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PHRM 82500 > Long-Term Control Medications in Asthma and COPD > Flashcards

Long-Term Control Medications in Asthma and COPD Flashcards

1
Q

What is the brand of Belomethasone?

A

QVAR

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2
Q

What is the generic of QVAR?

A

Belomethasone

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3
Q

What is the dosage form of Belomethasone and QVAR?

A

HFA inhaler

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4
Q

How many mcg/inhalation do Belomethasone and QVAR have? (2 available strengths)

A

40 or 80 mcg/inhalation

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5
Q

What are the brands of Budesonide? (2)

A

Pulmicort and Pulmicort Respules

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6
Q

What is the generic of Pulmicort?

A

Budesonide

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7
Q

What is the dosage form of Budesonide and Pulmicort?

A

Flexhaler

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8
Q

How many mcg/inhalation do Budesonide and Pulmicort have? (2 available strengths)

A

90 or 180 mcg/inhalation

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9
Q

What is the generic of Pulmicort Respules?

A

Budesonide

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10
Q

What is the dosage form of Budesonide and Pulmicort Respules?

A

Nebulizer Solution

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11
Q

What are the strengths of Budesonide and Pulmicort Respules? (3)

A

0.25mg/2mL
0.5mg/2mL
1mg/2mL

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12
Q

What is the brand of Ciclesonide?

A

Alvesco

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13
Q

What is the generic of Alvesco?

A

Ciclesonide

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14
Q

What is the dosage form of Ciclesonide and Alvesco?

A

HFA inhaler

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15
Q

How many mcg/inhalation do Ciclesonide and Alvesco have? (2 available strengths)

A

80 or 160 mcg/inhalation

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16
Q

What is the brand of Flunisolide?

A

Aerospan

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17
Q

What is the generic of Aerospan?

A

Flunisolide

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18
Q

What is the dosage form of Flunisolide and Aerospan?

A

HFA inhaler

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19
Q

How many mcg/inhalation do Flunisolide and Aerospan have?

A

80 mcg/inhalation

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20
Q

What are the brands of Fluticasone Propionate?

A

Flovent and ArmonAir

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21
Q

What is the generic of Flovent?

A

Fluticasone Propionate

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22
Q

What are the dosage forms of Fluticasone Propionate and Flovent? (2)

A

HFA and DPI

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23
Q

What are the available strengths of Fluticasone Propionate and Flovent in HFA form? (3)

A

44, 110 or 220 mcg/inhalation

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24
Q

What are the available strengths of Fluticasone Propionate and Flovent in DPI form? (3)

A

50, 100 or 250 mcg/inhalation

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25
Q

What is the generic of ArmonAir?

A

Fluticasone Propionate

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26
Q

What is the dosage form of Fluticasone Propionate and ArmonAir?

A

RespiClick

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27
Q

What are the available strengths of Fluticasone Propionate and ArmonAir? (3)

A

55, 113 or 232 mcg/inhalation

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28
Q

What is the brand of Fluticasone Furoate?

A

Arnuity Ellipta

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29
Q

What is the generic of Arnuity Ellipta?

A

Fluticasone Furoate

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30
Q

What is the dosage form of Fluticasone Furoate and Arnuity Ellipta?

A

Ellipta inhaler

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31
Q

What are the available strengths of Fluticasone Furoate and Arnuity Ellipta? (2)

A

100 or 200 mcg/inhalation

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32
Q

What is the brand of Mometasone?

A

Asmanex

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33
Q

What is the generic of Asmanex?

A

Mometasone

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34
Q

What are the dosage forms of Mometasone and Asmanex? (2)

A

HFA and Twisthaler

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35
Q

What are the available strengths of Mometasone and Asmanex in HFA form? (2)

A

100 or 200 mcg/inhalation

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36
Q

What are the available strengths of Mometasone and Asmanex in Twisthaler form? (2)

A

110 or 220 mcg/inhalation

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37
Q

What are some side effects/adverse events with ICS?

A

Oral thrush (candidiasis), cough, dysphonia (voice disorder - hard to talk normally)

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38
Q

What is a counseling tip for patients who are taking an ICS?

A

Rinse mouth and spit after use to prevent oral thrush

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39
Q

What is the most effective long-term control therapy for asthma?

A

ICS

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40
Q

What are some benefits to taking an ICS?

A

Improve quality of life, increase lung function, reduce the risk of exacerbations

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41
Q

How to dose ICS

A

Titrate to lowest effective dose

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42
Q

What drug should use Jet Nebulizer and should not be mixed with other nebulizer medications?

