ICS drugs

Question 1

Beclomethasone (Qvar)

Answer 1

BID

MDI

Question 2

Fluticasone (flovent)

Answer 2

BID

MDI or DPI

Question 3

Budesonide (pulmicort)

Answer 3

BID

DPI or SVN

Question 4

mometasone ( Asmanex)

Answer 4

BID or Q day

DPI

Question 5

ciclesonide (Alvesco)

Answer 5

is inactivate when inhaled
activates by protease in the lungs ( metabolize)
Qd
MID
currently the main use is after other ICS for severe asthmatics

Question 6

ICS - LABA combination

Answer 6

fluticasone/ salmeterol (advair) — DPI , BID
Budesonide/ Folmoterol (symbicort) DPI, BID
mommetasone/ formoterol (Zenhale) MDI, BID
Fluticasone/ Viranterol (breo ellipta) DPI, once daily

Question 7

what are two main uses for systemic corticosteroids ?

Answer 7

1. ) add on therapy if asthma still uncontrolled with high doses of ICS
2. ) Tx for status asthmaticus (unresponsive acute exacerbations

Question 8

oral options for systemic corticosteroids

Answer 8

Prednisone - PO, effect 12-36

Dexamethasone PO effect ~24 hrs

Question 9

IV options for systemic corticosteroids

Answer 9

Methylprednisone, Solu- medrol —– 1/2 life 18-36 hrs
Hydrocortisone, (solu- cortef) ——- 1/2 life ~ 8-10 hrs
Dexamethasone ( decadron ) ——– 1/2 life ~ 3hr
( also used to decrease swelling around ETT prior to extubation and Tx of croup