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32 Cards in this Set
- Front
- Back
Short-acting Beta-2 Agonists (SABA)
Asthma |
Racepinephrine (Asthmanefrin atomizer)
Albuterol (Ventolin HFA, Proventil HFA, ProAir HFA, AccuNeb, VoSpire ER) Levalbuterol (Xopenex, Xopenex HFA) Pirbuterol (Maxair Autohaler) |
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Side Effects (SABA)
Asthma |
tremor, shakiness, lightheadedness, cough, palpitations, hypokalemia, tachycardia, hyperglycemia
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(SABA): DOC for
Asthma |
Exercise-induced bronchospasm
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SABA Therapy for Asthma
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If using SABA> 2 days/week, then need to increase maintenance therapy
Used PRN as rescue inhaler |
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Asthma (SABA) Monitor
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number of days of use, symptom frequency, peak flow, BP, HR, blood glucose, and K+
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Albuterol
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(Ventolin HFA, Proventil HFA, ProAir HFA, AccuNeb, VoSpire ER)
90mcg, 200 sprays Shake the inhaler well before each spray DOC for pregnancy |
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levalbuterol
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Xopenex
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Pirbuterol
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Maxair Autohaler
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Asthma: LABA
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Salmeterol (Serevent Diskus)
Formoterol (Foradil Aerolizer) I capsule BID |
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Asthma: LABA + Corticosteroid
Salmeterol + Fluticasone |
(Advair Diskus, Advair HFA)
Diskus: 1 inhalation BID >4yo HFA: 2 inhalations BID |
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Asthma: LABA + Corticosteroid
Formoterol + Budesonide |
(Symbicort) 2 inhalations BID
Throw inhaler when counter = 0 or 3 months after first use Does not relieve sudden symptoms |
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Asthma: LABA + Corticosteroid
Mometasone + Formoterol |
(Dulera)
100, 200 mcg mometasone + 5 mcg formoterol Take 2 inhalations BID >12yo |
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Inhaled Corticosteroid
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Rinse mouth and throat after use
Inhaled steroids are first-line for long term control for all ages with persistent asthma Systemic steroids have a rapid onset of action and are used as "pulse" therapy for up to 15 days after an asthma attack |
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Inhaled Corticosteroid
Generic/Brand |
Beclomethasone (QVAR)
Budesonide (Pulmicort) Ciclesonide (Alvesco) prodrug Flunisolide (Aerospan HFA: has built-in spacer) Fluticasone (Flovent HFA,Diskus) Momentasone (Asmanex) |
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Beclomethasone
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QVAR
low dose: 80-240 mcg/d medium: >240-480 mcg/d high > 480 mcg/d |
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BUdesonide
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Pulmicort
low dose: 180-600 mcg/d medium: >600-1200 mcg/d high dose >1200 mcg/d respules: indicated for 1-8 yo |
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Ciclesonide
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Alvesco 80-320 mcg BID
do not need to shake before use |
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Flunisolide
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Aerospan
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Fluticasone
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Flovent
MDI: L : 88-264 mcg/d M: 264-440 mcg/d H: >440 Diskus L: 100-300 mcg/d M: >300-500 mcg/d H: >500 mcg/d |
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Oral Corticosteroids
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Cortisone
Hydrocortisone (Cortef (PO), Solu-CORTEF (Inj) Methylprednisolone (A-methapred, depo-medrol, solu-medrol (all inj), Medrol and medrol dosepak (PO) Prednisone (Prednisone Intensol (soln), Rayos (Delated-release tab) Prednisolone (Milipred, Orapred (tabs and soln), pediapred, veripred (soln), Prelone (syrup), Flo-Pred (susp), Orapred (ODT) Triamcinolone (Aristospan, Kenalog, Trivaris (inj)) |
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Leukotriene Modifying Agent
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Zafirlukast (Accolate)
Montelukast (Singulair) Zileuton (Zyflo, Zyflo CR) |
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Leukotriene Modifying Agent
Monitor |
Zileuton need to monitor LFT every month x 3, then every 2-3 months for the rest of the first year of therapy
DO NOT abruptly substitute these agents for inhaled or oral corticosteroids |
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Leukotriene Modifying Agent
Contraindications/ Cautions |
Active liver disease esp Zileuton
Caution: Neuropsychiatric event; Notify MD is develop signs of aggressive behavior, hostility, agitation, depression, suicidal thinking |
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Leukotriene Modifying Agent
Side-effects |
HA, dizziness, ab pain, increase LFTs, upper respiratory tract infections, pharyngitis, sinusitis, and Churg-Strauss syndrome may feature systemic eosinophilia,
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Zafirlukast
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Accolate
Take on empty stomach Children 5-11: 10mg BID |
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Montelukast
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Singulair
10mg daily every evening 12mos - 5yo: 4mg daily 5-14 yo: 5 mg daily Use for EIB: 2 hours before exercise Take it as long as your doctor prescribes Do NOT take an additional dose of singulair within 24 hours of previous dose Do not open packet until ready to use Granules (To not out in any liquid other than baby formula or breast milk) |
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Zileuton
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Zyflo: 600 mg QID
Zyflo CR: BID within 1 hour of morning and evening meals Not recommended on children |
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Theophylline: Dose, Thera level, SE, signs of toxicity, DDI
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IR: Elixophyllin
ER: Theolair, THeo-24, Theochron 200-600mg daily Therapeutic level 5-15 mcg/ml SE: Nausea, HA< tachycardia, insomnia, tremor, nervousness Signs of Toxicity: persistent and repetitive vomiting, vtach, seizure DDI: caffeine, extremem amount of protein, carbs |
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Omalizumab
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Xolair
Dosing based on pretreatment serum IgE levels and body weight Given SC every 2 or 4 weeks Always given in MD's office BBW: anaphylaxis: reaction occurs within 2 hours but can be delayed up to 24 hours |
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Asthma Rescuers
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SABA
Systemic (IV) steroids Anticholinergics |
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Controllers
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Inhaled steroids
Leukotriene MOdifying Agents Theophylline LABA Mast cell stabilizers Omalizumab |
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Stepwise approach for Managing Asthma
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