Quick-Relief Medications in Asthma and COPD

Question 1

How do SABAs work?

Answer 1

Increase cAMP and thus cause bronchodilation

Question 2

Brand names of Albuterol HFA (there’s 4 of them)

Answer 2

ProAir, Ventolin, Proventil, ProAir Respiclick

Question 3

Generic name of ProAir, Ventolin, Proventil, ProAir Respiclick

Answer 3

Albuterol HFA

Question 4

What is the dosage form of ProAir, Ventolin and Proventil?

Answer 4

Metered Dose Inhaler (MDI)

Question 5

What is the dosage form of ProAir Respiclick?

Answer 5

Aerosol Powder Inhaler

Question 6

What is the dosage form of albuterol (not an inhaler)?

Answer 6

Nebulizer Solution

Question 7

What are some side effects/adverse events of albuterol HFA, albuterol, ProAir, Ventolin, Proventil and ProAir Respiclick?

Answer 7

Tachycardia, tremor, hypokalemia, irritability

Question 8

Chronic use (>2 times per day) of what indicates poor asthma control?

Answer 8

SABAs (ProAir, Ventolin, Proventil, ProAir Respiclick, albuterol)

Question 9

You can mix albuterol nebulizer solution with…. (3 things)

Answer 9

cromolyn solution, budesonide inhalant suspension or ipratropium

Question 10

In mild to moderate exacerbations, ____ plus ____ is as effective as nebulized therapy with appropriate administration technique and coaching by trained personnel

Answer 10

MDI plus valved holding chamber (spacer)

Question 11

What is the brand name of Levalbuterol HFA?

Answer 11

Xopenex

Question 12

What is the generic of Xopenex?

Answer 12

Levalbuterol HFA

Question 13

What is the dosage form of Levalbuterol HFA and Xopenex?

Answer 13

MDI

Question 14

What is the dosage form of Levalbuterol (not an inhaler)?

Answer 14

Nebulizer Solution

Question 15

What are some side effects/adverse events with Levalbuterol HFA, Xopenex and Levalbuterol?

Answer 15

Tachycardia, tremor, hypokalemia, irrritability

Question 16

What is reserved for patients who do not respond to albuterol for quick relief?

Answer 16

Levalbuterol HFA, Xopenex, Levalbuterol

Question 17

What is Levalbuterol nebulizer solution compatible with?

Answer 17

Budesonide inhalant suspension

Question 18

Levalbuterol administered in ___ the mg dose of albuterol provides comparable efficacy and safety

Answer 18

1/2 the mg dose

Question 19

What has not been evaluated by continuous nebulization?

Answer 19

Levalbuterol

Question 20

What is the brand name of Ipratropium HFA?

Answer 20

Atrovent

Question 21

What is the generic name of Atrovent?

Answer 21

Ipratropium HFA

Question 22

What is the dosage form of Ipratropium HFA and Atrovent?

Answer 22

MDI

Question 23

What is the dosage form of Ipratropium (not an inhaler)?

Answer 23

Nebulizer Solution

Question 24

What are some side effects/adverse effects with Ipratropium HFA, Atrovent and Ipratropium?

Answer 24

Dry mouth, urinary retention, infection, sinusitis, bronchitis

Question 25

What is used in combo with albuterol for asthma exacerbation treatment?

Answer 25

Ipratropium HFA and Atrovent

Question 26

Ipratropium nebulizer solution can be mixed with?

Answer 26

albuterol

Question 27

SAMAs should ___ be used as first-line therapy; should be added to ___ therapy for severe exacerbations

Answer 27

not, SABA

Question 28

What is the brand name of Ipratropium/Albuterol?

Answer 28

Combivent Respimat

Question 29

What is the generic name of Combivent Respimat?

Answer 29

Ipratropium/Albuterol

Question 30

What is the dosage form of Ipratropium/Albuterol and Combivent Respimat?

Answer 30

MDI

Question 31

What are some side effects/adverse events with Ipratropium/Albuterol and Combivent Respimat?

Answer 31

Same as SABAs and SAMAs

Question 32

What is the dosage form of Ipratropium/Albuterol (not an inhaler)?

Answer 32

Nebulizer Solution

Question 33

What may be used for up to 3 hours in initial management of severe exacerbations?

Answer 33

Ipratropium/Albuterol nebulizer solution

Question 34

How do SAMAs work?

Answer 34

Inhibit cholinergic receptors, cause bronchodilation

Question 35

How do systemic corticosteroids work?

Answer 35

Lower inflammation, increase response to beta agonists

Question 36

What is the dosage form of methylprednisolone?

Answer 36

Tablet

Question 37

What are the dosage forms of Prednisolone?

Answer 37

Tablet and oral liquid

Question 38

What are the dosage forms of Prednisone?

Answer 38

Tablet, oral liquid

Question 39

What is the dosage form of methylprednisolone acetate?

Answer 39

Repository injection

Question 40

What are some side effects/adverse events with the systemic corticosteroids?

Answer 40

Short term use - hyperglycemia, increased appetite, fluid retention, demargination of WBCs, psychiatric disturbances

Question 41

What are some contraindications to the systemic corticosteroids?

Answer 41

Systemic fungal infections, administration of live vaccines if immunocompromised

Question 42

What are some drug interactions with the systemic corticosteroids?

Answer 42

Warfarin INR is increased, lowered efficacy of inactivated vaccines

Question 43

What can be used with ICS if the patient is already taking ICS before hospitalization?

Answer 43

Systemic corticosteroids

Question 44

What may also be used for chronic therapy in both asthma (and COPD) only in severe stages? These can also be used to treat exacerbations

Answer 44

Systemic corticosteroids

Question 45

"Bursts" of what drugs are effective for establishing control when initiating therapy or during period of gradual deterioration?

Answer 45

Systemic corticosteroids

Question 46

Injection of what drug can be used in place of "burst" if adherence is an issue or patient is vomiting

Answer 46

Methylprednisolone acetate

Question 47

How does magnesium sulfate IV help treat asthma exacerbations?

Answer 47

Inhibits Ca influx into smooth muscle, causes relaxation

Question 48

What are some side effects/adverse events with magnesium sulfate IV?

Answer 48

Flushing, hypotension, vasodilation

Question 49

What are some contraindications to magnesium sulfate IV?

Answer 49

Heart block, caution in renal dysfunction

Question 50

When should magnesium sulfate IV be considered to treat an asthma exacerbation?

Answer 50

If patient remains in life threatening exacerbation after 1 hour of therapy

Question 51

Examples of SABAs

Answer 51

Albuterol, Levalbuterol

Question 52

Example of a SAMA

Answer 52

Ipratropium

Question 53

Examples of systemic corticosteroids

Answer 53

Methylprednisolone, prednisolone, prednisone, methylprednisolone acetate