Pulm Pharm Flashcards
List some albuterol rescue inhalers
ProAir, Proventil, Ventolin
List an ICS/SABA inhaler
Airsupra (Budesonide/Albuterol)
What are ICS/SABA inhalers used for
asthma relief
List some SABA nebulizer solutions
albuterol sulfate & levalbuterol HCl
List 4 ICS/LABA inhalers
Symbicort (Budesonide/Formoterol)
Dulera (Mometasone/Formoterol)
Advair Diskus/HFA (Fluticasone/Salmeterol)
Breo Ellipta (Fluticasone/Vilanterol)
List 2 LABA inhalers for COPD
Striverdi Respimat (Olodaterol)
Servent Diskus (Salmeterol)
List 2 LABA nebulizer solutions for COPD
Brovana (Aformoterol) & Perforomist (Formoterol)
List one SAMA inhaler
Atrovent HFA (Ipratropium)
List a SAMA/SABA inhaler
Combivent Respimat (Ipratroprium/Albuterol)
List a SAMA/SABA nebulizer solutions
Ipratropium Bromide (DuoNeb)
List 2 LAMA inhalers
Spiriva Handihaler/Respimat (Tiotropium)
Incruse Ellipta (Umeclidinium)
List some ICS inhalers
- Beclomethasone HFA (Qvar RediHaler)
- Budesonide DPI (Pulmicort Flexhaler)
- Ciclesonide HFA (Alvesco)
- Fluticasone Proprionate HFA (Flovent HFA)
- Fluticasone Propionate DPI (Armonair Digihaler)
- Fluticasone Furoate DPI (Arnuity Ellipta)
- Mometasone DPI (Asmanex Twisthaler)
- Mometasone HFA (Asmanex HFA)
List 3 LABA/LAMA inhalers
- Stiolto Respimat (Olodaterol/Tiotropium)
- Anoro Ellipta (vilanterol/umeclidinium)
- Bevespi (Formoterol fumarate/glycopyrolate)
List 2 ICS/LABA/LAMA inhalers
- Trelegy Ellipta (Fluticasone/Umeclidinium/Vilanterol)
- Breztri Aerosphere (Budesonide/Glycopyrolate/Formoterol)
List one leukotriene inhibitor
Montelukast (Singulair) PO
List the core TB drugs
RIPE-s
R: Rifampin
I: Isonazid
P: Pyrazinamide
E: Ethambutol
S: Streptomycin (IV)
List some AEs of SABAs and LABAs
tachycardia, muscle tremor, hypokalemia, restlessness, metabolic effects
What are SABAs used for
- acute asthma/COPD exacerbations
- PRN usage
- preventative usage
albuterol, levalbuterol, fenoterol
What are LABAs used for
- scheduled maintenance for asthma/COPD
- best used in combo with ICS or LAMA
formoterol, salmeterol, oladaterol
What are SAMAs used for
- combo with albuterol as a rescue inhaler or for exacerbations
- can use 3-4x daily for COPD
- PRN monotherapy NOT recommended d/t longer onset
ipratropium bromide
What are LAMAs used for
- drug of choice for COPD
- can increase FEV and decrease moderate exacerbations
- can also be used for asthma
tiotropium, umeclidinium
What are some AEs of SAMAs & LAMAs
- small rebound increase in airway responsiveness, dry mouth, bitter taste, urinary retention in older pts
What are ICSs used for
- first line for persistent asthma in combo with SABA or LABA
- add-on for COPD
Fluticasone propionate/furoate, beclometasone, mometasone, budesonide
What are some AEs of ICSs
pharyngitis, thrush, hoarseness, increased IOP, pituitary axis suppression, growth deceleration
What are ICS/SABAs used for
asthma reliever PRN
(budesonide/albuterol)
What are ICS/LABAs used for
rescue or maintenance for COPD & asthma
(symbicort, dulera, breo ellipta)
What are ICS/LABA/LAMA used for
- cut back on meds for COPD patients
- also approved for asthma
(trelegy ellipta, breztiri aerosphere)
What are leukotriene inhibitors used for
- daily asthma treatment
- best for pts with allergies
(montelukast)
What is the BBW for montelukast
neuropsychiatric effects
What is Dupixent used for
moderate to severe eosinophilic asthma and in patients 6+
What is Xolair used for
moderate to severe persistent asthma
What are some AEs of dupixent and xolair
Dupixent: injection site rxn, transient eosinophilia, psoriasis risk
Xolair: hypersensitivity, anaphylaxis, urticaria, injection site rxn, possible CVD risk
List the monotherapy treatment of choice for CAP with no risk factors or allergies
Levofloxacin (FQ)
OR
OMadacycline (tetra)
OR
Lefamulin (pleuromutalin)
List the combo regimen for CAP (pneumococcal and atypical coverage)
Anti-pneumococcal
- ampicillin sulbactam (PCN)
- amoxicillin (PCN)
- ceftriaxone (3rd G ceph)
- cefotaxime (3rd G ceph)
- ertapenem (carbapenem)
Atypical
- azithromycin (macrolide)
- doxycycline (tetracycline)
List the monotherapy CAP regimen with MRSA coverage
CAP mono: Levofloxacin or moxifloxacin (FQs)
MRSA: Vancomycin (lipo/glycopeptide) or Linezolid (oxazolidinone)
List the combo therapy for CAP with MRSA coverage
Combo:
- Ampicillin-sulbactam (PCN) OR ceftriaxone (3 ceph) OR cefotaxime (3 ceph) OR Ertapenem (carb)
- azithromycin (macro) OR doxycycline (tetra)
MRSA
- vancomycin (lipo/glyco) OR linezolid (oxazolid)
List the therapy for CAP with pseudomonal coverage
antipneumococcal, antipseudomonal beta-lactam
- pip-tazo (PCN) OR cefepime (4 ceph) OR ceftazidime (3 ceph) OR meropenem (carb)
antipseudomonal
- ciprofloxacin OR levofloxacin (FQs)
List the treatment for CAP with MRSA and pseudomonal coverage
antipneumococcal, antipseudomonal beta-lactam
- pip-tazo (PCN) OR cefepime (4 ceph) OR ceftazidime (3 ceph) OR meropenem (carb)
antipseudomonal
- ciprofloxacin OR levofloxacin (FQs)
MRSA
- vancomycin (lipo/glyco) OR linezolid (oxazolid)
What should you give for CAP with a beta-lactam allergy and NO other risk factors
levofloxacin (FQ) (no aztreonam)
What should you give for CAP with a beta-lactam allergy AND MRSA risk
vancomycin OR Linezolid
What should you give for CAP with a beta-lactam allergy AND pseudomonas risk
One aminoglycoside (Tobramycin, gentamicin, amikacin)
AND
aztreonam (monobactam)
What should be given for CAP with a beta-lactam allergy AND risk of both pseudomonas and MRSA
CAP: aztreonam & levofloxacin
AND
MRSA: Vancomycin OR linezolid
AND
Pseudomonas: Tobramycin OR gentamicin OR amikacin
What is standard coverage for hospital acquired pneumonia
Standard coverage: Pip-tazo (PCN) and/or cefepime (4th ceph)
Gram-RFs: imipenem or meropenem
Carbapenem resistance hx: ceftazidime-avibactam OR ceftolozane-tazobactam OR iminpenem-cilistatin-relebactam OR meropenem-vaborbactam
