ICS and LABA only drugs Flashcards
beclomethasone brand
QVAR
beclomethasone (qvar) dosage form
redihaler (mdi)
40 or 80 mcg/inhalation
ciclesonide brand
alvesco
beclomethasone (qvar) dosing in 5-11 yos
40-80 mcg inhaled bid
beclomethasone (qvar) dosing in adults
40-320 mcg inhaled bid
budesonide brand
pulmicort
pulmicort respules
budesonide (pulmicort) dosage form
flexhaler
90 or 180 mcg/inhalation
budesonide (pulmicort) dosing in 5-11 yos
90-360 mcg inhaled bid
budesonide (pulmicort) dosing in adults
90-720 mcg inhaled bid
budesonide (pulmicort respules) dosage form
nebulizer solution
0.25mg/2mL
0.5mg/2mL
1mg/2mL
ciclesonide (alvesco) dosage form
HFA
80 or 160 mcg/inhalation
fluticasone propionate brand
flovent
armonAir diginhaler
fluticasone propionate (flovent, armonair diginhaler) dosage form
HFA - 44, 110, or 220 mcg/inhalation
DPI - 50, 100, or 250 mcg/inhalation
aerosol powder inhaler - 55, 113, 232 mcg/actuation
fluticasone propionate (flovent, ArmonAir Diginhaler) dosing in 0-4 yos
only over 4 yos
HFA - 88 mcg bid
DPI - 50 mcg bid
budesonide (pulmicort respules) dosing in 0-4 yos
0.25 to 1 mg/day qd or divided bid
budesonide (pulmicort respules) dosing in 5-11 yos
0.5 to 2 mg per day qd or divided bid
ciclesonide (alvesco) dosing in 5-11 yos
only over 6 yos
80 to 160 mcg qd
fluticasone propionate (flovent, armonair diginhaler) dosing in 5-11 yos
HFA - 44 to 88 mcg inhaled bid
DPI - 50 to 100 mcg inhaled bid
fluticasone propionate (flovent, armonair diginhaler) dosing in adults
HFA - 44 to 220 mcg inhaled bid
DPI - 50 to 250 mcg inhaled bid
MDPI - 55 to 232 mcg inhaled bid
ciclesonide (alvesco) dosing in adults
80 to 320 mcg inhaled bid
fluticasone furoate brand
arnuity ellipta
fluticasone furoate (arnuity ellipta) dosage form
50, 100, and 200 mcg per inhalation
mometasone (asmanex) dosage forms
HFA - 50, 100, and 200 mcg/inhalation
twisthaler - 110 and 220 mcg/inhalation
mometasone brand
asmanex
fluticasone fuorate (arnuity ellipta) dosing in 4-11 yos
50 mcg qd
fluticasone fuorate (arnuity ellipta) dosing in adults
100 to 200 mcg inhaled qd
mometasone (asmanex) dosing in 4-11 yos
HFA - 100 mcg bid
Twisthaler - 110 mcg qpm
mometasone (asmanex) dosing in adults
HFA - 200 to 400 mcg bid
twisthaler - 110 to 880 mcg qpm
inhaled corticosteroids (ICS) usage
prevent and control inflammation in asthma and COPD
inhaled corticosteroids (ICS) medications
beclomethasone (qvar)
budesonide (pulmicort, pulmicort respules)
ciclesonide (alvesco)
fluticasone propionate (flovent, armonair diginhaler)
fluticasone fuorate (arnuity ellipta)
mometasone (asmanex)
adverse effects of ICS
oral thrush (candidiasis)
cough
dysphonia
counseling tip of ICS
patients should rinse their mouth and spit after use to prevent oral thrush
clinical pearls of ICS
1) most effective long-term control therapy for asthma (improve quality of life, increase lung function, and reduce the risk of exacerbations)
2) may increase the risk of pneumonia in patients with COPD
3) titrate to lowest effective dose
4) pulmicort respules should use jet nebulizer and should not be mixed with other nebulizer medications
5) high doses increase the risk for systemic side effects
arformoterol tartrate brand
brovana
arformoterol tartrate (brovana) dosage form
nebulizer solution
15 mcg/2mL
formoterol brand
perforomist
formoterol (perforomist) dosage form
nebulizer solution
20 mcg/2mL
indacaterol brand
arcapata neohaler
indacaterol (arcapata neohaler) dosage form
neohaler
75 mcg per capsule
olodaterol brand
striverdi respimat
olodaterol (striverdi respimat) dosage form
respimate
2.5 mcg per inhalation
arformoterol tartrate (brovana) dosing in adults
15 mcg inhaled bid
COPD only
formoterol (perforomist) dosing in adults
20 mcg inhaled bid
COPD only unless used in combination with ICS in asthma
indacaterol (arcapta neohaler) dosing in adults
75 to 300 mcg inhaled qd
COPD only
olodaterol (striverdi respimat) dosing in adults
5 mcg (two inhalations) qd
COPD only
salmeterol brand
serevent
salmeterol (serevent) dosage form
diskus
50 mcg/blister
salmeterol (serevent) dosing in 4-11 yos
inhale contents of one blister (50 mcg) bid
salmeterol (serevent) dosing in adults
50 mcg (one blister) inhaled bid
adverse effects of LABA
tachycardia
headache
tremor hypokalemia
box warning for LABA
increased risk of asthma related death for all monotherapy LABA use (should not be used alone for asthma management)
increasing hospitalizations in pediatric and adolescent patients
clinical pearls of LABAs
prolonged QT seen with intentional overdoses
not for acute symptoms
may be helpful for exercise induce bronchospasm
formoterol and indacaterol capsules should not be taken orall
pediatric considerations of LABAs
most children under 4 yos cannot provide sufficient inspiratory flow for adequate lung delivering with a DPI
LABA
long acting beta agonists
increased cAMP
bronchial smooth muscle relaxation and inhibit hypersensitivity mediators from mast cells (histamine and leukotrienes)