Drugs Flashcards
Drug classes use for short term management
- Short acting beta-agonist (min)
- PO/IV corticosteroids (hours)
Drugs belong to SABA
- Agents
- MOA
- ADEs
- Albuterol
- Fenoterol
- Levalbuterol
- MOA: activates adenylate cyclase which increase cAMP (antagonism of bronchoconstriction)
- ADEs: palpitation, tachycardia, tremor, light-headedness, nervousness, HA and nausea
Xopenex
- Class:
- Dose/age
- Expiration
- Open up foil
- Open up but leave in foil
Lavalbuterol
- Form: HFA, Neb
- Class: SABA
- > 12 y.o: 0.63 mg TID
- 6-12 y.o: 0.31 mg TID
- Open up foil: good for 1 wk
- Open up but leave in foil: good for 2 weeks
Xopenex HFA MDI
- Class: SABA
- Dose: 2inh (90mcg) q4-6h or 1 inh q4h
- 1st line for persistent asthma:
- ADEs of inhaled corticosteroids
- Corticorsteroid is 1st line for persistent asthma in adults and children. It have high anti-inflammatory effects
ADEs
- Oral candidiasis, dysphonia, cough
- To prevent: use spacer device and rinse mouth after
Aerospan
- Form
- Age limited:
Flunisolide
- Form: HFA
- Age limited: >/= 6 y.o
- Come with built in space => no need to rec a spacer
Veramyst
- Indication
Fluticasone furoate
- Indication: allergic rhinitis, allergic conjunctivitis
Flonase
- Indication
Fluticasone propionate
- Indication: Allergic rhinitis
Dymista
- Indication
Fluticasone + Azelastine
- Indication: Allergic rhinitis
Alvesco
- Age
- Indication
Ciclesonide - Prodrug
- Age: for greater than 12 y.o
- Indication: Asthma
Omnaris
- Dose
- Indication
- Ketoconazole
Ciclesonide
- Omnaris: 2 spray per nostril QD
- Indication: Allergic rhinitis
=> Ketoconazole increase systemic [ ] may lead to adrenal suppression
NasalCrom OTC
Cromolyn Nasal Sol’n
- Class: Mast cell stabilizer
- Indication: allergic rhinitis
Opticrom
- Indication
Cromolyn
- Indication: allergic conjuctivitis for year round rhinitis
Servent diskus
- Class
Salmeterol DPI
Class: LABA
Foradil
- Form:
- Indication
- Storage
Formoterol
- Form: DPI
- Prevention of exercise induced: 1 puff 10 min prior to exercise
- Refrigerate the dry powder cap => dose BID
**Advair
- Dose:
- Exp after opened foil
Salmeterol + Fluticasone
- Form: Diskus and HFA
- After foil open: food for 1 month
**Symbycort
- Form:
- Indication
- Exp after opened foil wrap
- Age of use:
Formoterol + Budesonide: MDI
- Asthmas & COPD maintenance
- 2 puffs BID
- The foil wrap protects if from moisture: after open is only good for 90 days
Dulera
- Form
Formoterol + Mometasone:
- Form: MDI
Singulair
- Class
- Indication
- Frequency
Montelukast
- Anti Leukotriences. Preceptor antagonist
- Indication: allergy, asthma, exercise induce asthma
- Frequency: QPM
Accolate
- Class
- Indicaiton
- Adm
Zafirlukast
- Anti-Leukotriences
- Indication: ppx/tx of chronic asthma
- Adm: BID on empty stomach (accolate = eat later)
Zyflo CR
- Class
- Indication
- And
- Monitor
Zileuton
- Anti Leukotriences
- Indicaiton: ppx/tx of chronic asthma
- Adm: BID with Foods
- Monitor: LFTs
Xolair
- ADE:
- Monitor:
- Indication
- Frequency
Omalizumab
- Malignancies; anaphylaxis
- Monitor: IgE and Eosinophril
- Indication: allergic asthma, chronic idiopathic urticaria. Not for acute asthma
- Frequency: 2-4 weeks SC
Inhaler w/ Lactose
- Pulmicort Flexhaler
- Serevent diskus
- Flovent diskus
- Asmanex
- Advair Diskus
- Foradil
- Spiriva
Tornalate
- Class
- Indication
Bitolterol
- Class B2 - Agonist
- Indication: for preterm labor
Metaprel
ProMeta
- Class
- Indication
Metaproterenol
- Class: beta-2 agonist
- Indication: bronchoconstriction
Brethine
- Indication
- SE risk:
Terbutaline
- Class: beta-2 agonist
- Indication: suppress contraction
- ORAL: should not use for preterm tx: risk of cardiac problem. Have not shown to be effective
- Injectable: should NOT use > 2-3 days for suppressing contraction due to serious maternal heart problems & death
Common agents use to treat Preterm Labor
- Magnesium sulfate (MgSO4)
- Indomethacin
- Nifedipine
Makena
- Dose
- Indication
Hydroxyprogesterone caproate
- Dose: IM once a week from 16th to 37th week of pregnancy
- Indication: preterm pregnancy
Drugs use for prevention of exercise induced bronchoconstriction
- LABA
- Salmetrol
- Formoterol: 1 puff 10 min prior to exercise
