Long-Term Management of Asthma

Question 1

Inhaled Corticosteroids

Answer 1

• Beclomethasone
• Flunisolide
• Triamcinolone

Question 2

Inhaled Corticosteroids Indication

Answer 2

***1st line for longer term, persistent asthma!

Question 3

Inhaled Corticosteroids SEs

Answer 3

-Thrush (use of spacer decreases SEs)

Question 4

Long-Acting B2 Agonists (LABA)

Answer 4

• Salmeterol

- Symbicort (ICS/LABA combo)

Question 5

Long-Acting B2 Agonists (LABA) MOA

Answer 5

-Bronchodilator (prevents sx, **Esp nocturnal asthma!)

Question 6

Long-Acting B2 Agonists (LABA) Inidcations

Answer 6

• ADDED to ICS ONLY if persistent asthma not controlled w/ICS alone.
• *Once asthma control maintained (>3 mos), D/C

Question 7

Long-Acting B2 Agonists (LABA) CIs

Answer 7

• NOT a rescue drug (not used in exacerbations)

- NOT used alone!

Question 8

Mast Cell Modifiers

Answer 8

• Cromolyn

- Nedocromil

Question 9

Mast Cell Modifiers Indications

Answer 9

-Ccute phase response to cold air, sulfites, exercise* (decreases airway reactivity)

Question 10

Leukotriene Modifiers/Receptor Antagonists (LTRA)

Answer 10

-Montelukast

Question 11

Leukotriene Modifiers/Receptor Antagonists (LTRA) Indication

Answer 11

• Asthmatics w/allergic rhinitis*

- ASA induced asthma*

Question 12

Theophylline MOA

Answer 12

Bronchodilator that improves respirator muscle endurance

Question 13

Theophylline PEARLS

Answer 13

• Not used often d/t narrow therapeutic index

- Smoking decreases levels so higher doses must be used in smokers

Question 14

Theophylline Indications

Answer 14

• Long term prophylaxis

- NOT used in acute exacerbations!*

Question 15

Theophylline SEs

Answer 15

• Nervousness
• N/V, anorexia
• H/A
• numerous drug interactions
• Toxicity causes arrythmias & seizures!