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PHRM 825 > Long-Term Control Medications in Asthma and COPD > Flashcards

Long-Term Control Medications in Asthma and COPD Flashcards

1
Q

Class: Beclomethasone

A

inhaled corticosteroid

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2
Q

Brand Name: Beclomethasone

A

QVAR

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3
Q

Dosage Form: Beclomethasone

A

Redihaler (MDI)

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4
Q

Age Groups: Beclomethasone

A

5-11 yo, adults

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5
Q

Class: Budesonide

A

inhaled corticosteroids (ics)

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6
Q

Brand Name: Budesonide

A

Pulmicort

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7
Q

Dosage Form: Budesonide

A

Flexhaler

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8
Q

Age Groups: Budesonide

A

5-11 yo, adults

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9
Q

Class: Budesonide Solution

A

inhaled corticosteroids

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10
Q

Brand Name: Budesonide Solution

A

Pulmicort Respules

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11
Q

Dosage Form: Budesonide Solution

A

Nebulizer Solution

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12
Q

Age Group Dosing: Budesonide Solution

A

0-4, 5-11 yo

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13
Q

Class: Ciclesonide

A

inhaled corticosteroid

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14
Q

Brand Name: Ciclesonide

A

Alvesco

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15
Q

Dosage Form: Ciclesonide

A

HFA

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16
Q

Age Group Dosing: Ciclesonide

A

5-11 yo, adults

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17
Q

Class: Fluticasone Propionate

A

inhaled coritcosteroid

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18
Q

Brand Name: Fluticasone Propionate

A

Flovent (HFA, DPI), ArmonAir (Aerosol Powder Inhaler)

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19
Q

Dosage Form: Fluticasone Propionate

A

HFA, DPI, Aerosol Powder Inhaler

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20
Q

Age Group Dosing: Fluticasone Propionate

A

HFA ( 4+ yo)
DPI (4+ yo)
MDPI (adult only)

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21
Q

Class: Fluticasone Furoate

A

inhaled corticosteroids

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22
Q

Brand Name: Fluticasone Furoate

A

Arnuity Ellipta

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23
Q

Dosage Form: Fluticasone Furoate

A

Ellipta

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24
Q

Age Group Dosing: Fluticasone Furoate

A

5-11 yo, adults

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25
Q

Class: Mometasone

A

inhaled corticosteroid

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26
Q

Brand Name: Mometasone

A

Asmanex

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27
Q

Dosage Form: Mometasone

A

HFA, Twisthaler

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28
Q

Age Group Dosing: Mometasone

A

HFA: 5-11 yo, adult
Twisthaler: 4-11 yo, adult

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29
Q

Adverse Effects: ICS

A

oral thrush (candidiasis)

cough

dysphonia

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30
Q

Education Tips: ICS

A

patients should rinse their mouth and spit after use to prevent oral thrust

ICS are most effective long-term control therapy for asthma (improve QOL, increase lung function, and reduce risk of exacerbations)

Titrate to lowest effective dose: see low, medium, and high dose conversion tables

Pulmicort Respules should use Jet Nebulizer and should not be mixed with other nebulizer medications

High doses increase the risk for systemic side effects

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31
Q

Uses: ICS

A

prevent and control inflammation

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32
Q

Class: Arformoterol Tartrate

A

long acting beta agonist (LABA)

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33
Q

Brand Name: Arformoterol Tartrate

A

Brovana

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34
Q

Dosage Form: Arformoterol Tartrate

A

Nebulizing Solution

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35
Q

Age Group Dosing: Arformoterol Tartrate

A

Adults (COPD only)

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36
Q

Class: Formoterol

A

long acting beta agonist (LABA)

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37
Q

Brand Name: Formoterol

A

Perforomist

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38
Q

Dosage Form: Formoterol

A

Nebulizer Solution

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39
Q

Age Group Dosing: Formoterol

A

Adults (COPD only unless used in combination with ICS)

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40
Q

Class: Indacaterol

A

long acting beta agonist (LABA)

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41
Q

Brand Name: Indacaterol

A

Arcapta Neohaler

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42
Q

Dosage Form: Indacaterol

A

Neohaler

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43
Q

Age Group Dosing: Indacaterol

A

Adults (COPD only)

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44
Q

Class: Olodaterol

A

long acting beta agonist (LABA)

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45
Q

Brand Name: Olodaterol

A

Striverdi Respimat

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46
Q

Dosage Form: Olodaterol

A

Respimat

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47
Q

Age Group Dosing: Olodaterol

A

Adult (COPD only)