- Montelukast
- Cromolyn (Instal)
- Singulair: 10mg PO 2H before exercise
Open foil expiration date:
- Xopenex Nebulizer
- Servent Diskus
- Advair
- Formoterol (Foradil) DPI:
- Symbicort (budesonide & formoterol)
- Combivent Respimat
- Tudorza Pressair (Aclidinium):
- Brovana (arformoterol neb)
- Xopenex Nebulizer: Open up foil plastic good for 1 week & opened foil but left inside good for 2 weeks
- Servent Diskus: 6 weeks
- Advair: 1 months
- Formoterol (Foradil) DPI: 4 months from date of dispense (same as for Pradexa)
- Symbicort (budesonide & formoterol): after open, only good for 90 days
- Combivent Respimat: Write discard date on the label of the inhaler 3 months from the date the cartridge is inserted or when put on pharmacy label
- Tudorza Pressair (Aclidinium): discard when 60 counter goes to 0 or 45 days after open or taking it out of the sealed pouch
- Brovana (arformoterol neb): up to 6 weeks at RT
Which DPI can be dose QPM once daily or BID
- Asmanex - Mometasone
Strength for the following meds:
- Advair:
- Symbicort
- Advair: 100/50; 250/50; 500/50 (Steroid change but LABA stays same)
- Symbicort: 80 mcg/4.5mcg; 160 mcg/4.5 mcg
In asthma and COPD med, all medications are in mcg excepto two med, which are they:
- Theophyllin
- Xolair
Ventolin
- Brand/Form
- Dose
Albuterol
- Form: HFA
- Dose: 1-2 puffs Q4-6H prn
Proventil
- Generic/Form
- Dose
Albuterol
- Form: HFA
- Dose: 1-2 puffs Q4-6H prn
ProAir
- Generic/Form
- Dose
Albuterol
- Form: HFA
- Dose: 1-2 puffs Q4-6H prn
AccuNeb
- Generic/Form
Albuterol
- Form: Neb Sol’n
VoSpire
Generic/Dose
Albuterol Tab
- Dose: 4-8 mg PO Q12H Max 16mg Q12H
Albuterol Tab
- Form
- MDI
- Syrup 2mg/5mL
- IR: 2, 4 mg tab
- ER: 4, 8 mg
QVAR
- Form
- Dose
- Space:
Beclomethasone HFA
Adult dose:
- 40mcg 1-4 puffs BID
- 80 mcg 1-2 puffs BID
5-11 years
- 40 mcg: 1-2 puffs BID
- No need spacer b/c the particle is small & will deposit into the lung
Beconase AQ
- Indication:
- Frequency
Beclomethasone
- Indication: allergy rhinitis
- Frequency: BID
Qnasl
- Indication:
- Frequency
Beclomethasone
- Indication: Allergy rhinitis
- Frequency: 2 spray into each nostril QD
- For 12 y.o or older
- Prime 4x
Pulmicord Flexhalder
- Form
- How to use it
Budesonide
- Form: Dry powder => no need a spacer or shake
- Inhale quick forceful inspiration
Pulmicort Respules
- Form
- Age limited
Budesonide
- Form: Nebulizer
- Age: as young as 12 mo old
Rhinocort
- Indication
Budesonide
- Allergic rhinitis
Entocort EC
- Indication
- Dose
- Avoid
Budesonide
- Indication: Crohn’s Disease
- Dose: 9mg PO QD
- Avoid: grapefruit juice
Uceris
- Indication
- Dose
- Avoid
Budesonide
- Indication: ulcerative colitis
- Dose: 9mg PO QD in AM
- Avoid: grapefruit juice
Asmanex Twisthaler
- Generic/form
Mometasone
- Form: dry powder
Nasonex
- Indication
- Dose
Mometasone
- Indication: allergic rhinitis
- Dose: 2 prays in each nostril daily
Elocon
- Form
Mometasone
- Form: topical apply QD
Flovent
- Form
Fluticasone
- Form: MDI
Flovent Rotadisk
- Form
Fluticasone
- Form: DPI
Advair
Salmeterol + Flovent Rotadisk
Arnuity Ellipta
- Form
- Frequency
- Age
Fluticasone
- Form: DPI QD
- Age: > 12 y.o
Zetonna
- Dose
- Indication
- Ketoconazole
Ciclesonide
- Zetonna: 1 spray/nostril QD
- Indication: Allergic rhinitis
=> Ketoconazole increase systemic [ ] may lead to adrenal suppression
Flo-Pred
Prednisolone
Millipred
Prednisolone
Prelone
Prednisolone
- Contain EtOH
Pediapred
Prednisolone
Orapred
Prednisolone ODT
Veripred 20
Prednisolone
Corticosteroid equivalent
- Cortisone 25mg
- Hydrocortisone 20mg
- Prednisolone 5mg
- Prednisone 5mg
- Methylprednisolone 4mg
- Triamcinolone 4mg
- Dexamethasone 0.75mg
Alocril
Nedocromil
- I: allergic conjunctivitis
Elixophyllin
- Form
- MOA
- Dose
Theophylline - methylxanthines
- Form: Elixir = disulfram rxn
- MOA: Increase cAMP & cGMP
- Dose: 300-400mg/d. Max 900mg/d
Swallow as a whole w/ full glass of water. Do not crush
Theo-24
Theophylline - methylxanthines
Theochron ER-12H
Theophylline - methylxanthines
Theophylline - methylxanthines
Adult level:
Children level:
Adult level: 5-15 mcg/mL
Children level: 5-10 mcg/mL
Theophylline - Aminophylline conversion
Theophylline = 80% of aminophylline dose
Nasocort
Triamcinolone