COPD/Asthma Important Info Flashcards
what meds are inhaled corticosteroids?
- Beclomethasone (QVAR)
- Budesonide (pulmicort and pulmicort respules)
- ciclesonide (alvesco)
- fluticasone propionate (flovent/ armonair digihaler)
- fluticasone furoate (arnuity ellipta)
- mometasone (asmanex)
what meds are LABAs?
- arformoterol tartrate (brovana)
- formoterol (performist)
- indacterol (arcapta neohalar)
- olodaterol (striverdi respimat)
- salmoterol (servent)
what drugs are LAMAs?
- aclindinium (turdorza pressair)
- glycopyrrolate (seebri neohalar)
- revefenacin (yupelri)
- tiotropium (spiriva)
- umeclidinium (increuse ellipta)
what drugs are an ICS/LABA combo?
- fluticasone/ salmoterol (advair)
- fluticasone/ salmoterol (airduo & airduo digihaler)
- budesonide/ formoterol (symbicort)
- mometasone/ formoterol (dulera)
- fluticasone/ vilanterol (breo ellipta)
what meds are LABA/LAMA combos?
- olodaterol/ tiotropium (stiolto respimat)
- vilanterol/ umeclidinium (anoro ellipta)
- indacterol/ glycopyrronium (utibron neohalar)
- formoterol/ glycopyrronium (bevespi aerosphere)
- formoterol/ aclindinium (duaklir pressair)
what drugs are LABA/LAMA/ICS combo?
- fluticasone/ umeclidinium/ vilanterol (trelegy ellipta)
- budesonide/ glycopyrrolate/ formoterol fumarate (breztri aerosphere)
what meds are leuketriene modifiers?
- montelukast
- zafirlukast
- zileuton
what drug is an anti-IGE?
omalizumab
what med is a methylxanthine?
theophylline
what drugs are anti-IL5s?
- mepolizumab
- resiluzumab
- benralizumab
what drug is a anti-IL4/IL13?
dupilumab
what drug is a phosphodiesterase-4 inhibitor?
roflumilast
what do ICS drugs do?
prevent and control inflammation
what do LABAs do?
- inc. cAMP
- cause bronchial smooth muscle relaxation and inhibit hypersensitivity mediators from mast cells (leukotrienes and histamines)
what do LAMAs do?
- block the bronchoconstriction effects of acetlcholine on M3 and M2 receptors
what do leukotreine modifiers do?
block the production of leukotrienes
what do methylzanthines do?
cause bronchodilation through inhibition on PDE lll and PDE lV
what do anti-IgE’s do?
- inhibit IgE binding to receptors on mast cells and basophils
- inhibit mediator release and attenuation of early and late phase allergic response
what do anti-iL5s do?
- block the binding of IL-5 to the alpha chain of the IL-5 receptor complex, which results in reduced production and survival of eosinophils
what do phosphodiaesterase-4 inhibitors do?
inhibit PDE4 leading to increased cAMP
what do anti-IL4/IL13s do?
blocks binding of IL4 to reduce eosinophil trafficking and IgE reactions while also blocking IL-13 to reduce mucus secretion and airway remodeling
what drugs are COPD only (for adults specifically)?
LABAs (except servent), LAMAs (except spiriva respimat), LABA/LAMA combo, ICS/LABA/LAMA, and daliresp
what drugs are used mostly for asthma?
leukotriene modifiers, injectables
what do all people with asthma need?
an ICS
what are the age ranges for an adult vs. a child?
child <12 and adult > or equal to 12
when should you assume a medication isn’t for a child?
- when it says COPD only, otherwise assume it is for a child as well we just have no data.
- more so asthma is for children
what meds could be given to a child (doesn’t say COPD only)?
- an ICS
- leukotriene modifers
- Spiriva respimat
- servent (LABA)
- all injectables
what are the stages of COPD?
- A
- B
- E
what does a stage A mean ? and what would you give them?
a bronchodilator ( LAMA or LABA)
- mMRC ( 0 or 1
- CAT <10
what does stage B mean? and what would you give them?
- LAMA and LABA
- mMRC > or 2
- CAT > or 20
what is stage E mean? and what would you give them?
- they have had 2 or more exacerbations and or have been once or more hospitalized
- LAMA and LABA
or LAMA/ LABA. ICS ** eos > or equal to 300
what are the stages of the GOLD standard and what is more severe?
- 1 >80
- 2 50-79
- 3 30-49
- 4 ( <30 FEV1 predited)
what does the mMRC scale and how many grades?
- 0-4 with o being very mild and 4 being severe
what is a CAT assessment and what is the max score?
- 40 points and it is another assessment
can you go back on COPD? can you go back on asthma?
- COPD is progressive so no
- asthma yes you can go forward or back
what types of inhalers are DPI (dry powder)?
- flexhalar
- aerosol
- DPI
- ellipta
- twisthalar
- neohalar
- diskus
- handihalar
- respiclick
- aerosphere
what inhalers are mist inhalars?
respimat
what inhalers are a gas?
HFA, redihalar
are all inhalers MDIs?
yes; multiple dose inhalers
what type of breathing does a DPI need?
quick and deep
do all HFA inhalers need a spacer?
yes
when would you use a LABA in asthma patients?
never
what are advantaged of a DPI?
requires less coordination
Which of these is an environmental risk factor for asthma?
A. `Allergen exposure
B. Antibiotic exposure
C. Exposures to second hand smoke
Which symptom frequency would be classified as moderate persistent asthma?
A. Nighttime awakening >1 time/week
Which patient would be considered for a COPD diagnosis?
> 40 year old patient with a chronic cough, dyspnea and sputum production and An adult with a history of smoking >1 pack per day for 10 years
T/F Presence of a post bronchodilator FEV1/FVC of <0.7 confirms the presence airflow limitation consistent with COPD
true
When should you consider an ICS therapy for a patient living with COPD?
concurrent asthma diagnosis