A

Pulmicort Respules

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43
Q

(T/F): Aerospan has a built in spacer

A

True

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44
Q

What increases the risk of systemic side effects with ICS drugs?

A

High doses

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45
Q

How do ICS medications work?

A

Prevent and control inflammation

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46
Q

What medication class is Belomethasone (QVAR)?

A

ICS

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47
Q

What medication class is Budesonide (Pulmicort and Pulmicort Respules)?

A

ICS

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48
Q

What medication class is Ciclesonide (Alvesco)?

A

ICS

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49
Q

What medication class is Flunisolide (Aerospan)?

A

ICS

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50
Q

What medication class is Fluticasone Propionate (Flovent and ArmonAir)?

A

ICS

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51
Q

What medication class is Fluticasone Furoate (Arnuity Ellipta)?

A

ICS

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52
Q

What medication class is Mometasone (Asmanex)?

A

ICS

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53
Q

How do LABAs work?

A

Increase cAMP, cause bronchial smooth muscle relaxation, inhibit hypersensitivity mediators from mast cells (histamine and leukotrienes)

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54
Q

What is the brand of Arformoterol tartrate?

A

Brovana

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55
Q

What is the generic of Brovana?

A

Arformoterol tartrate

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56
Q

What is the dosage form of Arformoterol tartrate?

A

Nebulizer Solution

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57
Q

What is the brand of Formoterol?

A

Foradil Aerolizer

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58
Q

What is the generic of Foradil Aerolizer?

A

Formoterol

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59
Q

What is the dosage form of Formoterol (Foradil Aerolizer)?

A

Aerolizer

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60
Q

What is the brand of Indacaterol?

A

Arcapta Neohaler

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61
Q

What is the generic of Arcapta Neohaler?

A

Indacaterol

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62
Q

What is the dosage form of Indacaterol (Arcapta Neohaler)?

A

Neohaler

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63
Q

What is the brand of Olodaterol?

A

Striverdi Respimat

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64
Q

What is the generic of Striverdi Respimat?

A

Olodaterol

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65
Q

What is the dosage form of Olodaterol (Striverdi Respimat)?

A

Respimat inhaler

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66
Q

What is the brand of Salmeterol?

A

Serevent

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67
Q

What is the generic of Serevent?

A

Salmeterol

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68
Q

What is the dosage form of Salmeterol (Serevent)?

A

Diskus inhaler

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69
Q

What are some side effects/adverse events with LABAs?

A

tachydardia, headache, tremor, hypokalemia

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70
Q

What is the boxed warning for LABAs? (related to monotherapy)

A

Increased risk of asthma related death for all monotherapy LABA use

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71
Q

Should LABAs be used alone for asthma management?

A

NO!

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72
Q

What is the other boxed warning for LABAs? (related to age of patients)

A

Increasing hospitalizations in pediatric and adolescent patients

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73
Q

What is seen with intentional overdoses of LABAs?

A

Prolonged QT (irregular heart beats)

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74
Q

Should LABAs be used to treat acute symptoms?

A

No!

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75
Q

Would a LABA be potentially helpful for exercise induced bronchospams?

A

Yes

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76
Q

(T/F): Formoterol and Indacaterol capsules should be taken orally

A

False!!

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77
Q

Most children < 4 years old cannot provide sufficient inspiratory flow for adequate lung deliver with a….

A

DPI

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78
Q

What medication class is Arformoterol tartrate (Brovana)?

A

LABA

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79
Q

What medication class is Formoterol (Foradil Aerolizer)?

A

LABA

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80
Q

What medication class is Indacaterol (Arcapta Neohaler)?

A

LABA

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81
Q

What medication class is Olodaterol (Striverdi Respimat)?

A

LABA

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82
Q

What medication class is Salmeterol (Serevent)?

A

LABA

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83
Q

What three LABAs are used in COPD patients only?

A

Arformoterol tartrate (Brovana), Indacaterol (Arcapta Neohaler) and Olodaterol (Striverdi Respimat)

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84
Q

How do LAMAs work?

A

Block the bronchoconstrictor effects of acetylcholine on M3 and M2 receptors

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85
Q

What is the brand of Aclidinium?

A

Tudorza Pressair

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86
Q

What is the generic of Tudorza Pressair?

A

Aclidinium

87
Q

What is the dosage form of Aclidinium (Tudorza Pressair)?

A

DPI

88
Q

What is the brand of Tiotropium?

A

Spiriva

89
Q

What is the generic of Spirivia?

