1
Q
MOA
A
- Decreasing cytokine formation and suppressing the immune response in the lungs
- Overall reducing inflammation
2
Q
Examples
A
- Beclometasone
- Budesonide
- Fluticasone
- Ciclesonide
- Mometasone
3
Q
Beclometasone inhaler examples
A
- MDI: Clenil, Qvar
- DPI: EasyHaler
(beclometasone), Asmabec,
Pulvinal
4
Q
Budesonide inhaler examples
A
- DPI: Pulmicort Turbohaler,
Budelin Novolizer
5
Q
Fluticasone inhaler examples
A
- MDI: Flixotide Evohaler
- DPI: Flixotide Accuhaler
6
Q
Ciclesonide inhaler examples
A
- MDI: Alvesco
7
Q
Mometasone inhaler examples
A
- DPI: Asmanex
8
Q
ICS + LABA (MART)
A
- Beclometasone + formoterol
- Budesonide + formoterol
- Fluticasone + formoterol
- Fluticasone + salmeterol
- Fluticasone + vilanterol
9
Q
Beclometasone + Formoterol
A
- Fostair (MDI)
- Fostair Nexthaler (DPI)
10
Q
Budesonide + formoterol
A
- DuoResp
- Symbicort
11
Q
Fluticasone + formoterol
A
Flutiform pMDI
12
Q
Fluticasone + salmeterol
A
- Seretide
- Sereflo
- Sirdupla
13
Q
Fluticasone + vilanterol
A
- Relvar
14
Q
Are ICS doses equivalent?
A
- Budesonide + beclo are approx eq
- Beclometasone inhalers (QVAR and Clenil) are not interchangeable and should be prescribed by brand
- Fluticasone is 2x potent than beclometasone
15
Q
Are the different brands of
Beclometasone
inhalers equivalent to each other?
A
- There are extra-fine particles and traditional-size particles of beclometasone
- Extra-fine particles are Kelhale and Qvar = 2 x potent
- Qvar 100mcg TWO puffs BD = Clenil 200mcg TWO puffs BD
16
Q
Clenil doses
A
- Very-low
- 50mcg TWO puffs BD - Low
- 100mcg TWO puffs BD - Medium
- 200mcg TWO puffs BD - High
- 250mcg TWO-FOUR puffs BD (MAX 2000mcg in a day)
17
Q
What age are
Beclometasone and
Qvar licensed in?
A
- Beclometasone = 2+, 200mcg and 250mcg inhalers unlicensed in children
- Qvar is licensed from 5 years old
18
Q
Steroid card
A
> 1000mcg beclomethasone or eq daily
19
Q
SE
A
- Oral thrush
- Dysphonia (disorders of the voice)
- Hoarseness
- Paradoxical bronchospasms
- Adrenal suppressoin (high doses)
- Growth restriction in children
20
Q
Paradoxical bronchospasm
A
- MILD
- Prevented by inhalation of SABA before hand
- Change from an aerosol inhalation to dry powder inhalation
21
Q
Central serous chorioretinopathy
A
- Rare risk
- Visual disturbances - report
22
Q
Monitoring
A
o Monitor weight and height of children on prolonged treatment
o If growth slowed = refer to paediatrician
