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Theraputics > Controller Meds Asthma and COPD > Flashcards

Controller Meds Asthma and COPD Flashcards

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
Q

Fluticasone Furoate
brand

A

Arnuity Ellipta

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25
Q

Fluticasone Furoate (Arnuity ellipta)
drug class

A

ICS

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26
Q

Fluticasone Furoate (arnuity ellipta)
age groups

A

dosing for ages 5 and up

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27
Q

Mometasone
brand

A

Asmanex

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28
Q

Mometasone (asmanex)
drug class

A

ICS

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29
Q

Mometasone (asmanex)
dosage forms

A

HFA
Twisthaler

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30
Q

Mometasone (asmanex)
age groups

A

dosing for ages 5 and up

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31
Q

fluticasone furoate (arnuity ellipta)
dosage forms

A

ellipta

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32
Q

LABAs (long acting beta agonist)
mechanism of action

A

Increases cAMP
bronchial smooth muscle relaxation and inhibit hypersensitivity mediators from mast cells (histamine and leukotrienes)

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33
Q

LABAs (long acting beta agonist)
mechanism of action

A

Increases cAMP
bronchial smooth muscle relaxation and inhibit hypersensitivity mediators from mast cells (histamine and leukotrienes)

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34
Q

Arformoterol tartrate
brand

A

Brovana

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35
Q

Arformoterol tartrate (brovana)
drug class

A

LABA

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36
Q

Arformoterol tartrate (brovana)
dosage forms

A

nebulizer solution

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37
Q

Arformoterol tartrate (brovana)
age groups

A

adult dosing only

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38
Q

LABA
Adverse effects and clinical pearls

A

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

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39
Q

Formoterol
brand

A

Perforomist

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40
Q

Formoterol (preforomist)
drug class

A

LABA

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41
Q

Arformoterol tartrate (brovana)
disease state

A

COPD only

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42
Q

Formoterol (preforomist)
dosage forms

A

nebulizer solution

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43
Q

Formoterol (preforomist)
age groups

A

adult only dosing

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44
Q

Indacaterol
brand

A

Arcapta neohaler

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45
Q

Indacaterol (Arcapta neohaler)
drug class

A

LABA

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46
Q

Indacaterol (arcapta neohaler)
dosage forms

A

neohaler

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47
Q

indacaterol (arcapta neohaler)
age groups

A

adult only pts

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48
Q

Formoterol (preforomist)
disease states

A

COPD

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49
Q

Indacaterol ( arcapta neohaler)
disease state

A

COPD

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50
Q

Olodaterol
brand

A

Striverdi Respimat

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51
Q

Olodaterol (striverdi respimat)
drug class

A

LABA

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52
Q

Olodaterol (striverdi respimat)
disease state

A

COPD

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53
Q

Olodaterol (striverdi respimat)
dosage forms

A

respimat

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54
Q

Olodaterol (striverdi respimat)
age groups

A

adult only dosing

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55
Q

Salmeterol
brand

A

serevent

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56
Q

Salmeterol (servent)
drug class

A

LABA

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57
Q

Salmeterol (serevent)
dosage form

A

diskus

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57
Q

Salmeterol (serevent)
age groups

A

dosing for ages 5 and up

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58
Q

LAMA (long-acting antimuscarinics)
mechanism of action

A

block the bronchoconstrictor effects of acetylcholine on M2 and M3 receptors

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59
Q

LAMA
Adverse effects and clinical pearls

A

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

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60
Q

Aclidinium
brand name

A

Turdorza Pressair

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61
Q

Aclidinium (Turdorza Pressair)
drug class

A

LAMA

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62
Q

Aclidinium (turdorza pressair)
dosage form

A

DPI

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63
Q

Aclidinium (turdorza pressair)
age groups

A

adult dosing

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64
Q

Aclidinium (turdorza pressair)
disease state

A

COPD only

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65
Q

Glycopyrrolate
brand

A

seebri neohaler

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66
Q

Glycopyrrolate (seebri neohaler)
drug class

A

LAMA

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67
Q

Glycopyrrolate (seebri neohaler)
dosage form

A

DPI
Nebulizing solution

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68
Q

Glycopyrrolate (seebri neohaler)
age groups

A

adult dosing available

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69
Q

Glycopyrrolate (seebri neohaler)
disease states

A

COPD

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70
Q

Revefenacin
brand

A

yupelri

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71
Q

Revefenacin (yupelri)
drug class

A

LAMA

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72
Q

Revefenacin (yupelri)
dosage form

A

nebulization solution

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73
Q

Revefenacin (yupelri)
age groups

A

adult only dosing

74
Q

Revefenacin (yupelri)
disease state

A

COPD only

75
Q

Tiotropium
brand

A

Spiriva

76
Q

Tiotropium (spiriva)
drug class

A

LAMA

77
Q

Tiotropium (spiriva)
dosage forms

A

Handihaler
Respimat

78
Q

Tiotropium (Spiriva)
age groups

A

Handihaler- adult only dosing
Respimat- dosing for ages 5 and up

79
Q

Tiotropium (spiriva)
disease states

A

Handihaler - COPD only
Respimat- both asthma and COPD

80
Q

Umeclidinium
brand

A

Incruse ellipta

81
Q

Umeclidinium (incruse ellipta)
drug class

A

LAMA

82
Q

Umeclidinium (incruse ellipta)
dosage form

A

DPI

83
Q

Umeclidinium (incruse ellipta)
age groups

A

only adult dosing

84
Q

Umeclidinium (incruse ellipta)
disease state

A

COPD only

85
Q

ICS/LABA Combo products
adverse effects and clinical pearls

A

-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
Q

Fluticasone/Salmeterol
brand

A

Advair

87
Q

Fluticasone/Salmeterol (advair)
drug class

A

ICS/LABA

88
Q

Fluticasone/Salmeterol (advair)
dosage form

A

DPI
HFA MDI

89
Q

Fluticasone/Salmeterol (advair)
age groups

A

DPI- ages 5 and up
HFA- adult dosing available

90
Q

Fluticasone/Salmeterol
brand

A

AirDuo & AirDuo Digihaler

91
Q

Fluticasone/ Salmeterol (AirDuo & AirDuo digihaler)
drug class

A

ICS/LABA

92
Q

Fluticasone/Salmeterol (airduo & airduo digihaler)
dosage forms

A

Respiclick (DPI)

