Asthma & COPD Meds - Clinical Pearls Flashcards
(39 cards)
1
Q
Albuterol (ProAir, Ventolin, Proventil)
A
- Chronic use (>2 times daily) indicates poor control
- Correct use with a holding chamber is equally effective as mebulizer treatment for mild/moderate exacerbations
2
Q
Levalbuterol (Xopenex)
A
- Reserved for patients who do not respond to albuterol
3
Q
Ipratropium (Atrovent HFA)
A
- Should not be used as first line therapy
4
Q
Albuterol/Ipratropium (DuoNeb)
A
- May be used up for up to 3 hours for initial management of severe exacerbation
5
Q
Methylprednisolone
A
- Can be used in patients taking ICS before exacerbation
- Can be used as chronic therapy in COPD and Asthma for severe stages
6
Q
Prednisolone
A
- Can be used in patients taking ICS before exacerbation
- Can be used as chronic therapy in COPD and Asthma for severe stages
7
Q
Prednisone
A
- Can be used in patients taking ICS before exacerbation
- Can be used as chronic therapy in COPD and Asthma for severe stages
8
Q
Dexamethasone
A
- Can be used in patients taking ICS before exacerbation
- Can be used as chronic therapy in COPD and Asthma for severe stages
9
Q
Methylprednisolone Acetate
A
- Can be used in patients taking ICS before exacerbation
- Can be used as chronic therapy in COPD and Asthma for severe stages
- Repository injection for patients with vomiting or adherence issues
10
Q
Epinephrine
A
- No proven benefit of systemic use over aerosol
- Added to standard therapy for acute asthma if anaphylaxis/angioedema suspected
11
Q
Tertbutaline
A
- No proven benefit of systemic use over aerosol
12
Q
Magnesium Sulfate IV
A
- Can consider if patient in life-threatening exacerbation 1 hour after therapy
- Given via IV infusion
13
Q
Beclomethasone (QVAR)
A
- Lowest effective dose should be used
- Most effective long-term controller class
- Increased risk of pneumonia in COPD patients
14
Q
Budesonide (Pulmicort)
A
- Lowest effective dose should be used
- Most effective long-term controller class
- Increased risk of pneumonia in COPD patients
15
Q
Ciclesonide (Alvesco)
A
- Lowest effective dose should be used
- Most effective long-term controller class
- Increased risk of pneumonia in COPD patients
16
Q
Fluticasone Propionate (Flovent)
A
- Lowest effective dose should be used
- Most effective long-term controller class
- Increased risk of pneumonia in COPD patients
17
Q
Fluticasone Furoate (Arnuity Ellipta)
A
- Lowest effective dose should be used
- Most effective long-term controller class
- Increased risk of pneumonia in COPD patients
18
Q
Mometasone (Asmanex)
A
- Lowest effective dose should be used
- Most effective long-term controller class
- Increased risk of pneumonia in COPD patients
19
Q
Arformoterol Tartrate (Brovana)
A
- Increased risk of death as asthma monotherapy
- Boxed warning: increased hospitalizations in pediatrics
- Prolonged QT in overdose
- Not for acute symptoms
20
Q
Formoterol (Perforomist)
A
- Increased risk of death as asthma monotherapy
- Boxed warning: increased hospitalizations in pediatrics
- Prolonged QT in overdose
- Not for acute symptoms
21
Q
Indacaterol (Arcapta Neohaler)
A
- Increased risk of death as asthma monotherapy
- Boxed warning: increased hospitalizations in pediatrics
- Prolonged QT in overdose
- Not for acute symptoms
- Capsules should not be taken orally
22
Q
Olodaterol (Striverdi Respimat)
A
- Increased risk of death as asthma monotherapy
- Boxed warning: increased hospitalizations in pediatrics
- Prolonged QT in overdose
- Not for acute symptoms
- Capsules should not be taken orally
23
Q
Salmeterol (Serevent Diskus)
A
- Increased risk of death as asthma monotherapy
- Boxed warning: increased hospitalizations in pediatrics
- Prolonged QT in overdose
- Not for acute symptoms
- Capsules should not be taken orally
24
Q
Aclidinium (Turdorza Pressair)
A
- COPD only
25
Revefenacin (Yupelri)
- COPD only
26
Glycopyrrolate (Seebri Neohaler)
- COPD only
27
Tiotropium (Spiriva)
- COPD only
28
Umeclidinium (Incruse Ellipta)
- COPD only
29
Montekulast (Singulair)
- Less effective than low dose ICS or ICS/LABA in asthma
- Minor substrate of CYP2C8/9 and 3A4
- Not for acute relief of symptoms
30
Zafirlukast (Accolate)
- Less effective than low dose ICS or ICS/LABA in asthma
- Take at least 1 hour before or 2 hours after meals
- Can increase INR
- Major substrate/minor inhibitor of CYP2C9
31
Zileution (Zyflo CR)
- Less effective than low dose ICS/LABA in asthma
- Weal CYPP1A2 inhibitor
- Take with food
32
Omalizumab (Xolair)
- Boxed warning for anaphylaxis
- Do not administer >150mg per injection site
- Dosed by weight and serum IgE
33
Mepolizumab (Nucala)
- Precaution for anaphylaxis
| - Available as an autoinjector
34
Reslizumab (Cinqair)
- Boxed warning for anaphylaxis & malignancy
| - IV infusion
35
Benralizumab (Fasenra)
- Precaution for anaphylaxis
- Available as an autoinjector
- Acts on IL-5 receptors rather than IL-5
36
Dupilumab (Dupixent)
- Precaution for anaphylaxis
| - Available as prefilled syringes
37
Roflumilast (Daliresp)
- Monitor LFTs and weight
- Contraindicated in liver dysfunction
- Major substrate of CYP3A4 and minor of CYP1A2
38
Cromolyn (Intal)
- Less effective than low dose ICS
39
Theophylline (Theochron)
- Dose related toxicity: seizures, arrhythmia, tachycardia, N/V, headache
- Major substrate of CYP3A4, CYP1A2, and CYP2E1