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48
Q

Class: Salmeterol

A

long acting beta agonist (LABA)

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49
Q

Brand Name: Salmeterol

A

Serevent

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50
Q

Dosage Form: Salmeterol

A

Diskus

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51
Q

Age Group Dosing: Salmeterol

A

4+ yo, adults

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52
Q

Adverse Effect: Long Acting Beta Agonists (LABA)

A

tachycardia
headache
tremor
hypokalemia

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53
Q

Education Tips: Long Acting Beta Agonists

A

Boxed Warning: increased risk of asthma related death for all monotherapy. LABA should not be used alone for asthma management

Boxed Warning: increasing hospitalizations in pediatric and adolescent patients

Prolonged QT seen with intentional overdoses

Not for acute symptoms

May be helpful for exercise induced bronchospasm

Formoterol and indacaterol capsules should not be taken orally

Pediatric Considerations: most children > 4 yo cannot provide sufficient inspiratory flow for adequate lung delivery with a DPI

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54
Q

Use: Long Acting Beta Agonist (LABA)

A

increase cAMP

bronchial smooth muscle relaxation and inhibit hypersensitivity mediators from mast cells (histamine and leukotrienes)

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55
Q

Class: Aclindium

A

long acting antimuscarinics (LAMA)

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56
Q

Brand Name: Aclindinium

A

Turdorza Pressair

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57
Q

Dosage From: Aclindinium

A

DPI

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58
Q

Age Group Dosing: Aclindinium

A

Adult (COPD only)

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59
Q

Class: Glycopyrrolate

A

long acting antimuscarinics (LAMA)

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60
Q

Brand Name: Glycopyrrolate

A

Seebri Neohaler

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61
Q

Dosage Form: Glycopyrrolate

A

DPI, Nebulizing Solution

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62
Q

Age Group Dosing: Glycopyrrolate

A

Adult (COPD Only)

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63
Q

Class: Revefenacin

A

long acting antimuscarinics (LAMA)

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64
Q

Brand Name: Revefenacin

A

Yupelri

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65
Q

Dosage From: Revefenacin

A

Nebulizing solution

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66
Q

Age Group Dosing: Revefenacin

A

Adult (COPD only)

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67
Q

Class: Tiotropium

A

long acting antimuscarinics (LAMA)

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68
Q

Brand Name: Tiotropium

A

spirivia

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69
Q

Dosage From: Tiotropium

A

HandiHaler
Respimat

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70
Q

Age Group Dosing: Tiotropium

A

Handihaler: Adult (COPD only)
Respimat: 6+ yo

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71
Q

Class: Umeclidinium

A

long acting antimuscarinics (LAMA)

72
Q

Brand Name: Umeclinidium

A

Incruse Ellipta

73
Q

Dosage From: Umeclindinium

A

DPI

74
Q

Age Group Dosing: Umeclindinium

A

Adult (COPD only)

75
Q

Adverse Effect: Long Acting Antimuscarinics

A

dry mouth
dizziness
blurred vision
upper respiratory infections
paradoxical bronchospasms

76
Q

Education Tips: Long Acting Antimuscarinics

A

tiotropium has been approved for use in asthma as an add-on option for children 12+ yo

77
Q

Uses: Long Acting Antimuscarinics

A

block the bronchoconstrictor effects of acetylcholine on M3 and M2 receptors

78
Q

Class: Fluticasone/Salmeterol

A

ICS/LABA Combo

79
Q

Brand Name: Fluticasone/Salmeterol

A

HFA MDI and DPI: Advair
Respiclick: AirDuo and AirDuo Digihaler

80
Q

Dosage Form: Fluticasone/Salmeterol

A

DPI
HFA MDI
Respiclick

81
Q

Age Group Dosing: Fluticasone/Salmeterol

A

DPI: 4+ yo, adult
HFA: adult
Respiclick: adult

82
Q

Class: Budesonide/Formoterol

A

ICS/LABA

83
Q

Brand Name: Budesonide/Formoterol

A

Symbicort

84
Q

Dosage Form: Budesonide/Formoterol

A

HFA MDI

85
Q

Age Group Dosing: Budesonide/Formoterol

A

5-11 yo, adult

86
Q

Class: Mometasone/Formoterol

A

ICS/LABA Combo

87
Q

Brand Name: Mometasone/Formoterol

A

Dulera

88
Q

Dosage Form: Mometasone/Formoterol

A

MDI

89
Q

Age Group Dosing: Mometasone/Formoterol

A

Adult

90
Q

Class: Fluticasone/Vilanterol

A

ICS/LABA

91
Q

Brand Name: Fluticasone/Vilanterol

A

Breo Ellipta

92
Q

Dosage Form: Fluticasone/Vilanterol

A

DPI (Ellipta)