93
Q

Fluticasone/ Salmeterol (AirDuo & AirDuo digihaler)
age groups

A

Adult dosing available

94
Q

Budesonide/Formoterol
brand

A

Symbicort

95
Q

Budesonide/Formoterol (symbicort)
drug class

A

ICS/LABA

96
Q

Budesonide/Formoterol (symbicort)
dosage form

A

HFA MDI

97
Q

Budesonide/Formoterol (symbicort)
age groups

A

dosing for ages 5 and above

98
Q

Mometasone/Formoterol
brand

A

Dulera

99
Q

Mometasone/Formoterol (Dulera)
drug class

A

ICS/LABA

100
Q

Mometasone/Formoterol (dulera)
dosage forms

A

MDI

101
Q

Momestasone/Formoterol (dulera)
age groups

A

adult only dosing

102
Q

Fluticasone/Vilanterol
brand

A

breo ellipta

103
Q

Fluticasone/Vilanterol (breo ellipta)
drug class

A

ICS/LABA

104
Q

Fluticasone/Vilanterol (breo ellipta)
dosage form

A

DPI

105
Q

Fluticasone/Vilanterol (breo ellipta)
age groups

A

adult only dosing

106
Q

LABA/LAMA combo products
adverse effects & Clinical Pearls

A

-not indicated for the treatment of acute deterioration

107
Q

Olodaterol/Tiotropium
brand

A

Stiolto respimat

108
Q

Olodaterol/tiotropium (stiolto respimat)
drug class

A

LABA/LAMA

109
Q

Olodaterol/tiotropium (stiolto respimat)
dosage forms

A

respimat

110
Q

Olodaterol/tiotropium (stiloto respimat)
age groups

A

adult dosing

111
Q

Vilanterol/Umeclidnium
brand

A

Anoro Ellipta

112
Q

Vilanterol/Umeclidnium (anoro ellipta)
drug class

A

LABA/LAMA

113
Q

Vilanterol/Umeclidnium (anoro ellipta)
dosage forms

A

Ellipta

114
Q

Vilanterol/Umeclidnium (anoro ellipta)
age groups

A

Adult dosing only

115
Q

LABA/LAMA
disease states

A

COPD

116
Q

Indacaterol/glycopyrronium
brand

A

Utibron neohaler

117
Q

Indacaterol/glycopyrronium (utibron neohaler)
drug class

A

LABA/LAMA

118
Q

Indacterol/glycopyrronium (utibron neohaler)
dosage forms

A

Neohlaer

119
Q

Indacterol/glycopyrronium (utibron neohaler)
age groups

A

adult only dosing

120
Q

Formoterol/glycopyrronium
brand

A

bevespi aerosphere

121
Q

Formoterol/glycopyrronium (bevespi aerosphere)
drug class

A

LABA/LAMA

122
Q

Formoterol/glycopyrronium (bevespi aerosphere)
dosage form

A

aerosphere

123
Q

Formoterol/glycopyrronium (bevespi aerosphere)
age groups

A

adult only dosing

124
Q

Formoterol/aclidinium
brand

A

Duaklir pressair

125
Q

Formoterol/aclidinium (duaklir pressair)
drug class

A

LABA/LAMA

126
Q

Formoterol/aclidinium (duaklir pressair)
dosage form

A

DPI

127
Q

Formoterol/aclidinium (duaklir pressair)
age groups

A

adult only dosing

128
Q

Fluticasone/umeclidinium/vilanterol
brand

A

trelegy ellipta

129
Q

Fluticasone/umeclidinium/vilanterol (trelegy ellipta)
drug class

A

LABA/LAMA/ICS

130
Q

Fluticasone/umeclidinium/vilanterol (trelegy ellipta)
dosage form

A

ellipta

131
Q

Fluticasone/umeclidinium/vilanterol (trelegy ellipta)
age groups

A

adult dosing only

132
Q

Budesonide/glycopyrrolate/formoterol fumarate
brand

A

Breztri aerosphere

133
Q

Budesonide/glycopyrrolate/formoterol fumarate (breztri aerosphere)
drug class

A

LABA/LAMA/ICS

134
Q

Budesonide/glycopyrrolate/formoterol fumarate (breztri aerosphere)
dosage forms

A

aerosphere

135
Q

Budesonide/glycopyrrolate/formoterol fumarate (breztri aerosphere)
age groups

A

adult only dosing

136
Q

Cromolyn
brand

A

Intal

137
Q

Cromolyn (intal)
drug class

A

Mast cell stabilizer

138
Q

Cromolyn (intal)
dosage forms

A

nebulizer solution

139
Q

Cromolyn (intal)
age groups

A

all ages groups

140
Q

Mast cell stabilizer
counseling points & adverse effects

A

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
Q

Leukotriene modifiers
mechanism of action

