SABAs and SACAs

Question 1

SABAs

Answer 1

inhaled short acting B2 agonists
increases cAMP and antagonized bronchoconstriction
leads to smooth muscle relaxation
reverse obstruction and improve airflow

Question 1

SABA drugs

Answer 1

albuterol HFA (proair, ventolin, proventil, proair respiclick, proair digihaler)
albuterol nebulizer
levalbuterol hfa (xopenex)
levalbuterol nebulizer

Question 2

albuterol hfa brands

Answer 2

proair
ventolin
proventil
proair respiclick
proair digihaler

Question 3

albuterol hfa (pro air, ventolin, proventil, proair respiclick, proair digihaler) dosage form

Answer 3

MDI - 90 mcg/inhalation
Aerosol powder inhaler - 90mcg/inhalation

Question 4

albuterol hfa (pro air, ventolin, proventil, proair respiclick, proair digihaler) dosing

Answer 4

1 to 2 inhalations 5 minutes before exercise
2 inhalations q4-6h prn

Question 5

albuterol hfa (pro air, ventolin, proventil, proair respiclick, proair digihaler) dosing in 0-11 yos for exacerbations

Answer 5

4-8 inhalations every 20 minutes for 30 doses, then every 1 to 4 hours inhalation maneuver prn
use VHC (and mask in 0-4 yos)

Question 6

albuterol hfa (pro air, ventolin, proventil, proair respiclick, proair digihaler) dosing in adults for exacerbations

Answer 6

4 to 8 inhalations every 20 minutes for up to 4 hours, then every 1 to 4 hours prn

Question 7

adverse effects of albuterol

Answer 7

tachycardia
tremor
hypokalemia
irritability

Question 8

clinical pearls of albuterol

Answer 8

chronic use (over 2 times per day) indicates poor asthma control
may mix nebulizer solution with cromolyn solution, budesonide inhalant suspension, or ipratropium solution
in mild to moderate exacerbations, MDI plus VHC is as effective as nebulized therapy with appropriate admin technique and coaching by trained personnel

Question 9

albuterol nebulizer solution dosage

Answer 9

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

Question 10

albuterol nebulizer solution dosing in 0-4 yos

Answer 10

0.63 to 2.5mg in 3mL saline every 4-6h prn

Question 11

albuterol nebulizer solution dosing in 5-11 yos and adults

Answer 11

1.25 to 5 mg in 3mL saline every 4-8 hours prn

Question 12

albuterol nebulizer solution dosing for exacerbations in 0-11 yos

Answer 12

0.15mg/kg (minimum of 2.5mg) every 20 minutes for 3 doses, then 0.15 to 0.3mg/kg for up to 10mg every 1 to 4 hours prn
0.5mg/kg/hour by continuous nebulization

Question 13

albuterol nebulizer dosing for exacerbations in adults

Answer 13

2.5 to 5mg every 20 minutes for 3 doses, then 2.5 to 10mg every 1 to 4 hours prn
10 to 15 mg/hour by continuous nebulization

Question 14

levalbuterol hfa brand

Answer 14

xopenex

Question 15

levalbuterol hfa (xopenex) dosage form

Answer 15

MDI
45 mcg/inhalation

Question 16

levalbuterol nebulizer solution dosage form

Answer 16

0.31mg/3mL
0.63mg/3mL
1.25mg/0.5mL
1.25mg/3mL

Question 17

levalbuterol hfa (xopenex) dosing in 0-11 yos

Answer 17

2 inhalations every 4-6h prn

Question 18

levalbuterol hfa (xopenex) exacerbation dosing in 0-11 yos

Answer 18

4 to 8 inhalations every 20 minutes for 3 doses, then every 1 to 4 hours inhalation maneuver prn
use vhc

Question 19

levalbuterol hfa (xopenex) dosing in adults

Answer 19

2 inhalations 5 minutes prior to exercise
2 puffs q4-6h prn

Question 20

levalbuterol hfa (xopenex) exacerbation dosing in adults

Answer 20

4 to 8 inhalations every 20 minutes for up to 4 hours, then every 1 to 4 hours prn

