Brand/generic
What is the generic for Flovent Diskus?
Fluticasone
Name the PDE4 inhibitor used in COPD
Roflumilast (Daliresp)
Which of the following capsules used in COPD should NOT be swallowed but inhaled as DPI
a. Spiriva handihaler
b. Foradil aerolizer
c. Neohalers
d. a & b
e. all of the above
e. All of the above
How often should you clean Spiriva?
As needed
PH presents to the clinic today with the question of, "What are some medications to avoid if I start taking Roflumilast? (Name 1 or 2)
Carbamazepine
Phenobarbital
Rifampicin
St. John's wort
What is the brand name for tiotropium?
Spiriva
Which class of drugs have been shown to be most effective as monotherapy in treating COPD when used on a regular basis?
LABA's (long-acting beta agonists)
How do you prime Atrovent?
Spray 2x away from face and prime again if > 3 days from last use
Advair: Discard ____ after removal from pouch
62 year-old KP presents to the clinic today in hopes of finding a medication for her COPD that will modify the long-term decline in lung function, what should her provider recommend to meet this goal?
No medications will meet this particular goal, treatments are used to decrease symptoms and/or complications
What is/are the brand name(s) for salmeterol and fluticasone? (Name 2)
Wixela Inhub, Advair Diskus, Advair HFA, AirDuo Respiclick
The four long-acting anticholinergics (LAMAs) are...
Tiotropium, Umeclidinium, Aclidinium, Glycopyrrolate
One difference between Atrovent and Combivent is that Combivent requires ________ inhalation whereas Atrovent requires _________.
Atrovent: 2 inh QID vs. Combivent 1 inh QID
_________ doesn't need to be cleaned, but if you wish to clean it, do NOT use water
Dry powder inhalers
48 year-old JL is put on Roflumilast, what side effects should he be counseled on? (Name 3)
Diarrhea, weight loss, nausea, decreased appetite, insomnia, psychiatric events including suicidal ideation
What is the brand for umeclidinium and vilanterol inhalation powder?
Anoro ellipta
What is a recommended laboratory value needed prior to inhaled corticosteroid (ICS) treatment?
Eosinophil count should be >300 cells/microliter
True or false: The newer LABAs are dosed QD
True (Arcapta, Breo Ellipta, Striverdi Respimat)
How often should the Albuterol inhaler mouthpiece be cleaned?
Once a week with warm running water for 30 seconds and air dry it completely
79 year-old MC who is a current smoker at 1 pack per day for the past 27 years presents to the clinic with worsening shortness of breath, recurrent wheezing, and a productive chronic cough. Upon spirometry test, results comes back at 0.48. She reports being breathless after a few minutes of walking. She has had an exacerbation in the past, but did not need to go to the hospital. She is currently taking Albuterol 2 puffs every 4-6 hours as needed. What should her provider recommend today?
LABA or LAMA, smoking cessation!
What is the generic for Trelegy ellipta?
Fluticasone-umeclidinium-vilanterol
If a patient has an mMRC score of 1, CAT 5, and 3 moderate exacerbations, what class of inhalers would you use for treatment?
LAMA (long acting anticholinergics)
What is the range for classification of severity of airflow limitation in COPD based on post-bronchodilator FEV1 in patients with FEV1/FVC<0.70: GOLD-2 moderate?
50% ≤FEV1 <80% predicted
If a misstep occurs during inhalation administration (dropped, turned upside down, etc.), what should the patient do to correctly administer the medication?
Set another dose and inhale per usual instruction
57 year-old GW presents to the clinic with loss of taste and upon inspection, creamy white lesions on the tongue and the inner cheeks. His current medication regimen includes Lisinopril, Symbicort, and Albuterol. What medication could have caused this? What counseling points would you provide for future prevention?
Symbicort (budesonide); Rinse mouth after dose administration