A

block the production of leukotrienes

142
Q

Montelukast
brand

A

singular

143
Q

Montelukast (singular)
drug class

A

leukotriene modifier

144
Q

Montelukast (singular)
dosage form

A

tablets (chewable)
granule packets

145
Q

Montelukast (singular)
age groups

A

approved for all ages

146
Q

Leukotriene Modifiers
Adverse effects & clinical pearls

A

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
Q

Montelukast (singular)
clinical pearls

A

-minor substrate of CYP2C8/9 and 3A4
- not for acute relief of symptoms
-boxed warning: neuropsychiatric events

148
Q

Zafirlukast (Accolate)
clinical pearls

A
  • take at least 1 hour before or 2 hours after meals
  • can increase INR
  • major substrate, a minor inhibitor of CYP 2C9
149
Q

Zileuton (Zyflo CR)
clinical pearls

A

-weak CYP1A2 inhibitor
- take with food

150
Q

Zafirlukast (accolate)
drug class

A

Leukotriene modifiers

151
Q

Zafirlukast
brand

A

Accolate

152
Q

Zafirlukast (accolate)
dosage forms

A

Tablets

153
Q

Zafirlukast (accolate)
age groups

A

approved for ages 5 and up

154
Q

Zileuton
brand

A

Zyflo CR

155
Q

Zileuton (zyflo CR)
drug class

A

leukotriene modifiers

156
Q

Zileuton (Zyflo CR)
dosage form

A

IR tablets
Er tablets

157
Q

Zileuton (zyflo CR)
age groups

A

adult only dosing available

158
Q

Methylxanthines
mechanism of action

A

bronchodilation through inhibition of PDE III and PDE IV

159
Q

Methylxanthines
adverse effects and clinical pearls

A

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
Q

Theophylline
brand

A

theochron

161
Q

Theophylline (theochron)
drug class

A

Methylxanthines

162
Q

Theophylline (theocron)
dosage forms

A

ER 12 hour tablets
ER 24 hour tablets
ER 24 hour capsules
liquid

163
Q

Theophylline (theocron)
age groups

A

Adult dosing availble

164
Q

Anti-IgE
mechanism of action

A

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

165
Q

Anti-IgE
Adverse Effects and clinical Pearls

A

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
Q

Omalizumab
brand

A

Xolair

167
Q

Omalizumab (Xolair)
drug class

A

Anti-IgE

168
Q

Omalizumab (Xolair)
dosage forms

A

prefilled syringe
injection vial reconstiuted with sterile water

169
Q

Omalizumab (Xolair)
age groups

A

Dosing for ages 5 and up

170
Q

Anti-IL5
mechanism of action

A

blocks binding of IL-5 receptor complex, which results in reduced production and survival of eosinophils

171
Q

Mepolizumab
brand name

A

Nucala

172
Q

Mepolizumab (Nucala)
drug class

A

Anti-IL5

173
Q

Mepolizumab (nucala)
dosage forms

A

auto-injector
vial reconstituted w/ sterile water

174
Q

Mepolizumab (nucala)
age groups

A

dosing for ages 5 and up

175
Q

Mepolizumab (nucala)
adverse effects and clinical pearls

A

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
Q

Reslizumab (cinqair)
drug class

A

Anti-IL5

177
Q

Reslizumab
brand

A

Cinqair

178
Q

Reslizumab (cinqair)
dosage forms

A

solution diluted in normal saline

179
Q

Reslizumab (cinqair)
age groups

A

adult only dosing

180
Q

Benralizumab
brand

A

Fasenra

181
Q

Benralizumab (fasenra)
dosage forms

A

auto-injector
pre-filled syringe

182
Q

Benralizumab (fasenra)
age groups

A

adult only dosing

183
Q

Reslizumab (cinqair)
adverse effects and clinical pearls

A

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
Q

Benralizumab (fasenra)
adverse effects and clinical pearls

A

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
Q

Anti-IL4/IL13
mechanism of action

A

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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