PHRM 825 > Controller Medications > Flashcards

Controller Medications Flashcards

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1
Q

List the inhaled corticosteroids (ICS):

A

Beclomethasone
Budesonide
Ciclesonide
Fluticasone Propionate
Fluticasone Furoate
Mometasone

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2
Q

Function of ICSs:

A

prevent and control inflammation

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3
Q

Beclomethasone brand name:

A

QVAR

ICS

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4
Q

beclomethasone dosage form:

A

redihaler (MDI)

ICS

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5
Q

Beclomethasone age range:

A

5+

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6
Q

Budesonide flexhaler brand name:

A

Pulmicort

ICS

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7
Q

budesonide (Pulmicort) age range:

A

5+

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8
Q

budesonide nebulizer solution brand name:

A

Pulmicort respules

ICS

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9
Q

budesonide (pulmicort respules) age range

A

0-11 yrs

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10
Q

budesonide dosage forms:

A

flexhaler
nebulizer solution

ICS

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11
Q

ciclesonide brand name:

A

Alvesco

ICS

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12
Q

ciclesonide (Alvesco) dosage form:

A

HFA

ICS

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13
Q

ciclesonide (Alvesco) age range:

A

6+

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14
Q

Fluticasone propionate brand names:

A

Flovent
ArmonAir Digihaler

ICS

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15
Q

Fluticasone propionate dosage forms:

A

HFA
DPI
Aerosol Powder Inhaler

ICS

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16
Q

Fluticasone propionate age range:

A

4+

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17
Q

Fluticasone furoate brand name:

A

Arnuity Ellipta

ICS

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18
Q

Fluticasone furoate (Arnuity) dosage form:

A

Ellipta

ICS

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19
Q

Fluticasone furoate (Arnuity Ellipta) age range:

A

5+

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20
Q

Mometasone brand name:

A

Asmanex

ICS

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21
Q

Mometasone (Asmanex) dosage forms:

A

HFA
Twisthaler

ICS

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22
Q

Mometasone (Asmanex) age range:

A

5+

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23
Q

Inhaled corticosteroid adverse effects:

A

oral thrush
cough
dysphonia

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24
Q

ICS counseling tip:

