ICS Flashcards

1
Q

MOA

A
  • Decreasing cytokine formation and suppressing the immune response in the lungs
  • Overall reducing inflammation
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2
Q

Examples

A
  1. Beclometasone
  2. Budesonide
  3. Fluticasone
  4. Ciclesonide
  5. Mometasone
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3
Q

Beclometasone inhaler examples

A
  • MDI: Clenil, Qvar
  • DPI: EasyHaler
    (beclometasone), Asmabec,
    Pulvinal
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4
Q

Budesonide inhaler examples

A
  • DPI: Pulmicort Turbohaler,
    Budelin Novolizer
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5
Q

Fluticasone inhaler examples

A
  • MDI: Flixotide Evohaler
  • DPI: Flixotide Accuhaler
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6
Q

Ciclesonide inhaler examples

A
  • MDI: Alvesco
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7
Q

Mometasone inhaler examples

A
  • DPI: Asmanex
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8
Q

ICS + LABA (MART)

A
  1. Beclometasone + formoterol
  2. Budesonide + formoterol
  3. Fluticasone + formoterol
  4. Fluticasone + salmeterol
  5. Fluticasone + vilanterol
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9
Q

Beclometasone + Formoterol

A
  • Fostair (MDI)
  • Fostair Nexthaler (DPI)
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10
Q

Budesonide + formoterol

A
  • DuoResp
  • Symbicort
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11
Q

Fluticasone + formoterol

A

Flutiform pMDI

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12
Q

Fluticasone + salmeterol

A
  • Seretide
  • Sereflo
  • Sirdupla
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13
Q

Fluticasone + vilanterol

A
  • Relvar
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14
Q

Are ICS doses equivalent?

A
  • Budesonide + beclo are approx eq
  • Beclometasone inhalers (QVAR and Clenil) are not interchangeable and should be prescribed by brand
  • Fluticasone is 2x potent than beclometasone
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15
Q

Are the different brands of
Beclometasone
inhalers equivalent to each other?

A
  • There are extra-fine particles and traditional-size particles of beclometasone
  • Extra-fine particles are Kelhale and Qvar = 2 x potent
  • Qvar 100mcg TWO puffs BD = Clenil 200mcg TWO puffs BD
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16
Q

Clenil doses

A
  1. Very-low
    - 50mcg TWO puffs BD
  2. Low
    - 100mcg TWO puffs BD
  3. Medium
    - 200mcg TWO puffs BD
  4. High
    - 250mcg TWO-FOUR puffs BD (MAX 2000mcg in a day)
17
Q

What age are
Beclometasone and
Qvar licensed in?

A
  • Beclometasone = 2+, 200mcg and 250mcg inhalers unlicensed in children
  • Qvar is licensed from 5 years old
18
Q

Steroid card

A

> 1000mcg beclomethasone or eq daily

19
Q

SE

A
  • Oral thrush
  • Dysphonia (disorders of the voice)
  • Hoarseness
  • Paradoxical bronchospasms
  • Adrenal suppressoin (high doses)
  • Growth restriction in children
20
Q

Paradoxical bronchospasm

A
  • MILD
  • Prevented by inhalation of SABA before hand
  • Change from an aerosol inhalation to dry powder inhalation
21
Q

Central serous chorioretinopathy

A
  • Rare risk
  • Visual disturbances - report
22
Q

Monitoring

A

o Monitor weight and height of children on prolonged treatment
o If growth slowed = refer to paediatrician