Long-Term Control Medications in Asthma and COPD Flashcards
(213 cards)
1
Q
What is the brand of Belomethasone?
A
QVAR
2
Q
What is the generic of QVAR?
A
Belomethasone
3
Q
What is the dosage form of Belomethasone and QVAR?
A
HFA inhaler
4
Q
How many mcg/inhalation do Belomethasone and QVAR have? (2 available strengths)
A
40 or 80 mcg/inhalation
5
Q
What are the brands of Budesonide? (2)
A
Pulmicort and Pulmicort Respules
6
Q
What is the generic of Pulmicort?
A
Budesonide
7
Q
What is the dosage form of Budesonide and Pulmicort?
A
Flexhaler
8
Q
How many mcg/inhalation do Budesonide and Pulmicort have? (2 available strengths)
A
90 or 180 mcg/inhalation
9
Q
What is the generic of Pulmicort Respules?
A
Budesonide
10
Q
What is the dosage form of Budesonide and Pulmicort Respules?
A
Nebulizer Solution
11
Q
What are the strengths of Budesonide and Pulmicort Respules? (3)
A
0.25mg/2mL
0.5mg/2mL
1mg/2mL
12
Q
What is the brand of Ciclesonide?
A
Alvesco
13
Q
What is the generic of Alvesco?
A
Ciclesonide
14
Q
What is the dosage form of Ciclesonide and Alvesco?
A
HFA inhaler
15
Q
How many mcg/inhalation do Ciclesonide and Alvesco have? (2 available strengths)
A
80 or 160 mcg/inhalation
16
Q
What is the brand of Flunisolide?
A
Aerospan
17
Q
What is the generic of Aerospan?
A
Flunisolide
18
Q
What is the dosage form of Flunisolide and Aerospan?
A
HFA inhaler
19
Q
How many mcg/inhalation do Flunisolide and Aerospan have?
A
80 mcg/inhalation
20
Q
What are the brands of Fluticasone Propionate?
A
Flovent and ArmonAir
21
Q
What is the generic of Flovent?
A
Fluticasone Propionate
22
Q
What are the dosage forms of Fluticasone Propionate and Flovent? (2)
A
HFA and DPI
23
Q
What are the available strengths of Fluticasone Propionate and Flovent in HFA form? (3)
A
44, 110 or 220 mcg/inhalation
24
Q
What are the available strengths of Fluticasone Propionate and Flovent in DPI form? (3)
A
50, 100 or 250 mcg/inhalation
25
What is the generic of ArmonAir?
Fluticasone Propionate
26
What is the dosage form of Fluticasone Propionate and ArmonAir?
RespiClick
27
What are the available strengths of Fluticasone Propionate and ArmonAir? (3)
55, 113 or 232 mcg/inhalation
28
What is the brand of Fluticasone Furoate?
Arnuity Ellipta
29
What is the generic of Arnuity Ellipta?
Fluticasone Furoate
30
What is the dosage form of Fluticasone Furoate and Arnuity Ellipta?
Ellipta inhaler
31
What are the available strengths of Fluticasone Furoate and Arnuity Ellipta? (2)
100 or 200 mcg/inhalation
32
What is the brand of Mometasone?
Asmanex
33
What is the generic of Asmanex?
Mometasone
34
What are the dosage forms of Mometasone and Asmanex? (2)
HFA and Twisthaler
35
What are the available strengths of Mometasone and Asmanex in HFA form? (2)
100 or 200 mcg/inhalation
36
What are the available strengths of Mometasone and Asmanex in Twisthaler form? (2)
110 or 220 mcg/inhalation
37
What are some side effects/adverse events with ICS?
Oral thrush (candidiasis), cough, dysphonia (voice disorder - hard to talk normally)
38
What is a counseling tip for patients who are taking an ICS?
Rinse mouth and spit after use to prevent oral thrush
39
What is the most effective long-term control therapy for asthma?
ICS
40
What are some benefits to taking an ICS?
