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Flashcards in 00 Asthma Deck (60):
1

What is important to tell asthmatics in regards to reducing respiratory infections?

Get flu shot each year

2

What drug classes can be used in asthma for Quick Relief?

Short Acting Beta-2 Agonist (SABA), Anticholinergics, Systemic corticosteroids

3

What drug classes can be used in asthma for Long-Term Control?

Corticosteroids (inhaled or systemic), Long Acting Beta-2 Agonists (LABA). Alternates: Leukotriene modifiers, Mast cell stabilizers, Theophylline, Omalizumab

4

How many symptoms/week can a patient have to be considered intermittent Asthma?

2 or less days/week

5

How much SABA use can a patient have to be considered intermittent Asthma?

2 or less days/week

6

How much interference with normal activity can a patient have to be considered intermittent Asthma?

None

7

How many exacerbations requiring PO corticosteroids can a patient have to be considered intermittent Asthma?

0-1/year

8

How many symptoms or SABA use can a patient have to be considered Persistent MILD Asthma?

> 2 days/week but not daily

9

How many symptoms or SABA use can a patient have to be considered Persistent MODERATE Asthma?

Daily

10

How many symptoms or SABA use can a patient have to be considered Persistent SEVERE Asthma?

Throughout the day

11

What kind of asthma does someone have if they are in Step 1?

Intermittent Asthma

12

What kind of asthma does someone have if they are in Step 2?

Mild Persistent Asthma

13

What kind of asthma does someone have if they are in Step 3 or 4?

Moderate Persistent Asthma

14

What kind of asthma does someone have if they are in Step 5 or 6?

Severe Persistent Asthma

15

What is the treatment of choice for all ages who are in Step 1?

SABA PRN

16

What is the treatment of choice for all ages who are in Step 2?

ICS (Low Dose)

17

What is the treatment of choice for all ages who are in Step 3?

ICS (Medium Dose). For ages 5+ you could use ICS (Low Dose) + LABA as another preferred regimen

18

What is the treatment of choice for all ages who are in Step 4?

ICS (Medium Dose) + LABA

19

What is the treatment of choice for all ages who are in Step 5?

ICS (High Dose) + LABA

20

What is the treatment of choice for all ages who are in Step 6?

ICS (High Dose) + LABA + Oral CS

21

Which beta-blockers can precipitate bronchospasm in patients with asthma, and can decrease SABA's bronchodilating effect?

Non-selective BB's (Propranolol, Timolol)

22

What is the generic name of Ventolin HFA?

Albuterol (SABA)

23

What is the generic name of Proventil HFA?

Albuterol (SABA)

24

What is the generic name of Proair HFA?

Albuterol (SABA)

25

How is Albuterol dosed?

90mcg/puff. 2 puffs Q4-6h PRN or EIB: 2 puffs 5 mins prior

26

What is the generic name of Xopenex?

Levalbuterol HFA (SABA)

27

How is Levalbuterol dosed?

45mcg/puff. 2 puffs Q4-6h PRN or EIB: 2 puffs 5 mins prior

28

What are the corticosteroids used for short term control (3-10 days)?

Methylprednisolone (Medrol), Prednisolone, Prednisone

29

How are the corticosteroids dosed for short term control (3-10 days)?

7.5-60mg daily QAM x5 days, QAM or QOD as needed for control

30

What are the consequences of chronic steroid use?

PREDNISONE: PUD, Redistribution of fat, Electrolyte, Diabetes, Na or water retention, Insomnia/Immunosuppression, Skin thinning, Osteoporosis, Neuro (euphoria/depression), Eyes/cataracts

31

What is the generic name of Atrovent HFA?

Ipratropium bromide (Anticholintergic)

32

What are the ADRs with ICS?

Hoarseness, cough, dysphonia, throat irritation, oral thrust (candidiasis)

33

How do the potencies of the ICS's compare (in decreasing order of potency)?

"For More Beer, Buy From Target, Cool?": Fluticasone, Mometasone, Budesonide, Beclomethasone HFA, Flunisolide, Triamcinolone, Ciclesonide"

34

What is the generic name of QVAR HFA?

Beclomethasone HFA (ICS)

35

What is the generic name of Pulmicort Flexhaler?

Budesonide DPI (ICS)

36

What is the generic name of Pulmicort Respule?

Budesonide Neb (ICS)

37

What is the generic name of Alvesco?

Ciclesonide HFA (ICS)

38

What is the generic name of Aerospan HFA?

Flunisolide HFA (ICS)

39

What is the generic name of Flovent HFA?

Fluticasone HFA (ICS)

40

What is the generic name of Asmanex Twisthaler?

Mometsone (ICS)

41

Which medication class for asthma carries a BBW and what is it?

LABAs: Increased risk of severe asthma episodes or asthma-related deaths. DO NOT use as monotherapy

42

What is the generic name of Serevent Diskus?

Salmeterol DPI (LABA)

43

What is the generic name of Advair HFA?

Fluticasone + Salmeterol (ICS + LABA)

44

What is the generic name of Symbicort?

Budesonide + Formoterol (ICS + LABA)

45

What is the generic name of Dulera?

Mometasone + Formoterol (ICS + LABA)

46

What is the generic name of Foradil Aerolizer?

Formoterol DPI (LABA)

47

What dosage strengths does Advair HFA come in?

45/21, 115/21, 230/21 (1 inhale BID)

48

What dosage strengths does Advair Diskus come in?

100/50, 250/50, 500/50 (1 inhale BID)

49

What dosage strengths does Symbicort come in?

80/4.5, 160/4.5 (2 puffs BID)

50

What dosage strengths does Dulera come in?

100/5, 200/5 (2 puffs BID)

51

What are the age restrictions for the combination ICS + LABA drugs?

All require 12+ years, except Advair DISKUS (> 4 years)

52

What is the generic name of Intal?

Cromolyn Sodium (Mast Cell Stabilizer), not used much, dosed QID

53

What is the generic name of Singulair?

Montelukast (Leukotriene Receptor Antagonist (LTRA))

54

What can you mix the Singulair granules with?

CAIR: Carrots, Apple sauce, Ice cream, Rice. Can also use formula/breast milk

55

What is the generic name of Accolate?

Zafirlukast (LTRA)

56

What is important to note about taking Accolate (Zafirlukast)?

Take on empty stomach (1h before or 2h after meals)

57

What is the generic name of Zyflo?

Zileuton (Leukotriene Production Inhibitor (LPI))

58

When is Zyflo (Zileuton) contraindicated?

Active liver disease or persistent hepatic function enzyme elevation > 3x the upper limit of normal

59

What is the generic name of Xolair?

Omalizumab (monoclonal antibody) - used as last resort

60

If using Metered Dose Inhalers (MDI)s, how should you space the doses between themselves and other medications?

Separate SABA puffs by 1 min. No need to wait between ICS puffs. Separate different types of inhalers (e.g. SABA vs. ICS) by 5-10 min. Use bronchodilator first, then maintenance inhalers