A

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

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25
ICS clinical pearls:
- ICSs are the most effective long-term control therapy for asthma (improve quality of life, increase lung function, and reduce the risk of exacerbations) - ICSs may increase the risk of pneumonia in patients with COPD - Titrate to lowest effective dose - High doses increase the risk for systemic side effects
26
Pulmicort respules clinical pearl:
- Respules should not use Jet Nebulizer and should not be mixed with other nebulizer medications
27
List the Long-Acting Beta Agonists (LABAs):
Arformoterol tartrate Formoterol Indacaterol Olodaterol Salmeterol
28
Arformoterol tartrate brand name
Brovana LABA
29
Arformoterol tartrate (Brovana) dosage form:
nebulizer solution LABA
30
Arformoterol tartrate (Brovana) age range:
adults (COPD only)
31
Formoterol brand name
Perforomist LABA
32
Formoterol (Perforomist) dosage form:
nebulizer solution LABA
33
Formoterol (Perforomist) age range:
Adults (COPD only unless used in combination with ICS) LABA
34
Indacaterol brand name:
Arcapta Neohaler LABA
35
Indacaterol (Arcapta) dosage form:
Neohaler LABA
36
Indacaterol (Arcapta Neohaler) age range:
Adults (COPD only) LABA
37
Olodaterol brand name
Striverdi Respimat LABA
38
Olodaterol (Striverdi) dosage form:
Respimat LABA
39
Olodaterol (Striverdi Respimat) age range:
Adults (COPD only) LABA
40
Salmeterol brand name:
Serevent LABA
41
Salmeterol (Serevent) dosage form:
Diskus LABA
42
Salmeterol (Serevent) age range:
4+ LABA
43
Long-Acting Beta Agonist mechanism of action:
increases cAMP --> bronchial smooth muscle relaxation and inhibits hypersensitivity mediators from mast cells (histamine and leukotrienes)
44
Long-Acting Beta Agonist (LABAs) adverse effects:
tachycardia headache tremor hypokalemia
45
LABA clinical pearls:
- boxed warning for increased risk of asthma related death for all monotherapy LABA use -- should not be used alone for asthma management - boxed warning for increasing hospitalizations in pediatric and adolescent patients - prolonged QT seen with intentional overdoses - Not for acute symptoms - May be helpful for exercise induced bronchospasm - Don't take formoterol and indacaterol capsules orally
46
Pediatric considerations:
Most children under 4 years old cannot provide sufficient inspiratory flow for adequate lung delivery with a DPI
47
List the long-acting antimuscarinics (LAMAs):
Aclidinium Glycopyrrolate Revefenacin Tiotropium Umeclidinium
48
LAMA mechanism of action:
block the bronchoconstrictor effects of acetylcholine on M3 and M2 receptors
49
Aclidinium brand name:
Turdorza Pressair LAMA
50
Aclidinium (turdorza pressair) dosage form:
DPI LAMA
51
Aclidinium (turdorza pressair) age range:
Adults (COPD only) LAMA
52
Glycopyrrolate brand name
Seebri Neohaler LAMA
53
Glycopyrrolate (Seebri) dosage forms:
DPI Nebulizer solution LAMA
54
Glycopyrrolate (Seebri Neohaler) age range:
Adults (COPD only) LAMA
55
Revefenacin brand name
Yupelri LAMA
56
Revefenacin (Yupelri) dosage form:
nebulizer solution LAMA
57
revefenacin (Yupelri) age range:
Adults (COPD only) LAMA
58
tiotropium brand name
Spiriva LAMA
59
tiotropium (Spiriva) dosage forms:
handihaler respimat LAMA
60
tiotropium (Spiriva respimat) age range:
6+ LAMA
61
tiotropium (Spiriva handihaler) age range:
adults (COPD only)
62
Umeclidinium brand name:
Incruse ellipta LAMA
63
umeclidinium (Incruse Ellipta) dosage form:
DPI LAMA
64
umeclidinium (Incruse Ellipta) age range:
adults (COPD only)
65
LAMA adverse effects:
dry mouth dizziness blurred vision upper respiratory infections paradoxical bronchospasms
66
LAMA clinical pearl:
tiotropium (Spiriva) has been approved for use in asthma as add-on option for children 12+
67
List the ICS/LABA products:
Fluticasone/Salmeterol Budesonide/Formoterol Mometasone/Formoterol Fluticasone/Vilanterol
68
Which ICS/LABA products can be used in children?
