inhaled CCs

Question 1

Qvar and Kelhale products have extrafine particles and are twice as potent as other beclometasone inhalers. For example, if you have Clenil 200mg the equivalent QVar and Kelhale would be…

Answer 1

100mg!! TWICE as potent

Question 2

which ones have extrafine particles and are twice as potent as other beclometasone inhalers

Answer 2

qvar
kelhale

Question 3

local adverse effects include

Answer 3

Oral candidiasis, sore mouth, dysphonia, and hoarseness, especially in high doses.
Paradoxical bronchospasm.

Question 4

In children taking inhaled corticosteroids, what needs to be monitored regularly.

Answer 4

height

Question 5

Inhaled corticosteroids have potent anti-inflammatory activity — they inhibit or prevent inflammatory components of both the immediate and late phases of asthma. Inhaled corticosteroids:

(4)

Answer 5

Decrease formation of cytokines (an inflammatory mediator).
Decrease microvascular permeability.
Inhibit influx of eosinophils into the lung (reducing overall inflammation).
Reduce bronchial hyper-responsiveness.

Question 6

MHRA advice on CCs - what is it

Answer 6

rare risk of central serous chorioretinopathy with local as well as systemic administration

patients should be advised to report any blurred vision or other visual disturbances with corticosteroid treatment given by any route; consider referral to an ophthalmologist for evaluation of possible causes if a patient presents with vision problems.

Question 7

common side effects for inhaled CCs, including one that is specific for pt with COPD

Answer 7

headache
oral thrush
pneumonia in pt with COPD
taste altered
voice altered

Question 8

how can you reduce risk of candidiasis

Answer 8

spacer
rinse mouth with after inhaling device

Question 9

what is paradoxical bronchospasm

Answer 9

when the opposite intended effect of treatment occurs and bronchospasm occurs instead of bronchodilation

if this happens, discontinue and seek alternative therapy

mild bronchospasm may be prevented by inhaling SABA beforehead

Question 10

MHRA advice about Fostair

Answer 10

contains extra fine particles of beclomethasone
more potent than traditional beclomet CFC inhalers
dose in Fostair needs to be LOWER than in non extra fine formulations

Question 11

this CC inhaler is usually given OD but can be increased to BD dosage if needed

Answer 11

ciclesonide

Question 12

This inhaler comprises vilanterol in combination with fluticasone and umeclidinium and is only licensed for COPD

Answer 12

Trelegy Ellipta