93
Q

Age Group Dosing: Fluticasone/Vilanterol

A

Adult

94
Q

Adverse Effects: ICS/LABA Combo

A

see individual products

95
Q

Education Tips: ICS/LABA Combo

A

guidelines recommend combo LABA with ICS in asthma, as LABA should not be used as monotherapy

combo products developed to created convenient packaging and assist with patient adherence

96
Q

Class: Olodaterol/Tiotropium

A

LABA/LAMA Combination

97
Q

Brand Name: Olodaterol/Tiotropium

A

Stiolto Respimat

98
Q

Dosage Form: Olodaterol/Tiotropium

A

Respimat

99
Q

Age Group Dosage: Olodaterol/Tiotropium

A

adult (COPD only)

100
Q

Class: Vilanterol/Umeclidinium

A

LAMA/LABA Combo

101
Q

Brand Name: Vilanterol/Umeclidinium

A

Anoro Ellipta

102
Q

Dosage Form: Vilanterol/Umeclidinium

A

Ellipta

103
Q

Age Group Dosing: Vilanterol/Umeclindium

A

adult (COPD only)

104
Q

Class: Indacaterol/Glycopyrronium

A

LABA/LAMA combo

105
Q

Brand Name: Indacaterol/Glycopyrronium

A

Utibron Neohaler

106
Q

Dosage Form: Indacaterol/Glycopyrronium

A

Neohaler

107
Q

Age Group Dosage: Indacaterol/Glycopyrronium

A

adult (COPD only)

108
Q

Class: Formoterol/Glycopyrronium

A

LABA/LABA combination

109
Q

Brand Name: Formoterol/Glycopyrronium

A

Bevespi Aerosphere

110
Q

Dosage Form: Formoterol/Glycopyrronium

A

Aerosphere

111
Q

Age Group Dosing: Formoterol/Glycopyrronium

A

adult (COPD only)

112
Q

Class: Formoterol/Aclindinium

A

LABA/LABA combo

113
Q

Brand Name: Formoterol/Aclindinium

A

Duaklir Pressair

114
Q

Dosage Form: Formoterol/Aclindinium

A

DPI

115
Q

Age Group Dosing: Formoterol/Aclindinium

A

Adult (COPD only)

116
Q

Class: Fluticasone/Umeclindinium/Vilanterol

A

LABA/LAMA/ICS Combo

117
Q

Brand Name: Fluticasone/Umeclindinium/Vilanterol

A

Trelegy Ellipta

118
Q

Dosage Form: Fluticasone/Umeclindinium/Vilanterol

A

Ellipta

119
Q

Age Group Dosing: Fluticasone/Umeclindinium/Vilanterol

A

Adult (COPD and Asthma)

120
Q

Class: Budesonide/Glycopyrrolate/Formoterol Fumarate

A

LABA/LAMA/ICS

121
Q

Brand Name: Budesonide/Glycopyrrolate/Formoterol Fumarate

A

Breztri Aerosphere

122
Q

Dosage Form: Budesonide/Glycopyrrolate/Formoterol Fumarate

A

Aerosphere

123
Q

Age Group Dosing: Budesonide/Glycopyrrolate/Formoterol Fumarate

A

adult (COPD only)

124
Q

Education Tips: LABA/LAMA

A

not indicated for treatment of acute deteriorations

125
Q

Class: Cromolyn

A

Mast Cell Stabilizer

126
Q

Brand Name: Cromolyn

A

Intal

127
Q

Dosage Form: cromolyn

A

nebulizer solution

128
Q

Age Group Dosing: Cromolyn

A

0-4, 5-11 yo, adult

129
Q

Adverse Effect: Cromolyn

A

high incidence of unpleasant taste in mouth, rare cardiac arrhythmias, coughing, dyspnea, sore throat, N/V/D if absorbed systemically