Fluticasone/Salmeterol (Advair) (4+) Budesonide/ Formoterol (Symbicort) (5+)
69
Fluticasone/Salmeterol brand names:
Advair AirDuo AirDuo Digihaler
70
Fluticasone/Salmeterol (Advair) dosage forms:
DPI HFA MDI
71
Fluticasone/Salmeterol (AirDuo) dosage form:
respiclick (DPI)
72
Budesonide/Formoterol brand name
Symbicort
73
Budesonide/Formoterol (Symbicort) dosage form:
HFA MDI
74
Mometasone/Formoterol brand name:
Dulera
75
Mometasone/formoterol (Dulera) dosage form:
MDI
76
Fluticasone/vilanterol brand name:
Breo Ellipta
77
fluticasone/vilanterol (Breo Ellipta) dosage form:
DPI
78
ICS/LABA clinical pearls:
- guidelines recommend combination LABA with ICS in asthma, as LABA should not be used as monotherapy - Combination products developed to create convenient packaging and assist with patient adherence
79
List the LABA/LAMA combination products:
Olodaterol/tiotropium Vilanterol/Umeclidinium Indacaterol/Glycopyrronium Formoterol/glycopyrronium formoterol/aclidnium
80
Age range for LABA/LAMA products:
Adults (COPD only)
81
LABA/LAMA clinical pearl:
not indicated for treatment of acute deteriorations
82
olodaterol/tiotropium brand name:
Stiolto Respimat LABA/LAMA
83
olodaterol/tiotropium (Stiolto) dosage form:
Respimat
84
vilanterol/umeclidinium brand name:
Anoro Ellipta LABA/LAMA
85
vilanterol/umeclidinium (Anoro) dosage form:
Ellipta
86
indacaterol/glycopyrronium brand name:
Utibron Neohaler LABA/LAMA
87
indacaterol/glycopyrronium (Utibron) dosage form:
Neohaler
88
formoterol/glycopyrronium brand name:
Bevespi Aerosphere LABA/LAMA
89
formoterol/glycopyrronium (Bevespi) dosage form:
aerosphere
90
formoterol/aclidinium brand name:
Duaklir Pressair LABA/LAMA
91
formoterol/aclidinium (Duaklir) dosage form:
DPI
92
List the LABA/LAMA/ICS products:
fluticasone/umeclidinium/vilanterol (Trelegy) budesonide/glycopyrrolate/formoterol fumarate (Breztri)
93
fluticasone/umeclidinium/vilanterol brand name:
Trelegy Ellipta LABA/LAMA/ICS
94
fluticasone/umeclidinium/vilanterol (Trelegy) dosage form:
Ellipta
95
Trelegy Ellipta (LABA/LAMA/ICS) indication:
Asthma and COPD
96
budesonide/glycopyrrolate/formoterol fumarate brand name:
Breztri Aerosphere
97
budesonide/glycopyrrolate/formoterol fumarate (Breztri) dosage form:
Aerosphere
98
Breztri Aerosphere (LABA/LAMA/ICS) indication:
COPD only
99
Cromolyn info: mast cell stabilizer (likely not on exam)
Brand name: Intal Dosage Form: Nebulizer solution Age: 2+ Adverse Effects: unpleasant taste in mouth, cardiac arrhythmias, coughing, dyspnea, sore throat Less effective than low-dose ICS Prevents increase in bronchial hyperreactivity seen in allergy season
100
List the leukotriene modifiers:
montelukast zafirlukast zileuton
101
Leukotriene modifier mechanism of action:
block the production of leukotrienes
102
Leukotriene modifier adverse effects:
- neuropsychiatric events (agitation, anxiety, abnormal dreams, hallucinations, depression, suicidal thinking) - churg-strauss syndrome - increased hepatic transaminases
103
Leukotriene modifier clinical pearls:
- Less effective than low dose ICS and ICS/LABA in asthma - have not been adequately trialed in COPD
104
Montelukast brand name:
singulair
105
montelukast (Singulair) dosage form:
tablets chewable tablets granule packets
106
montelukast (Singulair) age range:
1+
107
montelukast (Singulair) clinical pearls:
- minor substrate of CYP2C8/9 and 3A4 - not for acute relief of symptoms - boxed warning: neuropsychiatric events
108
zafirlukast brand name:
Accolate
109
zarfirlukast (Accolate) dosage form:
tablets
110
zarfirlukast (Accolate) age range:
6+
111
zarfirlukast (Accolate) clinical pearls:
- take at least 1 hour before or 2 hours after meals - can increase INR - major substrate, minor inhibitor of CYP 2C9
112
zileuton brand name:
Zyflo CR
113
zileutron (Zyflo CR) dosage forms:
IR tablets ER tablets
114
zileutron (Zyflo CR) age range:
adults
115
zileutron (Zyflo CR) clinical pearls:
- weak CYP1A2 inhibitor - take with food - increased hepatic transaminases
116
