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Therapeutics I - Spring 2023 > Rescue Medication - Asthma and COPD > Flashcards

Rescue Medication - Asthma and COPD Flashcards

1
Q

SABA - Meds

A

albuterol, levalbuterol

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2
Q

SAMA - Meds

A

ipratropium, ipratropium/albuterol

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3
Q

Systemic Corticosteroid - Meds

A

methylprednisolone, prednisolone, prednisone, dexamethasone, methylprednisolone acetate

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4
Q

Systemic/Subcutaneous Beta-2 Agonists - Meds

A

epinephrine, terbutaline

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5
Q

albuterol - Age Group

A

all ages

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6
Q

albuterol - Dosage Forms

A

HFA: MDI, Aerosol Powder Inhaler
Nebulizer

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7
Q

albuterol - Adverse Effects

A

Tachycardia, tremor, hypokalemia (low potassium), irritability

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8
Q

albuterol - Clinical Pearls

A
  • Chronic use (>2x /day) indicates poor asthma control
  • May mix nebulizer solution with cromolyn solution, budesonide inhalant suspension, or ipratropium solution
  • In mild to moderate exacerbation, MDI plus valved holding chamber is as effective as nebulized therapy w/ appropriate administration technique and coaching by trained personnel
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9
Q

albuterol - Brand Name

A

ProAir, Ventolin, Proventil, ProAir Respiclick, ProAir Digihaler

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10
Q

levalbuterol - Brand Name

A

Xopenex

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11
Q

levalbuterol - Age Group

A

all ages

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12
Q

levalbuterol - Dosage Forms

A

HFA: MDI
Nebulizer

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13
Q

levalbuterol - Adverse Effects

A

tachycardia, tremor, hypokalemia (low potassium), irritability

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14
Q

levalbuterol - Clinical Pearls

A
  • Reserved for pts who do not respond to albuterol for quick relief
  • Nebulizer solution compatible with budesonide inhalant suspension
  • Levalbuterol administered in 1/2 the mg dose of albuterol provides comparable efficacy and safety
  • Has not been evaluated by continuous nebulization
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15
Q

ipratropium - Brand Name

A

Atrovent

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16
Q

ipratropium - Dosage Forms

A

HFA: MDI
Nebulizer

17
Q

ipratropium - Age Group

A

all ages

18
Q

ipratropium - Adverse Effects

A

Dry mouth, urinary retention, infection, sinusitis, bronchitis

19
Q

ipratropium - Clinical Pearls

A
  • Used in combo w/ albuterol for asthma exacerbation treatment
  • May mix in same nebulizer w/ albuterol
  • Should NOT be used as first-line therapy; should be added to SABA therapy for severe exacerbations
20
Q

ipratropium/albuterol - Brand Name

A

Combivent Respimat, DuoNeb

21
Q

ipratropium/albuterol - Dosage Forms

A

MDI, nebulizer

22
Q

ipratropium/albuterol - Age Group

A

all ages

23
Q

ipratropium/albuterol (DuoNeb) - Clinical Pearls

A

May be used for up to 3 hours in initial management of severe exacerbations

24
Q

prednisolone - Dosage Forms

A

tablets, oral liquid

25
Q

Systemic Corticosteroids - Age Group

A

all ages

26
Q

prednisone - Dosage Forms

A

tablets, oral liquid

27
Q

dexamethasone - Dosage Forms

A

oral liquid, tablets, injection

28
Q

methylprednisolone acetate - Dosage Forms

A

repository injection

29
Q

Systemic Corticosteroids - Adverse Effects

A

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

30
Q

Systemic Corticosteroids - Contraindications

A

systemic fungal infections, administration of live vaccines if immunocompromised

31
Q

Systemic Corticosteroids - Drug Interactions

A

Warfarin INR (clotting levels) increase, decrease efficacy of inactivated vaccines

32
Q

Systemic Corticosteroids - Clinical Pearls

A
  • May be used w/ ICS if patient is already taking ICS before hospitalization
  • May also be used for chronic therapy in both asthma (and COPD) only in severe stages
  • “Bursts” effective for establishing control when initiating therapy or during period of gradual deterioration
  • Injection may be used in place of “burst” if adherence is an issue or patient is vomiting
33
Q

Systemic/Subcutaneous Beta-2 Agonists - Age Group

A

all ages

34
Q

Systemic/Subcutaneous Beta-2 Agonists - Comments

A

No proven advantage of systemic therapy over aerosol
epinephrine: indicated in addition to standard therapy for acute asthma associated w/ anaphylaxis and/or angioedema

35
Q

magnesium sulfate - Dosage Forms

A

IV

36
Q

magnesium sulfate - Age Groups

A

all ages

37
Q

magnesium sulfate - Adverse Effects

A

flushing, hypotension, vasodilation

38
Q

magnesium sulfate - Contraindications

A

Heart block, caution in renal dysfunction

39
Q

magnesium sulfate - Comments

A

Consider if patient remains in life threatening exacerbation after 1 hour of therapy

Therapeutics I - Spring 2023 (3 decks)

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