Improve quality of life, increase lung function, reduce the risk of exacerbations
41
How to dose ICS
Titrate to lowest effective dose
42
What drug should use Jet Nebulizer and should not be mixed with other nebulizer medications?
Pulmicort Respules
43
(T/F): Aerospan has a built in spacer
True
44
What increases the risk of systemic side effects with ICS drugs?
High doses
45
How do ICS medications work?
Prevent and control inflammation
46
What medication class is Belomethasone (QVAR)?
ICS
47
What medication class is Budesonide (Pulmicort and Pulmicort Respules)?
ICS
48
What medication class is Ciclesonide (Alvesco)?
ICS
49
What medication class is Flunisolide (Aerospan)?
ICS
50
What medication class is Fluticasone Propionate (Flovent and ArmonAir)?
ICS
51
What medication class is Fluticasone Furoate (Arnuity Ellipta)?
ICS
52
What medication class is Mometasone (Asmanex)?
ICS
53
How do LABAs work?
Increase cAMP, cause bronchial smooth muscle relaxation, inhibit hypersensitivity mediators from mast cells (histamine and leukotrienes)
54
What is the brand of Arformoterol tartrate?
Brovana
55
What is the generic of Brovana?
Arformoterol tartrate
56
What is the dosage form of Arformoterol tartrate?
Nebulizer Solution
57
What is the brand of Formoterol?
Foradil Aerolizer
58
What is the generic of Foradil Aerolizer?
Formoterol
59
What is the dosage form of Formoterol (Foradil Aerolizer)?
Aerolizer
60
What is the brand of Indacaterol?
Arcapta Neohaler
61
What is the generic of Arcapta Neohaler?
Indacaterol
62
What is the dosage form of Indacaterol (Arcapta Neohaler)?
Neohaler
63
What is the brand of Olodaterol?
Striverdi Respimat
64
What is the generic of Striverdi Respimat?
Olodaterol
65
What is the dosage form of Olodaterol (Striverdi Respimat)?
Respimat inhaler
66
What is the brand of Salmeterol?
Serevent
67
What is the generic of Serevent?
Salmeterol
68
What is the dosage form of Salmeterol (Serevent)?
Diskus inhaler
69
What are some side effects/adverse events with LABAs?
tachydardia, headache, tremor, hypokalemia
70
What is the boxed warning for LABAs? (related to monotherapy)
Increased risk of asthma related death for all monotherapy LABA use
71
Should LABAs be used alone for asthma management?
NO!
72
What is the other boxed warning for LABAs? (related to age of patients)
Increasing hospitalizations in pediatric and adolescent patients
73
What is seen with intentional overdoses of LABAs?
Prolonged QT (irregular heart beats)
74
Should LABAs be used to treat acute symptoms?
No!
75
Would a LABA be potentially helpful for exercise induced bronchospams?
Yes
76
(T/F): Formoterol and Indacaterol capsules should be taken orally
False!!
77
Most children < 4 years old cannot provide sufficient inspiratory flow for adequate lung deliver with a....
DPI
78
What medication class is Arformoterol tartrate (Brovana)?
LABA
79
What medication class is Formoterol (Foradil Aerolizer)?
LABA
80
What medication class is Indacaterol (Arcapta Neohaler)?
LABA
81
What medication class is Olodaterol (Striverdi Respimat)?
LABA
82
What medication class is Salmeterol (Serevent)?
LABA
83
What three LABAs are used in COPD patients only?
Arformoterol tartrate (Brovana), Indacaterol (Arcapta Neohaler) and Olodaterol (Striverdi Respimat)
84
How do LAMAs work?
Block the bronchoconstrictor effects of acetylcholine on M3 and M2 receptors
85
What is the brand of Aclidinium?
Tudorza Pressair
86
What is the generic of Tudorza Pressair?
Aclidinium
87
What is the dosage form of Aclidinium (Tudorza Pressair)?
DPI
88
What is the brand of Tiotropium?
Spiriva
89
What is the generic of Spirivia?
Tiotropium
90
What are the dosage forms of Tiotropium and Sprivia? (2)
HandiHaler and Respimat
91
What is the brand of Umeclidinium?
