Quick Relief Medications for Asthma

Question 1

How do Short Acting B2 agonists work

Answer 1

increasing cAMP and antagonizing constriction–> smooth muscle relaxation
-reverses obstruction and improves airflow

Question 2

Adverse Effects of SABA

Answer 2

Tachycardia, tremor, hypokalemia, irritability

Question 3

Chronic use of a SABA indicates poor asthma control ( what is considered chronic use?)

Answer 3

> 2 times/ day

Question 4

Most common SABAs

Answer 4

Albuterol HFA, Albuterol, Levalbuterol HFA, Levalbuterol

Question 5

Generic: Albuterol HFA

Answer 5

Brand: ProAir, Ventolin, Proventil, or ProAir Respiclick

Question 6

Generic: Levalbuterol HFA

Answer 6

Brand: Xopenex

Question 7

All albuterol products come with what dosing strength?

Answer 7

90 mcg/ inhalation

Question 8

What dosage forms can you receive albuterol products in?

Answer 8

MDI: ProAir, Ventolin, Proventil
or
Aerosol Powder Inhaler: ProAir Respiclick

Question 9

what age group would it be appropriate to use a mask in

Answer 9

0-4 y/o

Question 10

When comparing albuterol or levalbuterol, which is FDA approved for ages 0-4

Answer 10

albuterol

Question 11

Albuterol nebulizer solution comes in what strength?

Answer 11

0.63mg/mL
1.25 mg/3 mL
2.5 mg/ 3 mL
5mg/mL

Question 12

What dosage form and strength does leavalbuterol HFA come in?

Answer 12

An MDI at 45mcg/ inhalation

Question 13

What strength does Levalbuterol nebulizer solution come in?

Answer 13

0. 31 mg/3 mL
1. 63 mg/3 mL
2. 25 mg/0.5 mL
3. 25 mg/ 3mL

Question 14

Albuterol nebulizer solution can be mixed with what?

Answer 14

cromylyn solution
budesonide inhalant suspension
ipatropium solution

Question 15

In mild/ moderate asthma exacerbations and MDI plus_____ can be effective with nebulizer therapy?

Answer 15

valved holding chamber

Question 16

When would you use levalbuterol

Answer 16

when albuterol does not work for a patient

Question 17

What kind of suspension is compatible with levalbuterol nevulizer solution ( can mix)

Answer 17

budesonide inhalant suspension

Question 18

Biggest difference between albuterol and Levalbuterol?

Answer 18

Strength of dosing ( Levo is half strength of albuterol becuase of INC potency)

Question 19

How do short acting anti-muscarinics work?

Answer 19

competitively inhibit cholinergic receptors in bronchial smooth muscle by DEC cGMP and inducing dilation

Question 20

AE’s of short acting anti-muscarinics

Answer 20

Dry mouth, urinary retention, infection, sinusitis, bronchitis

Question 21

Short acting Anti-muscarinics are typically used in combo with what? and for what?

Answer 21

albuterol, asthma exacerbation

Question 22

This class should not be used as a first line therapy choice, but should be added to SABA therapy for severe exacerbation

Answer 22

SA anti-muscarinics

Question 23

Most common SA Anti-muscarinics

Answer 23

Ipatropium

ipatropium/ albuterol

Question 24

Ipatropium HFA: generic

Answer 24

Brand: Atrovent

Question 25

Dosage forms that ipatropium come in

Answer 25

MDI or nebulizer sln

Question 26

Ipatropium dose strength of MDI

Answer 26

17mcg/ inhalation

Question 27

ipatropium nebulizer soln dosage strength

Answer 27

0.25mg/mL

Question 28

Ipatropium/ albuterol: generic

Answer 28

brand: Combivent respimat

Question 29

Ipatropium/ albuterol products come in what different dosage forms?

Answer 29

MDI and Nebulizer solution

Question 30

Ipatropium/ albuterol MDI strength

Answer 30

20mcg/ 100mcg per inhalation

Question 31

Ipatropium/ albuterol nebulizer soln strength

Answer 31

0.5mg/2.5mg per 3ml vial

Question 32

What is important to note about ipatropium/ albuterol nebulizer soln?

Answer 32

May be used for up to 3 hours in initial treatment management of severe exacerbation

Question 33

How do systemic Corticosteroids work?

Answer 33

They decrease inflammation and increase response to B2 agonists

Question 34

Four main systemic corticosteroids

Answer 34

Methylprednisolone Prednisolone Prednisone Methylprednisolone acetate

Question 35

AE of short term oral corticosteroid use

Answer 35

hyperglycemia, INC appetite, fluid retention, demargiation of WBC's, psychiatric disturbances

Question 36

Contraindications of Systemic Corticosteroids

Answer 36

systemic fungal infections, admin of live vaccines ( if immunocompromised)

Question 37

Drug interactions associated with systemic corticosteroids

Answer 37

Warfarin INR will INC, and experience a DEC of efficacy in inactivated vaccines

Question 38

When can you take a systemic CS while also using an ICS

Answer 38

if pt is staking ICS proir to hospitalization

Question 39

This class can be used in chronic therapy of COPD and Asthma, but only in the severe stages.

Answer 39

Systemic CS

Question 40

What is a "burst" dosage form and why is it effective

Answer 40

burst is a short term, high dose therapy option. They are useful for establishing control when initiating therapy or during periods of general deterioration

Question 41

When should injection of a systemic CS be used instead of burst

Answer 41

in case of adherence issues or patient is vomiting

Question 42

Available dosage forms of methylpredisolone

Answer 42

tablets (2,4,6,8,16,32 mg)

Question 43

Available dosage forms of prednisolone

Answer 43

``` tablets (5mg) oral liquid ( 5mg/5ml and 15mg/5ml) ```

Question 44

Available dosage forms of prednisone

Answer 44

``` tablets (1,2.5,5,10,20,50 mg) oral liquid ( 5mg/5ml) ```

Question 45

Available dosage forms of methylprednsiolone acetate

Answer 45

repository injection ( 40mg/mL or 80mg/mL)

Question 46

Max Dose prednisolone

Answer 46

60mg/ day PO for 3-10 days

Question 47

Additional medications used for asthma exacerbation

Answer 47

epinephrine Terbutaline Magnesium Sulfate IV

Question 48

Dosage form of epinephrine and terbutaline

Answer 48

SubQ

Question 49

These two drugs have no proven effect over aerosol

Answer 49

epinephrine | terbutaline

Question 50

How does magnesium sulfate work as a short term / fast acting dilator

Answer 50

inhibit calcium influx into smooth muscle cells, inhibiting muscle contraction--> smooth muscle relaxation