduce mucus secretion and airway remodeling

A

dupilumab

60
Q

dupilumab

A

dupixent
dosage form: injection
for adults only
AE: injection site reactions, antibody development, arthralgias, conjunctivitis
precaution: anaphylaxis
available in pre-filled syringe for in-office or at-home administration
indicated as an add-on maintenance treatment in patients with moderate to-sever asthma aged 12 years and older with an eosinophilic phenotype or with oral corticosteroid dependent asthma

61
Q

phosphodiasterase-4 inhibitors: inhibits PDE4 leading to increase in cAMP

A

roflumilast

62
Q

roflumilast

A

daliresp
dosage form: tablets
for adults only and COPD only
AE: HA, weight loss, diarrhea, nausea
monitoring: liver function test, weight
DI: CYP3A4 (major), CYP1A2 (minor)
CI: child-pugh class B or C

COPD and Asthma (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions