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Theraputics > Controller Meds Asthma and COPD > Flashcards

Controller Meds Asthma and COPD Flashcards

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1
Q

Inhaled Corticosteroids (ICS)
Adverse effects & clinical pearls

A

AE: oral thrush, cough, dysphonia
CPs: pt should rinse mouth and spit after use
-ICSs are most effective long-term control therapy for asthma
-ICSs may increase risk of pneumonia in pts w/ COPD
-Titrate to lowest effective does
-High doses increase risk for systemic side effects

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2
Q

Inhaled Corticosteroids (ICS)
mechanism of action

A

prevent and control inflammation

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3
Q

Beclomethasone (QVAR)
drug class

A

ICS- inhaled corticosteroid

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4
Q

Beclomethasone (QVAR)
dosage form

A

Redihaler (MDI)

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5
Q

Beclomethasone (QVAR)
age groups

A

ages 5 and up

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6
Q

Beclomethasone
brand

A

QVAR

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7
Q

Budesonide (Pulmicort)
drug class

A

ICS - inhaled corticoidsteroid

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8
Q

Budesonide (pulmicort)
dosage form

A

flexhaler

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9
Q

Budesonide (pulmicort)
age groups

A

ages 5 and up

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10
Q

Budesonide
brand

A

pulmicort

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11
Q

Budesonide (Pulmicort Respules)
counseling point

A

Pulmicort Respulses should use Jet Nebulizer and should not be mixed with other nebulizer meds

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12
Q

Budesonide (pulmicort respules)
dosage form

A

nebulizer solution

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13
Q

Budesonide (pulmicort respules)
drug class

A

ICS

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14
Q

Budesonide (pulmicort respules)
age groups

A

no available dosing for adults

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15
Q

Budesonide (neb solution)
brand

A

pulmicort respules

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16
Q

Ciclesonide (Avlesco)
drug class

A

ICS

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17
Q

Ciclesonide (Avlesco)
dosage form

A

HFA

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18
Q

Ciclesonide (avlesco)
age groups

A

ages 5 and up

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19
Q

Ciclesonide
brand

A

Avlesco

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20
Q

Fluticasone Propionate
drug class

A

ICS

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21
Q

Fluticasone Propionate
brand names

A

Flovent
ArmonAir Digihaler

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22
Q

Fluticasone Propionate
dosage forms

A

HFA
DPI
Aerosol Powder Inhaler

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23
Q

Fluticasone Propionate
age groups

A

HFA and DPI approved dosing for all ages
MDPI approved for adults

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23
Q

Fluticasone Propionate
age groups

A

HFA and DPI approved dosing for all ages
MDPI approved for adults

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24
Fluticasone Furoate brand
Arnuity Ellipta
25
Fluticasone Furoate (Arnuity ellipta) drug class
ICS
26
Fluticasone Furoate (arnuity ellipta) age groups
dosing for ages 5 and up
27
Mometasone brand
Asmanex
28
Mometasone (asmanex) drug class
ICS
29
Mometasone (asmanex) dosage forms
HFA Twisthaler
30
Mometasone (asmanex) age groups
dosing for ages 5 and up
31
fluticasone furoate (arnuity ellipta) dosage forms
ellipta
32
LABAs (long acting beta agonist) mechanism of action
Increases cAMP bronchial smooth muscle relaxation and inhibit hypersensitivity mediators from mast cells (histamine and leukotrienes)
33
LABAs (long acting beta agonist) mechanism of action
Increases cAMP bronchial smooth muscle relaxation and inhibit hypersensitivity mediators from mast cells (histamine and leukotrienes)
34
Arformoterol tartrate brand
Brovana
35
Arformoterol tartrate (brovana) drug class
LABA
36
Arformoterol tartrate (brovana) dosage forms
nebulizer solution
37
Arformoterol tartrate (brovana) age groups
adult dosing only
38
LABA Adverse effects and clinical pearls
AE- tachycardia, headache, tremor, hypokalemia Boxed warning- increased risk for asthma-related death for all monotherapy LABA use (should not be used alone for asthma therapy) -prolonged QT seen with intentional overdose -not for acute symptoms -may be helpful for exercise-induced bronchospasms -Formoterol and Indacaterol capsules should not be taken orally - pediatric considerations: most children <4 cannot provide sufficient inspiratory flow for adequate lung delivery with a DPI
39
Formoterol brand
Perforomist
40
Formoterol (preforomist) drug class
LABA
41
Arformoterol tartrate (brovana) disease state
COPD only
42
Formoterol (preforomist) dosage forms
nebulizer solution
43
Formoterol (preforomist) age groups
adult only dosing
44
Indacaterol brand
Arcapta neohaler
45
Indacaterol (Arcapta neohaler) drug class
LABA
46
Indacaterol (arcapta neohaler) dosage forms
neohaler
47
indacaterol (arcapta neohaler) age groups
adult only pts
48
Formoterol (preforomist) disease states
COPD
49
Indacaterol ( arcapta neohaler) disease state
COPD
50
Olodaterol brand
Striverdi Respimat
51
Olodaterol (striverdi respimat) drug class
LABA
52
Olodaterol (striverdi respimat) disease state
COPD
53
Olodaterol (striverdi respimat) dosage forms
respimat
54
Olodaterol (striverdi respimat) age groups
adult only dosing
55
Salmeterol brand
serevent
56
Salmeterol (servent) drug class
LABA
57
Salmeterol (serevent) dosage form
diskus
57
Salmeterol (serevent) age groups
dosing for ages 5 and up
58
LAMA (long-acting antimuscarinics) mechanism of action
block the bronchoconstrictor effects of acetylcholine on M2 and M3 receptors
59
LAMA Adverse effects and clinical pearls
AE: dry mouth, dizziness, blurred vision, upper respiratory infections and paradoxical bronchospasm -Tiotropium has been approved for use in asthma as an add-on option for children 12 and up
60
Aclidinium brand name
Turdorza Pressair
61
Aclidinium (Turdorza Pressair) drug class
LAMA
62
Aclidinium (turdorza pressair) dosage form
DPI
63
Aclidinium (turdorza pressair) age groups
adult dosing
64
Aclidinium (turdorza pressair) disease state
COPD only
65
Glycopyrrolate brand
seebri neohaler
66
Glycopyrrolate (seebri neohaler) drug class
LAMA
67
Glycopyrrolate (seebri neohaler) dosage form
DPI Nebulizing solution
68
Glycopyrrolate (seebri neohaler) age groups
adult dosing available
69
Glycopyrrolate (seebri neohaler) disease states
COPD
70
Revefenacin brand
yupelri
71
Revefenacin (yupelri) drug class
LAMA
72
Revefenacin (yupelri) dosage form
nebulization solution
73
Revefenacin (yupelri) age groups
adult only dosing
74
Revefenacin (yupelri) disease state
COPD only
75
Tiotropium brand
Spiriva
76
Tiotropium (spiriva) drug class
LAMA
77
Tiotropium (spiriva) dosage forms
Handihaler Respimat
78
Tiotropium (Spiriva) age groups
Handihaler- adult only dosing Respimat- dosing for ages 5 and up
79
Tiotropium (spiriva) disease states
Handihaler - COPD only Respimat- both asthma and COPD
80
Umeclidinium brand
Incruse ellipta
81
Umeclidinium (incruse ellipta) drug class
LAMA
82
Umeclidinium (incruse ellipta) dosage form
DPI
83
Umeclidinium (incruse ellipta) age groups
only adult dosing
84
Umeclidinium (incruse ellipta) disease state
COPD only
85
ICS/LABA Combo products adverse effects and clinical pearls
-guidelines recommend combination LABA w/ ICS in asthma, as LABA should not be used as monotherapy -combo products developed to create convenient packaging and assist w/ pt adherence
86
Fluticasone/Salmeterol brand
Advair
87
Fluticasone/Salmeterol (advair) drug class
ICS/LABA
88
Fluticasone/Salmeterol (advair) dosage form
DPI HFA MDI
89
Fluticasone/Salmeterol (advair) age groups
DPI- ages 5 and up HFA- adult dosing available
90
Fluticasone/Salmeterol brand
AirDuo & AirDuo Digihaler
91
Fluticasone/ Salmeterol (AirDuo & AirDuo digihaler) drug class
ICS/LABA
92
Fluticasone/Salmeterol (airduo & airduo digihaler) dosage forms
Respiclick (DPI)
93
Fluticasone/ Salmeterol (AirDuo & AirDuo digihaler) age groups
Adult dosing available
94
Budesonide/Formoterol brand
Symbicort
95
Budesonide/Formoterol (symbicort) drug class
ICS/LABA
96
Budesonide/Formoterol (symbicort) dosage form
HFA MDI
97
Budesonide/Formoterol (symbicort) age groups
dosing for ages 5 and above
98
Mometasone/Formoterol brand
Dulera
99
Mometasone/Formoterol (Dulera) drug class
ICS/LABA
100
Mometasone/Formoterol (dulera) dosage forms
MDI
101
Momestasone/Formoterol (dulera) age groups
adult only dosing
102
Fluticasone/Vilanterol brand
breo ellipta
103
Fluticasone/Vilanterol (breo ellipta) drug class
ICS/LABA
104
Fluticasone/Vilanterol (breo ellipta) dosage form
DPI
105
Fluticasone/Vilanterol (breo ellipta) age groups
adult only dosing
106
LABA/LAMA combo products adverse effects & Clinical Pearls
-not indicated for the treatment of acute deterioration
107
Olodaterol/Tiotropium brand
Stiolto respimat
108
Olodaterol/tiotropium (stiolto respimat) drug class
LABA/LAMA
109
Olodaterol/tiotropium (stiolto respimat) dosage forms
respimat
110
Olodaterol/tiotropium (stiloto respimat) age groups
adult dosing
111
Vilanterol/Umeclidnium brand
Anoro Ellipta
112
Vilanterol/Umeclidnium (anoro ellipta) drug class
LABA/LAMA
113
Vilanterol/Umeclidnium (anoro ellipta) dosage forms
Ellipta
114
Vilanterol/Umeclidnium (anoro ellipta) age groups
Adult dosing only
115
LABA/LAMA disease states
COPD
116
Indacaterol/glycopyrronium brand
Utibron neohaler
117
Indacaterol/glycopyrronium (utibron neohaler) drug class
LABA/LAMA
118
Indacterol/glycopyrronium (utibron neohaler) dosage forms
Neohlaer
119
Indacterol/glycopyrronium (utibron neohaler) age groups
adult only dosing
120
Formoterol/glycopyrronium brand
bevespi aerosphere
121
Formoterol/glycopyrronium (bevespi aerosphere) drug class
LABA/LAMA
122
Formoterol/glycopyrronium (bevespi aerosphere) dosage form
aerosphere
123
Formoterol/glycopyrronium (bevespi aerosphere) age groups
adult only dosing
124
Formoterol/aclidinium brand
Duaklir pressair
125
Formoterol/aclidinium (duaklir pressair) drug class
LABA/LAMA
126
Formoterol/aclidinium (duaklir pressair) dosage form
DPI
127
Formoterol/aclidinium (duaklir pressair) age groups
adult only dosing
128
Fluticasone/umeclidinium/vilanterol brand
trelegy ellipta
129
Fluticasone/umeclidinium/vilanterol (trelegy ellipta) drug class
LABA/LAMA/ICS
130
Fluticasone/umeclidinium/vilanterol (trelegy ellipta) dosage form
ellipta
131
Fluticasone/umeclidinium/vilanterol (trelegy ellipta) age groups
adult dosing only
132
Budesonide/glycopyrrolate/formoterol fumarate brand
Breztri aerosphere
133
Budesonide/glycopyrrolate/formoterol fumarate (breztri aerosphere) drug class
LABA/LAMA/ICS
134
Budesonide/glycopyrrolate/formoterol fumarate (breztri aerosphere) dosage forms
aerosphere
135
Budesonide/glycopyrrolate/formoterol fumarate (breztri aerosphere) age groups
adult only dosing
136
Cromolyn brand
Intal
137
Cromolyn (intal) drug class
Mast cell stabilizer
138
Cromolyn (intal) dosage forms
nebulizer solution
139
Cromolyn (intal) age groups
all ages groups
140
Mast cell stabilizer counseling points & adverse effects
AE: high incidence of unpleasant taste in mouth, rare cardiac arrhythmias, coughing, dyspnea, sore throat, N/V/D if absorbed systemically -less effective than low dose ICS - prevents increase in bronchial hyperactivity seen in allergy season
141
Leukotriene modifiers mechanism of action
block the production of leukotrienes
142
Montelukast brand
singular
143
Montelukast (singular) drug class
leukotriene modifier
144
Montelukast (singular) dosage form
tablets (chewable) granule packets
145
Montelukast (singular) age groups
approved for all ages
146
Leukotriene Modifiers Adverse effects & clinical pearls
AE: neuropsychiatric events, Churg-Strauss syndrome, increased hepatic transaminases -less effective than low dose ICS and ICS/LABA in asthma -have not been adequately tried in COPD
147
Montelukast (singular) clinical pearls
-minor substrate of CYP2C8/9 and 3A4 - not for acute relief of symptoms -boxed warning: neuropsychiatric events
148
Zafirlukast (Accolate) clinical pearls
- take at least 1 hour before or 2 hours after meals - can increase INR - major substrate, a minor inhibitor of CYP 2C9
149
Zileuton (Zyflo CR) clinical pearls
-weak CYP1A2 inhibitor - take with food
150
Zafirlukast (accolate) drug class
Leukotriene modifiers
151
Zafirlukast brand
Accolate
152
Zafirlukast (accolate) dosage forms
Tablets
153
Zafirlukast (accolate) age groups
approved for ages 5 and up
154
Zileuton brand
Zyflo CR
155
Zileuton (zyflo CR) drug class
leukotriene modifiers
156
Zileuton (Zyflo CR) dosage form
IR tablets Er tablets
157
Zileuton (zyflo CR) age groups
adult only dosing available
158
Methylxanthines mechanism of action
bronchodilation through inhibition of PDE III and PDE IV
159
Methylxanthines adverse effects and clinical pearls
AE: insomnia, GI upset, hyperactivity, hypotension, tumor dose-related toxicity: tachycardia, nausea, vomiting, headache, seizures, arrhythmias CI: peptic ulcer disease, arrhythmias, seizure disorder DI: Major substrate of CYP3A4, 1A4, 1A2, 2E1 -> increase concentration of cimetidine, erythromycin, clarithromycin, ciprofloxacin, ticlopidine -> decrease concentration of phenobarbital, phenytoin, carbamazepine, rifampin, smoking - PDE III inhibition likely cause for hypotension, tachycardia and nausea
160
Theophylline brand
theochron
161
Theophylline (theochron) drug class
Methylxanthines
162
Theophylline (theocron) dosage forms
ER 12 hour tablets ER 24 hour tablets ER 24 hour capsules liquid
163
Theophylline (theocron) age groups
Adult dosing availble
164
Anti-IgE mechanism of action
inhibit IgE binding to receptors on mast cells and basophils, inhibit mediator release and attenuation of early and late phase allergic response
165
Anti-IgE Adverse Effects and clinical Pearls
AE: headache, injection site reactions, arthralgias, thrombocytopenia, pharyngitis, sinusitis, upper respiratory tract infections boxed warning: anaphylaxis - do not give more than 150mg per injection site -monitor for anaphylaxis before and after the injection site - FDA-approved for moderate to severe persistent asthma in patients w/ positive skin test or reactivity to perennial aeroallergen and symptoms that are inadequately controlled with ICS
166
Omalizumab brand
Xolair
167
Omalizumab (Xolair) drug class
Anti-IgE
168
Omalizumab (Xolair) dosage forms
prefilled syringe injection vial reconstiuted with sterile water
169
Omalizumab (Xolair) age groups
Dosing for ages 5 and up
170
Anti-IL5 mechanism of action
blocks binding of IL-5 receptor complex, which results in reduced production and survival of eosinophils
171
Mepolizumab brand name
Nucala
172
Mepolizumab (Nucala) drug class
Anti-IL5
173
Mepolizumab (nucala) dosage forms
auto-injector vial reconstituted w/ sterile water
174
Mepolizumab (nucala) age groups
dosing for ages 5 and up
175
Mepolizumab (nucala) adverse effects and clinical pearls
AE: headache, injection site reactions, arthralgias, herpes zoster infection precaution: anaphylaxis - available as in-clinic or at home injection -monitor for anaphylaxis before and after injection -indicated for add-on maintenance treatment of pts w/ sever asthma w/ an eosinophilic phenotype
176
Reslizumab (cinqair) drug class
Anti-IL5
177
Reslizumab brand
Cinqair
178
Reslizumab (cinqair) dosage forms
solution diluted in normal saline
179
Reslizumab (cinqair) age groups
adult only dosing
180
Benralizumab brand
Fasenra
181
Benralizumab (fasenra) dosage forms
auto-injector pre-filled syringe
182
Benralizumab (fasenra) age groups
adult only dosing
183
Reslizumab (cinqair) adverse effects and clinical pearls
AE: injection site, myalgias, increased creatine phosphokinase boxed warning: anaphylaxis, malignancies -monitor for anaphylaxis before & after injection - indicated for add-on maintenance treatment of pts w/severe asthma w/ an eosinophilic phenotype
184
Benralizumab (fasenra) adverse effects and clinical pearls
AE: injection site reactions, antibody development, headache, pharyngitis, fever precaution: anaphylaxis -available as an in-clinic or at-home injection -indicated for add-on maintenance treatment of sever asthma in adults and children 12 and up w/ an eosinophilic phenotype - acts on IL-5 receptors while others act on IL-5
185
Anti-IL4/IL13 mechanism of action
blocks binding of IL/4 to reduce eosinophil trafficking and IgE reactions while also blocking IL-13 to reduce mucus secretion and airway remodeling

Theraputics (4 decks)

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