List the one methylxanthine and it's mechanism of action:
Theophylline (Theochron) bronchodilation through inhibition of PDE III and PDE IV not really used anymore Side effects: insomnia, GI upset, hyperactivity, hypotension, tremor
117
List the Anti-IgE drug:
omalizumab
118
Anti-IgE mechanism of action
inhibit IgE binding to receptors on mast cells and basophils, inhibit mediator release and attenuation of early- and late-phase allergic response
119
Anti-IgE adverse effects:
Arthralgias iNjection site reactions Thrombocytopenia sInusitis URI pharynGitis headachE
120
omalizumab (Xolair) clinical pearls:
- 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
121
omalizumab brand name:
Xolair
122
omalizumab (Xolair) dosage form:
injection
123
omalizumab (Xolair) age range:
6+
124
List the anti-IL5 drugs:
mepolizumab reslizumab benralizumab
125
Anti-IL5 drugs mechanism of action:
blocks the binding of IL-5 to the alpha chain of the IL-5 receptor complex, which results in reduced production and survival of eosinophils
126
mepolizumab brand name:
Nucala Anti-IL5
127
mepolizumab (Nucala) dosage form:
autoinjector vial for reconstitution
128
mepolizumab (Nucala) age range:
6+
129
mepolizumab (Nucala) adverse effects:
headache injection site reactions arthralgias Herpes Zoster infection
130
mepolizumab (Nucala) clinical pearls:
- precaution: anaphylaxis - available as an in-clinic or at-home injection - monitor for anaphylaxis before and after injection - indicated for add-on maintenance treatment of patients with severe asthma with an eosinophilic phenotype
131
Reslizumab brand name:
Cinqair Anti-IL5
132
Reslizumab (Cinqair) age range:
18+
133
Reslizumab (Cinqair) dosage form:
solution for dilution in normal saline
134
Reslizumab (Cinqair) adverse effects:
- injection site reactions - myalgias - increased creatinine phosphokinase
135
Reslizumab (Cinqair) clinical pearls:
- boxed warning: anaphylaxis, malignancies - monitor for anaphylaxis before and after injection - indicated for add-on maintenance treatment of patients with severe asthma with an eosinophilic phenotype
136
Benralizumab brand name:
Fasenra Anti-IL5
137
Benralizumab (Fasenra) dosage form:
auto injector pre-filled syringe
138
Benralizumab (Fasenra) age range:
adults
139
Benralizumab (Fasenra) adverse effects:
injection site reactions antibody development headache pharyngitis fever
140
Benralizumab (Fasenra) clinical pearls:
- precaution: anaphylaxis - available as an in-clinic or at-home injection - indicated for add-on maintenance treatment of severe asthma in adults and children >12 years of age with an eosinophilic phenotype - acts on IL-5 receptors while others act on IL-5
141
List the Anti-IL4/IL13 drug:
Dupilumab (Dupixent)
142
Anti-IL4/IL13 mechanism of action:
blocks the binding of IL4 to reduce eosinophil trafficking and IgE reactions while also blocking IL-13 to reduce mucus secretion and airway remodeling
143
Dupilumab brand name:
Dupixent Anti-IL4/IL13
144
Dupilumab (Dupixent) dosage form:
injection
145
Dupilumab (Dupixent) age range:
12+
146
Dupilumab (Dupixent) adverse reactions:
- injection site reactions - antibody development - conjunctivitis
147
Dupilumab (Dupixent) clinical pearls:
- precaution: anaphylaxis - available as prefilled syringe for in-office or at-home administration - indicated as add-on maintenance treatment in patients with moderate to-severe asthma aged 12+ with and eosinophilic phenotype or with an oral corticosteroid dependent asthma
148
Phosphodiaesterase-4 inhibitor drug:
Roflumilast
149
Roflumilast age range:
Adults COPD only
150
Roflumilast mechanism of action:
Inhibits PDE4 leading to increased cAMP
151
Roflumilast dosage form:
tablets
152
Roflumilast adverse effects:
headache weight loss diarrhea nausea
153
Roflumilast clinical pearls:
- monitoring: liver function test, weight - Drug interactions: CYP3A4 major, CYP1A2 minor - CI: Child-Pugh class B or C
PHRM 825
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