Incruse Ellipta
92
What is the generic of Incruse Ellipta?
Umeclidinium
93
What is the dosage form of Umeclidinium (Incruse Ellipta)?
DPI
94
What are some side effects/adverse events with LAMAs?
dry mouth, dizziness, blurred vision, upper respiratory infections and paradoxical bronchospams
95
What LAMA has been approved for use in asthma as an add-on option in step 4 or 5 (history of exacerbations despite ICS + LABA use)
Tiotropium
96
What medication class is Aclidinium (Tudorza Pressair)?
LAMA
97
What medication class is Tioptropium (Spiriva)?
LAMA
98
What medication class is Umeclidinium (Incruse Ellipta)?
LAMA
99
All LAMAs are only to be used in patients with what?
COPD
100
What are the brands of Fluticasone/Salmeterol? (2)
Advair and AirDuo
101
What is the generic of Advair?
Fluticasone/Salmeterol
102
What are the dosage forms of Fluticasone/Salmeterol (Advair)? (2)
DPI and HFA MDI
103
What is the generic of AirDuo?
Fluticasone/Salmeterol
104
What is the dosage form of Fluticasone/Salmeterol and AirDuo?
Respiclick (DPI)
105
What is the brand of Budesonide/Formoterol?
Symbicort
106
What is the generic of Symbicort?
Budesonide/Formoterol
107
What is the dosage form of Budesonide/Formoterol (Symbicort)?
HFA MDI
108
What is the brand of Mometasone/Formoterol?
Dulera
109
What is the generic of Dulera?
Mometasone/Formoterol
110
what is the dosage form of Mometasone/Formoterol (Dulera)?
MDI
111
What is the brand of Fluticasone/Vilanterol?
Breo Ellipta
112
What is the generic of Breo Ellipta?
Fluticasone/Vilanterol
113
What is the dosage form of Fluticasone/Vilanterol (Breo Ellipta)?
DPI
114
What are some side effects/adverse events with ICS/LABA combo products?
See individual products (ICS and LABA)
115
Guidelines recommend combination ____ with ____ in asthma, as ____ should not be used as monotherapy
LABA, ICS, LABA
116
Combination products were developed to create convenient packaging and assist with _____
patient adherence
117
What medication class is Fluticasone/Salmeterol (Advair)?
ICS/LABA
118
What medication class is Fluticasone/Salmeterol (AirDuo)?
ICS/LABA
119
What medication class is Budesonide/Formoterol (Symbicort)?
ICS/LABA
120
What medication class is Mometasone/Formoterol (Dulera)?
ICS/LABA
121
What medication class is Fluticasone/Vilanterol (Breo Ellipta)?
ICS/LABA
122
What is the brand of Olodaterol/Tiotropium?
Stiolto Respimat
123
What is the generic of Stiolto Respimat?
Olodaterol/Tiotropium
124
What is the dosage form of Olodaterol/Tiotropium (Stiolto Respimat)?
Respimat inhaler
125
What is the brand of Vilanterol/Umeclidinium?
Anoro Ellipta
126
What is the generic of Anoro Ellipta?
Vilanterol/Umeclidinium
127
What is the dosage form of Vilanterol/Umeclidinium (Anoro Ellipta)?
Ellipta inhaler
128
What is the brand of Indacanterol/Glycopyrronium?
Utibron Neohaler
129
What is the generic of Utibron Neohaler?
Indacanterol/Glycopyrronium
130
What is the dosage form of Indacanterol/Glycopyrronium (Utibron Neohaler)
Neohaler
131
What is the brand of Formoterol/Glycopyrronium?
Bevespi Aerosphere
132
What is the generic of Bevespi Aerosphere?
Formoterol/Glycopyrronium
133
What is the dosage form of Formoterol/Glycopyrronium (Bevespi Aerosphere)?
Aerosphere
134
All LABA/LAMA combo products are only to be used in patients with what?
COPD
135
What are some side effects/adverse events with LABA/LAMA combo products?