Question 21

adverse effects of levalbuterol

Answer 21

tachycardia
tremor
hypokalemia
irritability

Question 22

clinical pearls of levalbuterol

Answer 22

reserved for patients who do not response to albuterol for quick relief
nebulizer solution compatible with budesonide inhalant suspension
levalbuterol administered in the 1/2 the mg dose of albuterol provides comparable efficacy and safety
has not been evaluated by continuous nebulization

Question 23

levalbuterol nebulizer solution dosing in 0-4 yos

Answer 23

0.31 to 1.25 mg q4-6h prn

Question 24

levalbuterol nebulizer solution dosing in 5-11 yos

Answer 24

0.31 to 0.63 mg q8h prn

Question 25

levalbuterol nebulizer solution exacerbation dosing in 0-11 yos

Answer 25

0.075 mg/kg (minimum dose of 1.25) every 20 minutes for 3 doses, then 0.075 mg to 0.15mg/kg for up to 5mg every 1 to 4 hours prn

Question 26

levalbuterol nebulizer solution dosing in adults

Answer 26

0.63 to 1.25 mg q8h prn

Question 27

levalbuterol nebulizer solution exacerbation dosing in adults

Answer 27

1.25 to 2.5mg every 20 minutes for 3 doses then 1.25 to 5 mg every 1 to 4 hours prn

Question 28

short acting anticholinergics

Answer 28

competitively inhibit cholinergic receptors in bronchial smooth muscles decreased cGMP leads to bronchodilation ipratropium hfa (atrovent) ipratropium ipratropium/albuterol (combivent respimat, duoneb)

Question 29

ipratropium hfa brand

Answer 29

atrovent

Question 30

iptratropium hfa (atrovent) dosage form

Answer 30

MDI 17 mcg/inhalation

Question 31

ipratropium nebulizer solution dosage form

Answer 31

0.125mg/mL 0.25mg/mL

Question 32

ipratropium/albuterol brand

Answer 32

combivent respimat duoneb

Question 33

ipratropium/albuterol (combivent respimat) dosage form

Answer 33

MDI 20mcg/100mcg/inhalation

Question 34

iptratropium/albuterol (duoneb) dosage form

Answer 34

nebulizer solution 0.5mg/2.5mg per 3mL vial

Question 35

ipratropium hfa (atrovent) and ipratropium/albuterol (combivent respimat) exacerbation dosing in 0-11 yos

Answer 35

4-8 inhalations every 20 minutes prn for up to 3 hours use with VHC (and mask for under 4)

Question 36

ipratropium hfa (atrovent) dosing in adults

Answer 36

2 inhalation q6h

Question 37

ipratropium hfa (atorvent) exacerbation dosing in adults

Answer 37

8 inhalations every 20 minutes prn for up to 3 hours

Question 38

adverse effects of ipratropium

Answer 38

dry mouth urinary retention infection sinusitis bronchitis

Question 39

clinical pearls of ipratropium

Answer 39

used in combo with albuterol for asthma exacerbation treatment may mix in same nebulizer with albuterol should not be used as first-line therapy; should be added to saba therapy for severe exacerbations

Question 40

ipratropium nebulizer solution exacerbation dosing in 0-11 yos

Answer 40

0.25 mg to 0.5 mg every 20 minutes for 3 doses then prn

Question 41

ipratropium nebulizer solution dosing in adults

Answer 41

0.25mg q6h

Question 42

ipratropium nebulizer solution exacerbation dosing in adults

Answer 42

0.5mg every 20 minutes for 3 does then prn

Question 43

ipratropium/albuterol (combivent respimat) dosing in adults

Answer 43

1 inhalation q6h

Question 44

ipratropium/albuterol (combivent respimat) exacerbation dosing in adults

Answer 44

8 inhalations every 20 minutes prn for up to 3 doses

Question 45

ipratropium/albuterol (duoneb) dosing in 0-4 yos

Answer 45

1.5mL every 20 minutes for 3 doses then prn

Question 46

ipratropium/albuterol (duoneb) dosing in 5-11 yos

Answer 46

3mL every 20 minutes for 3 doses then prn

Question 47

ipratropium/albuterol (duoneb) dosing in adults

Answer 47

3mL every 20 minutes for 3 doses then prn OFF LABEL

Question 48

clinical pearls of ipratropium/albuterol (duoneb)

Answer 48

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