Asthma 1
Preferred reliever strategy in modern asthma guidelines combining bronchodilation and anti-inflammatory effect
What is: PRN low dose ICS-formoterol
This LABA cannot be used PRN like formoterol because its onset is slower.
What is salmeterol?
Initial maintenance therapy for symptomatic COPD without frequent exacerbations
What is: A bronchodilator
Key vaccination strongly recommended in COPD to reduce exacerbation risk.
What are influenza and pneumococcal vaccines?
Device covering LABA/LAMA/ICS combination
What is: Trelegy Ellipta, Enerzair Breezhaler
This short acting bronchodilator is associated with tachycardia, tremors and palpilations
Two key things to reassess before stepping up asthma therapy
What are adherence and inhaler technique? (± trigger control)
Blood eosinophil threshold warranting ICS therapy
What is: > 300 cells/uL
Most important non-drug intervention to slow COPD progression.
What is smoking cessation?
What is: MDI
This short acting bronchodilator has a slower onset than it's short acting counterpart
What is: SAMA
Leukotriene receptor antagonist with neuropsychiatric warnings
What is montelukast?
Important ICS adverse effect risk in COPD
What is: pneumonia risk
Typical pharmacologic treatment during moderate COPD exacerbation besides bronchodilators.
What are systemic corticosteroids (± antibiotics if indicated)?
This inhaler type might not be compatible with a person with low coordination or dexterity
What is: Handihaler, Breezhaler
Uncontrolled asthma on low dose ICS-formoterol MART, what is the next common pharmacologic escalation?
What is: increase to medium dose of ICS-formoterol for maintenance
If asthma is controlled ≥3 months, guidelines suggest reducing this therapy first.
What is ICS dose (step-down)?
First pharmacologic escalation is symptoms persist on single long acting bronchodilator
What is: dual bronchodilator therapy (LABA/LAMA)
LU code criteria to be met for coverage of SITTs in COPD
COPD patient with history of exacerbations, ICS/LABA/LAMA is indicated/required
This inhaler type has audio/visual dose confirmation
What is: Genuair DPI
During early asthma exacerbation, some action plans recommend temporarily increasing this ICS medication dose up to this amount.
What is: quadrupling ICS dose
This SABA overuse threshold (canisters/year) signals poor asthma control and increased exacerbation risk in guidelines.
What is ≥3 SABA canisters per year?
High risk COPD exacerbation history per CTS definition
What is: 2+ moderate exacerbations or 1+ severe exacerbation
Reasons SAMA/SAMA combination (Combivent) might not be preferred as rescue in COPD
Not covered by ODB, cumulating anticholinergic side effects if LAMA is also added to regimen
This inhaler type doesn't require high inspiratory force
What is: Respimat, MDI (with spacer)