A

Tiotropium

90
Q

What are the dosage forms of Tiotropium and Sprivia? (2)

A

HandiHaler and Respimat

91
Q

What is the brand of Umeclidinium?

A

Incruse Ellipta

92
Q

What is the generic of Incruse Ellipta?

A

Umeclidinium

93
Q

What is the dosage form of Umeclidinium (Incruse Ellipta)?

A

DPI

94
Q

What are some side effects/adverse events with LAMAs?

A

dry mouth, dizziness, blurred vision, upper respiratory infections and paradoxical bronchospams

95
Q

What LAMA has been approved for use in asthma as an add-on option in step 4 or 5 (history of exacerbations despite ICS + LABA use)

A

Tiotropium

96
Q

What medication class is Aclidinium (Tudorza Pressair)?

A

LAMA

97
Q

What medication class is Tioptropium (Spiriva)?

A

LAMA

98
Q

What medication class is Umeclidinium (Incruse Ellipta)?

A

LAMA

99
Q

All LAMAs are only to be used in patients with what?

A

COPD

100
Q

What are the brands of Fluticasone/Salmeterol? (2)

A

Advair and AirDuo

101
Q

What is the generic of Advair?

A

Fluticasone/Salmeterol

102
Q

What are the dosage forms of Fluticasone/Salmeterol (Advair)? (2)

A

DPI and HFA MDI

103
Q

What is the generic of AirDuo?

A

Fluticasone/Salmeterol

104
Q

What is the dosage form of Fluticasone/Salmeterol and AirDuo?

A

Respiclick (DPI)

105
Q

What is the brand of Budesonide/Formoterol?

A

Symbicort

106
Q

What is the generic of Symbicort?

A

Budesonide/Formoterol

107
Q

What is the dosage form of Budesonide/Formoterol (Symbicort)?

A

HFA MDI

108
Q

What is the brand of Mometasone/Formoterol?

A

Dulera

109
Q

What is the generic of Dulera?

A

Mometasone/Formoterol

110
Q

what is the dosage form of Mometasone/Formoterol (Dulera)?

A

MDI

111
Q

What is the brand of Fluticasone/Vilanterol?

A

Breo Ellipta

112
Q

What is the generic of Breo Ellipta?

A

Fluticasone/Vilanterol

113
Q

What is the dosage form of Fluticasone/Vilanterol (Breo Ellipta)?

A

DPI

114
Q

What are some side effects/adverse events with ICS/LABA combo products?

A

See individual products (ICS and LABA)

115
Q

Guidelines recommend combination ____ with ____ in asthma, as ____ should not be used as monotherapy

A

LABA, ICS, LABA

116
Q

Combination products were developed to create convenient packaging and assist with _____

A

patient adherence

117
Q

What medication class is Fluticasone/Salmeterol (Advair)?

A

ICS/LABA

118
Q

What medication class is Fluticasone/Salmeterol (AirDuo)?

A

ICS/LABA

119
Q

What medication class is Budesonide/Formoterol (Symbicort)?

A

ICS/LABA

120
Q

What medication class is Mometasone/Formoterol (Dulera)?

A

ICS/LABA

121
Q

What medication class is Fluticasone/Vilanterol (Breo Ellipta)?

A

ICS/LABA

122
Q

What is the brand of Olodaterol/Tiotropium?

A

Stiolto Respimat

123
Q

What is the generic of Stiolto Respimat?

A

Olodaterol/Tiotropium

124
Q

What is the dosage form of Olodaterol/Tiotropium (Stiolto Respimat)?

A

Respimat inhaler

125
Q

What is the brand of Vilanterol/Umeclidinium?

A

Anoro Ellipta

126
Q

What is the generic of Anoro Ellipta?

A

Vilanterol/Umeclidinium

127
Q

What is the dosage form of Vilanterol/Umeclidinium (Anoro Ellipta)?

A

Ellipta inhaler

128
Q

What is the brand of Indacanterol/Glycopyrronium?

A

Utibron Neohaler

129
Q

What is the generic of Utibron Neohaler?

A

Indacanterol/Glycopyrronium

130
Q

What is the dosage form of Indacanterol/Glycopyrronium (Utibron Neohaler)

A

Neohaler

131
Q

What is the brand of Formoterol/Glycopyrronium?

A

Bevespi Aerosphere

132
Q

What is the generic of Bevespi Aerosphere?

A

Formoterol/Glycopyrronium

133
Q

What is the dosage form of Formoterol/Glycopyrronium (Bevespi Aerosphere)?

A

Aerosphere

134
Q

All LABA/LAMA combo products are only to be used in patients with what?

