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Rx Prep > Asthma - Quiz 3 > Flashcards

Asthma - Quiz 3 Flashcards

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1
Q

What is asthma?

A

Inflammation and bronchoconstriction cause airway obstruction causing expiratory airflow limitation

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2
Q

What are the common triggers for asthma?

A
  1. Pollution
  2. Cigarettes
  3. Cold air
  4. Pets
  5. Dust, pollen, roaches
  6. Perfume
  7. Drugs (Aspirin, NSAIDs, non-selective beta blockers)
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3
Q

What is FEV1?

A

How much air can be forcefully exhaled in one second

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4
Q

What is FVC?

A

The max volume of air exhaled after taking a deep breath

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5
Q

What is FEV1/FVC?

A

The percentage of total air capacity that can be forcefully exhaled in one second

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6
Q

What is the asthma diagnostic criteria?

A
  1. Measure baseline FEV1 with spirometry
  2. Give albuterol
  3. Measure post-bronchodilator FEV1

An FEV1 increase >12% post-bronchodilator is consistent with asthma diagnosis (reversible)

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7
Q

Guidelines for asthma tx?

A

GINA

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8
Q

Initial asthma tx step 1?

A

Daytime sx: <2/month
Night sx: none

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9
Q

Initial asthma tx step 2?

A

Daytime sx: <2/month but <4-5 d/wk
Night sx: none

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10
Q

Initial asthma tx step 3?

A

Daytime sx: Most days
Night sx: <1/wk

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11
Q

Initial asthma tx step 4?

A

Daytime sx: Daily
Night sx: ≥1/wk

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12
Q

How often are follow ups?

A

2-6 wks

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13
Q

How do you control RF?

A
  1. Avoid smoking
  2. Annual flu vaccine
  3. Pneumococcal and COVID vaccines
  4. Allergen test
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14
Q

What are relievers for ?

A

Acute sx

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15
Q

What are the preferred reliever regimens?

A

low dose ICS+formoterol
SABA

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16
Q

Types of relievers?

A
  1. low dose ICS+formoterol
  2. SABA
  3. Systemic steroids
  4. Inhaled epinephrine
  5. SAMA
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17
Q

Reliever that quickly reverses bronchoconstriction?

A

SABA

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18
Q

Agents that are used for exacerbations?

A

low dose ICS+formoterol
PO systemic steroids

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19
Q

What is first line controllers?

A

ICS

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20
Q

What agent is commonly used in children

A

LTRAs

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21
Q

Examples of SABA?

A
  1. Albuterol
  2. Levalbuterol
  3. Epinephrine
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22
Q

Albuterol

A

ProAir, Ventolin, Proventil

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23
Q

Levalbuterol

A

Xopenex

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24
Q

LABA example?

A

Salmeterol

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25
Salmeterol
Serevent Diskus
26
ADRs of SABAs?
1. Nervousness 2. Tremor 3. Tachycardia 4. Palpitations 5. Cough 6. Hyperglycemia 7. Low K
27
How many inhalations are in albuterol?
Albuterol: 200 inh/canister Ventolin: 200 or 60 inh/canister
28
BBW of LABA?
1. Increased asthma deaths without ICS 2. Increased asthma hospitalization (pediatric and adolescents)
29
Beclomethasone
QVAR Redihaler
30
Budesonide
Pulmicort
31
Fluticasone
Flovent, Arnuity
32
Mometasone
Asmanex
33
Budesonide/Formoterol
Symbicort, Breyna
34
Fluticasone/Salmeterol
Advair
35
Fluticasone/Vilanterol
Breo Ellipta
36
Mometasone/formoterol
Dulera
37
ADRs of ICS?
1. Increased risk for fractures, growth, immunosuppression 2. Dysphonia 3. Oral candida 4. Cough
38
Counseling when using ICS
Rinse mouth with water and spit out to avoid thrush
39
What ICS don't need to be shaken?
1. Ciclesonide (Alvesco) 2. QVAR Redihaler
40
ICS that is available as a neb solution?
Budesonide
41
Tiotropium
Spiriva
42
Umeclidinium/vilanterol/fluticasone
Trelegy
43
What agents are preferred for maintanance asthma?
ICS ICS/LABA
44
What are the LTRAs?
1. Montelukast 2. Zafirlukast 3. Zileuton
45
Montelukast
Singulair
46
Zafirlukast
Accolate
47
Zileuton
Zyflo
48
BBW of Singular
Neuropsychiatric events
49
Indicatiosn for SIngulair?
ALlergic rhinitis, exercise-induced broncocontriction
50
How do you adminsiter Singulair granuales?
* Can be administered directly in the mouth * Dissolved in breast milk or formula * Applesauce, carrots, rice, or ice cream
51
When do you administer Singulair?
In the evening
52
MOA of theophylline?
Blocks PE -> increase in cAMP -> bronchodilation
53
What are the active metabolites in theophylline?
Caffein and 3-methylxanthine
54
Therapeutic range of theophylline?
5-15mcg/mL
55
Drugs that increase theophylline levels?
Ciprofloxacin, zileuton, zafirlukast
56
Conversion from aminophylline to theophilline * Vice versa?
Aminophylline to theophylline multiply by 0.8 Vice versa: divide by 0.8
57
Drugs that decrease theophylline levels?
1. Carbamazepine 2. Fosphenytoin 3. Phenobarbital 4. Phenytoin 5. Primidone 6. RIfampin 7. Ritonavir
58
When should anticholinergics be used for asthma?
Add on with ICS
59
When are biologics used?
Severe asthma that remains uncontrolled
60
MOA of Omalizumab?
Inhibits IgE binding
61
How is Omalizzumab adminsitered?
SC Iniitate in a healthcare setting under med supervision
62
Omalizumab
Xolair
63
Indications for Xolair?
Severe allergic asthma
64
BBW of Xolair?
Anaphylaxis
65
Interleukin receptor antagonsits that are administered via SC?
1. Mepolizumab (Nucala) 2. Benralizumab (Fasenra) 3. Dupilumab (Dupixent)
66
Interleukin receptor antagonsits that are administered via IV?
Reslizumab (Cinqair)
67
Indications of IRA?
Severe eosinophillic asthma
68
BBW for reslizumab?
Anaphylaxis
69
Indication for Tezepelumab?
Severe asthma (any type)
70
Administration of Tezepelumab?
SC
71
What is the tx for EIBS?
SABA Low dose ICS+formoterol Taken 5-15 min before exercise
72
Describe the timing and order of inhaler use?
Wait 60 seconds between each one: 1. SABA for rescue 2. Bronchodilators to open airways 3. ICS for maintenace and sx relief
73
What is a neb?
Device that turns liquid medications into fine mist
74
What are spacers for?
Children and anyone with dexterity issues
75
Spacer brands?
AeroChamber OptiHaler OptiChamber
76
Counseling for budesonide (pulmicort respules)
Ampules should be used within 2 weeks of opening the aluminum package

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