Ex. 3 - Asthma Drugs - ICS

Question 1

Inhaled Corticosteroids (ICS) - Prevent and control inflammation

Answer 1

Beclomethasone (QVAR)
Budesonide (Plumicort)
Budesonide (Plumicort Respules)
Ciclesonide (Alvesco)
Fluticasone Propionate (Flovent)
ArmonAir (Digihaler)
Fluticasone Furoate (Arnuity Ellipta)
Mometasone (Asmanex)

Question 2

ICS function

Answer 2

Prevent and control inflammation

Question 3

Beclomethasone

Answer 3

Inhaled Corticosteroid
Brand: QVAR
Dosage form: Redihaler (MDI)
40 or 80
mcg/inhalation

Question 4

Beclomethasone dosing: 0-4, 5-11, Adult dosing

Answer 4

0-4 - yes
5-11 - yes
Adult - yes

Question 5

Budesonide

Answer 5

Inhaled Corticosteroid
Brand: Pulmicort
Dosage form: Flexhaler
90 or 180 mcg/inhalation

Question 6

Budesonide dosing:
0-4, 5-11, Adult

Answer 6

0-4 - yes
5-11 - yes
Adult - yes

Question 7

Budesonide (other)

Answer 7

Inhaled Corticosteroid
Brand: Pulmicort Respules
Dosage form: Nebulizer solution
0.25mg/2mL
0.5mg/2mL
1mg/2mL

Question 8

Budesonide Nebulizer Dosing:
0-4, 5-11, Adult

Answer 8

0-4: yes
5-11: yes
Adult: yes ?

Question 9

Ciclesonide

Answer 9

Inhaled corticosteroid
Brand: Alvesco
Dosage form: HFA
80 or 160 mcg/inhalation

Question 10

Ciclesonide dosing:
0-4, 5-11, Adult

Answer 10

0-4: yes
5-11: yes
Adult: yes

Question 11

Fluticasone Propionate

Answer 11

Inhaled corticosteroid
Brand: Flovent
Dosage forms:
HFA: 44, 110 or 220mcg/inhalation
DPI: 50, 100, or 250 mcg/inhalation

Question 12

Fluticasone Propionate alternative

Answer 12

Inhaled corticosteroid
Brand: Armonair Digihaler
Dosage form: Aersol powder inhaler
55, 113, 232 mcg/inhalation

Question 13

Fluticasone Propionate HFA and DPI dosing:
0-4, 5-11, Adult

Answer 13

0-4: yes
5-11: yes
Adult: yes

Question 14

Fluticasone Propionate Aerosol powder inhaler dosing:
0-4, 5-11, Adult

Answer 14

0-4: yes
5-11: yes
Adult: yes

Question 15

Fluticasone Furoate

Answer 15

Inhaled corticosteroid
Brand: Arnuity Ellipta
Dosage form: Ellipta
50, 100, and 200 mcg/inhalation

Question 16

Fluticasone Furoate dosing:
0-4, 5-11, Adult

Answer 16

0-4: yes
5-11: yes
Adult: yes

Question 17

Mometasone

Answer 17

Inhaled corticosteroid
Brand: Asmanex
Dosage form: 50, 100, and 200 mcg/inhalation
Twisthaler:
110 and 220 mcg/inhalation

Question 18

Mometasone dosage 0-4, 5-11, Adult

Answer 18

Both HFA and Twisthaler:
0-4: yes
5-11: yes
Adult: yes

Question 19

Inhaled corticosteroids AE

Answer 19

Oral thrush (candidiasis), cough, dysphoria

Question 20

Inhaled corticosteroids counseling:

Answer 20

Patients should rinse their mouth and spit after use to prevent oral thrush
ICSs are the most effective long term control therapy for asthma (improve quality of life, increase lung function, and reduce risk of exacerbations)
ICSs may increase the risk of pneumonia in patients with COPD
Titrate to lowest effective dose- see low, medium and high dose conversion table
Pulmicort Respules should use Jet nebulizer and should not be mixed w/other nebulizer meds
High dose increase the risk for systemic side effects
See steroid potency chart for dosing