A

COPD

135
Q

What are some side effects/adverse events with LABA/LAMA combo products?

A

See individual products (LABA and LAMA)

136
Q

What medication class is not indicated for treatment of acute deteriorations?

A

LABA/LAMA

137
Q

What medication class is Olodaterol/Tioptropium (Stiolto Respimat)?

A

LABA/LAMA

138
Q

What medication class is Vilanterol/Umeclidinium (Anoro Ellipta)?

A

LABA/LAMA

139
Q

What medication class is Indacanterol/Glycopyrronium (Utibron Neohaler)?

A

LABA/LAMA

140
Q

What medication class is Formoterol/Glycopyrronium (Bevespi Aerosphere)?

A

LABA/LAMA

141
Q

What is Cromolyn?

A

Mass cell stabilzer

142
Q

What is the dosage form of Cromolyn?

A

Nebulizer Solution

143
Q

What are some side effects/adverse events with Cromolyn?

A

High incidence of unpleasant taste in mouth (>10%), rare cardiac arrhythmias, coughing, dyspnea (shortness of breath), sore throat, N/V/D if absorbed systemically

144
Q

Is Cromolyn less or more effective than a low-dose ICS?

A

Less effective

145
Q

Cromolyn prevents an increase in _______ seen in allergy season

A

bronchial hyperreactivity

146
Q

What is the brand of Montelukast?

A

Singular

147
Q

What is the generic of Singulair?

A

Montelukast

148
Q

What are the dosage forms of Montelukast and Singulair? (2)

A

Tablets (chewable) and Granule Packets

149
Q

What is the brand of Zafirlukast?

A

Accolate

150
Q

What is the generic of Accolate?

A

Zafirlukast

151
Q

What is the dosage form of Zafirlukast and Accolate?

A

Tablet

152
Q

What is the brand of Zileuton?

A

Zyflo CR

153
Q

What is the generic of Zyflo CR?

A

Zileuton

154
Q

What is the dosage form of Zileuton and Zyflo CR?

A

Tablet

155
Q

How do leukotriene modifiers work?

A

Block the production of leukotrienes

156
Q

What are some side effects/adverse events with leukotriene modifiers?

A

Neuropsychiatric events (agitation, anxiety, abnormal dreams, hallucinations, depression, suicidal thinking), Churg-Strauss syndrome (Rare)

157
Q

Zafirlukast and Zileuton may cause increased…

A

hepatic transaminases

158
Q

Are leukotriene modifiers more or less effective than a low dose ICS or ICS/LABA in asthma?

A

Less effective

159
Q

(T/F): Leukotriene modifiers have been adequately trialed in COPD patients

A

False

160
Q

Montelukast is a weak inhibitor of…. (2 enzymes)

A

CYP2C8 and 2C9

161
Q

Monteluast is a major substrate of… (2 enzymes)

A

CYP2C9 and 3A4

162
Q

Montelukast is not for….

A

acute relief of symptoms

163
Q

Zafirlukast should be taken at least ____ before or ____ after meals

A

1 hour before or 2 hours after

164
Q

Zafirlukast can increase…

A

INR

165
Q

Zileuton is a moderate inhibitor of…

A

CYP1A2

166
Q

Zileuton is a minor substrate of…. (3 enzymes)

A

CYP1A2, 2C9 and 3A4

167
Q

What medication class is Montelukast (Singulair)?

A

Leukotriene modifier

168
Q

What medication class is Zafirlukast (Accolate)?

A

Leukotriene modifier

169
Q

What medication class is Zileuton (Zyflo CR)?

A

Leukotriene modifier

170
Q

How do methylxanthines work?

A

Cause bronchodilation through inhibition of PDE III and PDE IV (reduced breakdown of cAMP to AMP)

171
Q

What medication class is Theophylline?

A

Methylxanthines

172
Q

What are the dosage forms of Theophylline? (3)

A

ER tablets, ER capsules, liquid

173
Q

What are some side effects/adverse events with Theophylline? (4)

A

Insomnia, GI upset, hyperactivity, hypotension

174
Q

What are some one dose related toxicities for Theophylline? (6)

A

Tachycardia, nausea, vomiting, headache, seizures, arrhythmias

175
Q

What are some contraindications of Theophylline?

