Quick-Relief Medications in Asthma and COPD Flashcards

1
Q

How do SABAs work?

A

Increase cAMP and thus cause bronchodilation

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2
Q

Brand names of Albuterol HFA (there’s 4 of them)

A

ProAir, Ventolin, Proventil, ProAir Respiclick

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3
Q

Generic name of ProAir, Ventolin, Proventil, ProAir Respiclick

A

Albuterol HFA

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4
Q

What is the dosage form of ProAir, Ventolin and Proventil?

A

Metered Dose Inhaler (MDI)

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5
Q

What is the dosage form of ProAir Respiclick?

A

Aerosol Powder Inhaler

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6
Q

What is the dosage form of albuterol (not an inhaler)?

A

Nebulizer Solution

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7
Q

What are some side effects/adverse events of albuterol HFA, albuterol, ProAir, Ventolin, Proventil and ProAir Respiclick?

A

Tachycardia, tremor, hypokalemia, irritability

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8
Q

Chronic use (>2 times per day) of what indicates poor asthma control?

A

SABAs (ProAir, Ventolin, Proventil, ProAir Respiclick, albuterol)

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9
Q

You can mix albuterol nebulizer solution with…. (3 things)

A

cromolyn solution, budesonide inhalant suspension or ipratropium

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10
Q

In mild to moderate exacerbations, ____ plus ____ is as effective as nebulized therapy with appropriate administration technique and coaching by trained personnel

A

MDI plus valved holding chamber (spacer)

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11
Q

What is the brand name of Levalbuterol HFA?

A

Xopenex

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12
Q

What is the generic of Xopenex?

A

Levalbuterol HFA

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13
Q

What is the dosage form of Levalbuterol HFA and Xopenex?

A

MDI

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14
Q

What is the dosage form of Levalbuterol (not an inhaler)?

A

Nebulizer Solution

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15
Q

What are some side effects/adverse events with Levalbuterol HFA, Xopenex and Levalbuterol?

A

Tachycardia, tremor, hypokalemia, irrritability

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16
Q

What is reserved for patients who do not respond to albuterol for quick relief?

A

Levalbuterol HFA, Xopenex, Levalbuterol

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17
Q

What is Levalbuterol nebulizer solution compatible with?

A

Budesonide inhalant suspension

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18
Q

Levalbuterol administered in ___ the mg dose of albuterol provides comparable efficacy and safety

A

1/2 the mg dose

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19
Q

What has not been evaluated by continuous nebulization?

A

Levalbuterol

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20
Q

What is the brand name of Ipratropium HFA?

A

Atrovent

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21
Q

What is the generic name of Atrovent?

A

Ipratropium HFA

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22
Q

What is the dosage form of Ipratropium HFA and Atrovent?

A

MDI

23
Q

What is the dosage form of Ipratropium (not an inhaler)?

A

Nebulizer Solution

24
Q

What are some side effects/adverse effects with Ipratropium HFA, Atrovent and Ipratropium?

A

Dry mouth, urinary retention, infection, sinusitis, bronchitis

25
Q

What is used in combo with albuterol for asthma exacerbation treatment?

A

Ipratropium HFA and Atrovent

26
Q

Ipratropium nebulizer solution can be mixed with?

A

albuterol

27
Q

SAMAs should ___ be used as first-line therapy; should be added to ___ therapy for severe exacerbations

A

not, SABA

28
Q

What is the brand name of Ipratropium/Albuterol?

A

Combivent Respimat

29
Q

What is the generic name of Combivent Respimat?

A

Ipratropium/Albuterol

30
Q

What is the dosage form of Ipratropium/Albuterol and Combivent Respimat?

A

MDI

31
Q

What are some side effects/adverse events with Ipratropium/Albuterol and Combivent Respimat?

A

Same as SABAs and SAMAs

32
Q

What is the dosage form of Ipratropium/Albuterol (not an inhaler)?

A

Nebulizer Solution

33
Q

What may be used for up to 3 hours in initial management of severe exacerbations?

A

Ipratropium/Albuterol nebulizer solution

34
Q

How do SAMAs work?

A

Inhibit cholinergic receptors, cause bronchodilation

35
Q

How do systemic corticosteroids work?

A

Lower inflammation, increase response to beta agonists

36
Q

What is the dosage form of methylprednisolone?

A

Tablet

37
Q

What are the dosage forms of Prednisolone?

A

Tablet and oral liquid

38
Q

What are the dosage forms of Prednisone?

A

Tablet, oral liquid

39
Q

What is the dosage form of methylprednisolone acetate?

A

Repository injection

40
Q

What are some side effects/adverse events with the systemic corticosteroids?

A

Short term use - hyperglycemia, increased appetite, fluid retention, demargination of WBCs, psychiatric disturbances

41
Q

What are some contraindications to the systemic corticosteroids?

A

Systemic fungal infections, administration of live vaccines if immunocompromised

42
Q

What are some drug interactions with the systemic corticosteroids?

A

Warfarin INR is increased, lowered efficacy of inactivated vaccines

43
Q

What can be used with ICS if the patient is already taking ICS before hospitalization?

A

Systemic corticosteroids

44
Q

What may also be used for chronic therapy in both asthma (and COPD) only in severe stages? These can also be used to treat exacerbations

A

Systemic corticosteroids

45
Q

“Bursts” of what drugs are effective for establishing control when initiating therapy or during period of gradual deterioration?

A

Systemic corticosteroids

46
Q

Injection of what drug can be used in place of “burst” if adherence is an issue or patient is vomiting

A

Methylprednisolone acetate

47
Q

How does magnesium sulfate IV help treat asthma exacerbations?

A

Inhibits Ca influx into smooth muscle, causes relaxation

48
Q

What are some side effects/adverse events with magnesium sulfate IV?

A

Flushing, hypotension, vasodilation

49
Q

What are some contraindications to magnesium sulfate IV?

A

Heart block, caution in renal dysfunction

50
Q

When should magnesium sulfate IV be considered to treat an asthma exacerbation?

A

If patient remains in life threatening exacerbation after 1 hour of therapy

51
Q

Examples of SABAs

A

Albuterol, Levalbuterol

52
Q

Example of a SAMA

A

Ipratropium

53
Q

Examples of systemic corticosteroids

A

Methylprednisolone, prednisolone, prednisone, methylprednisolone acetate