See individual products (LABA and LAMA)
136
What medication class is not indicated for treatment of acute deteriorations?
LABA/LAMA
137
What medication class is Olodaterol/Tioptropium (Stiolto Respimat)?
LABA/LAMA
138
What medication class is Vilanterol/Umeclidinium (Anoro Ellipta)?
LABA/LAMA
139
What medication class is Indacanterol/Glycopyrronium (Utibron Neohaler)?
LABA/LAMA
140
What medication class is Formoterol/Glycopyrronium (Bevespi Aerosphere)?
LABA/LAMA
141
What is Cromolyn?
Mass cell stabilzer
142
What is the dosage form of Cromolyn?
Nebulizer Solution
143
What are some side effects/adverse events with Cromolyn?
High incidence of unpleasant taste in mouth (>10%), rare cardiac arrhythmias, coughing, dyspnea (shortness of breath), sore throat, N/V/D if absorbed systemically
144
Is Cromolyn less or more effective than a low-dose ICS?
Less effective
145
Cromolyn prevents an increase in _______ seen in allergy season
bronchial hyperreactivity
146
What is the brand of Montelukast?
Singular
147
What is the generic of Singulair?
Montelukast
148
What are the dosage forms of Montelukast and Singulair? (2)
Tablets (chewable) and Granule Packets
149
What is the brand of Zafirlukast?
Accolate
150
What is the generic of Accolate?
Zafirlukast
151
What is the dosage form of Zafirlukast and Accolate?
Tablet
152
What is the brand of Zileuton?
Zyflo CR
153
What is the generic of Zyflo CR?
Zileuton
154
What is the dosage form of Zileuton and Zyflo CR?
Tablet
155
How do leukotriene modifiers work?
Block the production of leukotrienes
156
What are some side effects/adverse events with leukotriene modifiers?
Neuropsychiatric events (agitation, anxiety, abnormal dreams, hallucinations, depression, suicidal thinking), Churg-Strauss syndrome (Rare)
157
Zafirlukast and Zileuton may cause increased...
hepatic transaminases
158
Are leukotriene modifiers more or less effective than a low dose ICS or ICS/LABA in asthma?
Less effective
159
(T/F): Leukotriene modifiers have been adequately trialed in COPD patients
False
160
Montelukast is a weak inhibitor of.... (2 enzymes)
CYP2C8 and 2C9
161
Monteluast is a major substrate of... (2 enzymes)
CYP2C9 and 3A4
162
Montelukast is not for....
acute relief of symptoms
163
Zafirlukast should be taken at least ____ before or ____ after meals
1 hour before or 2 hours after
164
Zafirlukast can increase...
INR
165
Zileuton is a moderate inhibitor of...
CYP1A2
166
Zileuton is a minor substrate of.... (3 enzymes)
CYP1A2, 2C9 and 3A4
167
What medication class is Montelukast (Singulair)?
Leukotriene modifier
168
What medication class is Zafirlukast (Accolate)?
Leukotriene modifier
169
What medication class is Zileuton (Zyflo CR)?
Leukotriene modifier
170
How do methylxanthines work?
Cause bronchodilation through inhibition of PDE III and PDE IV (reduced breakdown of cAMP to AMP)
171
What medication class is Theophylline?
Methylxanthines
172
What are the dosage forms of Theophylline? (3)
ER tablets, ER capsules, liquid
173
What are some side effects/adverse events with Theophylline? (4)
Insomnia, GI upset, hyperactivity, hypotension
174
What are some one dose related toxicities for Theophylline? (6)
Tachycardia, nausea, vomiting, headache, seizures, arrhythmias
175
What are some contraindications of Theophylline?
Peptic ulcer disease, arrhythmias, seizure disorders
176
Theophylline is a major substrate of... (3 enzymes)
CYP 3A4, 1A2 and 2E1
177
There is an increased concentration of these drugs when Theophylline reacts with CYP 3A4, 1A2 or 2E1 (5)
cimetidine, erythromycin, clarithromycin, ciprofloxacin and ticlopidine
178
What is a decreased concentration of these drugs when Theophylline reacts with CYP 3A4, 1A2 or 2E1 (5)
Phenobarbital, phenytoin, carbamazepine, rifampin, smoking
179
PDE III inhibition from Theophylline is the likely cause of____, ___ and _____
hypotension, tachycardia and nausea
180
How do Anti-IgE monoclonal antibodies work?