A

Peptic ulcer disease, arrhythmias, seizure disorders

176
Q

Theophylline is a major substrate of… (3 enzymes)

A

CYP 3A4, 1A2 and 2E1

177
Q

There is an increased concentration of these drugs when Theophylline reacts with CYP 3A4, 1A2 or 2E1 (5)

A

cimetidine, erythromycin, clarithromycin, ciprofloxacin and ticlopidine

178
Q

What is a decreased concentration of these drugs when Theophylline reacts with CYP 3A4, 1A2 or 2E1 (5)

A

Phenobarbital, phenytoin, carbamazepine, rifampin, smoking

179
Q

PDE III inhibition from Theophylline is the likely cause of____, ___ and _____

A

hypotension, tachycardia and nausea

180
Q

How do Anti-IgE monoclonal antibodies work?

A

Inhibit IgE from binding to receptors on mast cells and basophils, thus inhibiting degranulation

181
Q

What is the brand of Omalizumab?

A

Xolair

182
Q

What is the generic of Xolair?

A

Omalizumab

183
Q

Omalizumab (Xolair) is dosed depending on _____ and pretreatment serum _____

A

body weight, IgE levels

184
Q

What are some side effects/adverse events with Omalizumab (Xolair)? (7)

A

Headache, injection site reactions, arthralgias (joint pain), thrombocytopenia (not enough platelets in blood), pharyngitis (inflammation of back of throat), sinusitis, upper respiratory tract infections

185
Q

What is a boxed warning for Omalizumab (Xolair)?

A

Anaphylaxis

186
Q

Do not administer Omalizumab (Xolair) more than ___ per injection site

A

150mg

187
Q

Monitor patient for ___ before and after injection of Omalizumab (Xolair)

A

anaphylaxis

188
Q

Omalizumab (Xolair) is FDA approved for ____ to ____ persistent asthma in patients with a positive skin test or reactivity to a perennial aeroallergen and symptoms that are inadequately controlled wth ICS

A

moderate to severe

189
Q

What medication class is Omalizumab (Xolair)?

A

Anti-IgE monoclonal antibody

190
Q

How do Anti-IL5 monoclonal antibodies work?

A

Prevent IL-5 from binding to IL-5 receptor, thus reducing production and survival of eosinophils

191
Q

What is the brand of Mepolizumab?

A

Nucala

192
Q

What is the generic of Nucala?

A

Mepolizumab

193
Q

What are some side effects/adverse events with Mepolizumab (Nucala)? (4)

A

Headache, injection site reactions, arthralgias, Herpes Zoster infection

194
Q

What is a precaution with Mepolizumab (Nucala)?

A

Anaphylaxis (NOT A BOXED WARNING LIKE THE OTHERS)

195
Q

Monitor for ____ before and after injection of Mepolizumab (Nucala)

A

anaphylaxis

196
Q

Mepolizumab (Nucala) is indicated for add-on maintenance treatment of patients with ____ asthma with an _____ phenotype

A

severe, eosinophilic

197
Q

What is the brand of Reslizumab?

A

Cinqair

198
Q

What is the generic of Cinqair?

A

Reslizumab

199
Q

What are some side effects/adverse events with Reslizumab (Cinqair)? (3)

A

injection site reactions, myalgias (muscle pain), increased creatinine phosphokinase

200
Q

What are the boxed warnings for Reslizumab (Cinqair)? (2)

A

Anaphylaxis, malignancies (cancerous growths)

201
Q

Monitor for ___ before and after injection of Reslizumab (Cinqair)

A

Anaphylaxis

202
Q

Reslizumab (Cinqair) is indicated for add-on maintenance treatment of patients with ___ severe asthma with an _____ phenotype

A

severe, eosinophilic

203
Q

What medication class is Mepolizumab (Nucala)?

A

Anti-IL5 monoclonal antibody

204
Q

What medication class is Reslizumab (Cinqair)?

A

Anti-IL5 monoclonal antibody

205
Q

How do Phosphodiaesterase-4 inhibitors work?

A

Inhibit PDE4, thus decreasing breakdown of cAMP to AMP, ultimately increasing cAMP levels

206
Q

What is the brand of Roflumilast?

A

Daliresp

207
Q

What is the generic of Daliresp?

A

Roflumilast

208
Q

What is the dosage form of Roflumist and Daliresp?

A

Tablet

209
Q

Roflumilast and Daliresp are indicated for ____ patients only

A

COPD

210
Q

Patients taking Roflumilast and Daliresp need to have _____ and monitor their ____

A

liver function tests and weight

211
Q

What are some drug interactions with Roflumilast and Daliresp? (2)

A

CYP3A4 (major), CYP1A2 (minor)

212
Q

What are contraindications for Roflumilast and Daliresp?

A

Child-Pugh class B or C

213
Q

What medication class is Roflumilast (Daliresp)?

A

PDE4 inhibitor

PHRM 82500 (5 decks)

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