less effective than low-dose ICS

prevents increase in bronchial hyperactivity seen in allergy season

130
Q

Class: Montelukast

A

Leukotriene Modifiers

131
Q

Brand Name: Montelukast

A

Singulair

132
Q

Dosage Form: Montelukast

A

tablets
granule packts

133
Q

Age Group Dosing: Montelukast

A

1-11 yo, adult

134
Q

Class: Zafirlukast

A

Leukotriene Modifiers

135
Q

Brand Name: Zafirlukast

A

Accolate

136
Q

Dosage Form: Zafirlukast

A

tablet

137
Q

Age Group Dosing: Zafirlukast

A

5-11 yo, adult

138
Q

Class: Zileuton

A

leukotriene modifiers

139
Q

Brand Name: Zileuton

A

Zyflo CR

140
Q

Dosage Form: Zileuton

A

IR and ER tablets

141
Q

Age Group Dosing: Zileuton

A

adult

142
Q

Class: Theophylline

A

methylxanthines

143
Q

Brand Name: Theophylline

A

Theochron

144
Q

Dosage Form: Theophylline

A

ER 12 Hour Tablets
ER 24 Hour Tablets
ER 24 Hour Capsules
Liquid

145
Q

Age Group Dosing: Theophylline

A

Adult: acute exacerbation, chronic management

146
Q

Adverse Effect: Theophylline

A

insomnia
gastrointestinal upset
hyperactivity
hypertension
tremor

147
Q

Clinical Pearls: Theophylline

A

Dose Related Toxicity: tachycardia, nausea, vomiting, headache, seizures, arrhythmias

CI: peptic ulcer disease, arrhythmias, seizure disorders

DI: major substrate of CYP 34A, 1A2, 2E1

Increase Concentration: cimetidine, erythromycin, clarithromycin, ciprofloxacin, ticlopidine

Decrease Concentration: phenobarbital, phenytoin, carbamazepine, rifampin, smoking

PDE III inhibition likely cause for hypotension, tachycardia, and nausea

148
Q

Uses: methylzanthines

A

bronchodilation through inhibition of PDE III and PDE IV

149
Q

Class: omalizumab

A

Anti-Ige

150
Q

Brand Name: omalizumab

A

Xolair

151
Q

Dosage From: omalizumab

A

injection
solution vial

152
Q

Age Group Dosing: omalizumab

A

6 yo+

153
Q

Adverse Effect: Omalizumab

A

headache
injection site reactions
arthralgia
thrombocytopenia
pharyngitis
sinusitis
upper respiratory tract infections

154
Q

Clinical Pearls: omalizumab

A

Boxed Warning: anaphylaxis

do not give more than 150 mg per injection site

monitor for anaphylaxis before and after injection

FDA approved for moderate to severe persistent asthma in patients with a positive skin test or reactivity to a perennial aeroallergen and symptoms that are inadequately controlled with ICS

155
Q

Class: Mepolizumab

A

Anti-IL 5

156
Q

Brand Name: Mepolizumab

A

Nucala

157
Q

Dosage Form: Mepolizumab

A

autoinjector
solution vial

158
Q

Age Group Dosing: mepolizumab

A

6+ yo

159
Q

Class: reslizumab

A

Anti-IL5

160
Q

Brand Name: reslizumab

A

Cinqair

161
Q

Dosage Form: reslizumab

A

solution

162
Q

Age Group Dosing: Reslizumab

A

18+ yo

163
Q

Class: Benralizumab

A

Anti-IL 5

164
Q

Brand Name: Benralizumab

A

Fasenra

165
Q

Dosage Form: Benralizumab

A

autoinjector
pre-filled syringe

166
Q

Age Group Dosing: Benralizumab

A

adult

167
Q

Class: Dupilumab

A

Anti- IL4/IL-13

168
Q

Brand Name: Dupilumab

A

dupixent

169
Q

Dosage Form: Dupilumab

A

injection

170
Q

Age Group Dosing: Dupilumab

A

adult

171
Q

Class: Roflumilast

A

PDE4 Inhibitor

172
Q

Brand Name: Roflumilast

A

Daliresp

173
Q

Dosage Form: Roflumilast

A

Tablets

174
Q

Age Group Dosing: Roflumilast

A

Adult (COPD only)

175
Q

Adverse Effect: Roflumilast

A

HA
weight loss
diarrhea
nausea

176
Q

Clinical Pearls: Roflumilast

A

Monitoring: liver function test, weight
DI: cyp3A4 (major), CYP 1A2 (minor)
CI: Child Pugh class B or C

PHRM 825 (8 decks)

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