Inhibit IgE from binding to receptors on mast cells and basophils, thus inhibiting degranulation
181
What is the brand of Omalizumab?
Xolair
182
What is the generic of Xolair?
Omalizumab
183
Omalizumab (Xolair) is dosed depending on _____ and pretreatment serum _____
body weight, IgE levels
184
What are some side effects/adverse events with Omalizumab (Xolair)? (7)
Headache, injection site reactions, arthralgias (joint pain), thrombocytopenia (not enough platelets in blood), pharyngitis (inflammation of back of throat), sinusitis, upper respiratory tract infections
185
What is a boxed warning for Omalizumab (Xolair)?
Anaphylaxis
186
Do not administer Omalizumab (Xolair) more than ___ per injection site
150mg
187
Monitor patient for ___ before and after injection of Omalizumab (Xolair)
anaphylaxis
188
Omalizumab (Xolair) is FDA approved for ____ to ____ persistent asthma in patients with a positive skin test or reactivity to a perennial aeroallergen and symptoms that are inadequately controlled wth ICS
moderate to severe
189
What medication class is Omalizumab (Xolair)?
Anti-IgE monoclonal antibody
190
How do Anti-IL5 monoclonal antibodies work?
Prevent IL-5 from binding to IL-5 receptor, thus reducing production and survival of eosinophils
191
What is the brand of Mepolizumab?
Nucala
192
What is the generic of Nucala?
Mepolizumab
193
What are some side effects/adverse events with Mepolizumab (Nucala)? (4)
Headache, injection site reactions, arthralgias, Herpes Zoster infection
194
What is a precaution with Mepolizumab (Nucala)?
Anaphylaxis (NOT A BOXED WARNING LIKE THE OTHERS)
195
Monitor for ____ before and after injection of Mepolizumab (Nucala)
anaphylaxis
196
Mepolizumab (Nucala) is indicated for add-on maintenance treatment of patients with ____ asthma with an _____ phenotype
severe, eosinophilic
197
What is the brand of Reslizumab?
Cinqair
198
What is the generic of Cinqair?
Reslizumab
199
What are some side effects/adverse events with Reslizumab (Cinqair)? (3)
injection site reactions, myalgias (muscle pain), increased creatinine phosphokinase
200
What are the boxed warnings for Reslizumab (Cinqair)? (2)
Anaphylaxis, malignancies (cancerous growths)
201
Monitor for ___ before and after injection of Reslizumab (Cinqair)
Anaphylaxis
202
Reslizumab (Cinqair) is indicated for add-on maintenance treatment of patients with ___ severe asthma with an _____ phenotype
severe, eosinophilic
203
What medication class is Mepolizumab (Nucala)?
Anti-IL5 monoclonal antibody
204
What medication class is Reslizumab (Cinqair)?
Anti-IL5 monoclonal antibody
205
How do Phosphodiaesterase-4 inhibitors work?
Inhibit PDE4, thus decreasing breakdown of cAMP to AMP, ultimately increasing cAMP levels
206
What is the brand of Roflumilast?
Daliresp
207
What is the generic of Daliresp?
Roflumilast
208
What is the dosage form of Roflumist and Daliresp?
Tablet
209
Roflumilast and Daliresp are indicated for ____ patients only
COPD
210
Patients taking Roflumilast and Daliresp need to have _____ and monitor their ____
liver function tests and weight
211
What are some drug interactions with Roflumilast and Daliresp? (2)
CYP3A4 (major), CYP1A2 (minor)
212
What are contraindications for Roflumilast and Daliresp?
Child-Pugh class B or C
213
What medication class is Roflumilast (Daliresp)?
PDE4 inhibitor
