CAE E-Pharmacology

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samatwell
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97210
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CAE E-Pharmacology
Updated:
2011-08-16 13:42:33
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asthma educator
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asthma educator
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  1. Alpha receptor
    • vasoconstriction (narrow vessels)
    • vasopressor (inc bp)
  2. Beta1 receptor
    • increased hr
    • increased heart muscle contraction
  3. Beta2 receptor
    • relaxation of bronchial smooth muscles
    • increased mucociliary activity
    • inhibit inflammatory mediator release
  4. Two types of asthma medications
    • Relievers - short acting B2 agonists and anthichlinergics
    • Controllers - corticosteroids, leukotriene modifiers and long acting B2 agonists
  5. Short acting B2 drugs
    • Albuterol
    • Pirbuterol
    • Levalbuterol
    • Terbutaline
    • Metaproteronol
  6. Albuterol facts
    • Ventolin and Proventil
    • Very selective B2
    • TX of bronchospasm
  7. Albuterol SVN
    Solution in (0.63, 1.25, 2.5 and 5 mg)/3ml

    • 0-4: 0.63 - 2.5 mg Q 4-6 hrs prn
    • 5-11: 1.25 - 5.0 mg Q 4-6 hrs prn
    • > 12: 1.25 to 5.0 mg Q 4-6 hrs prn
  8. Albuterol MDI
    Solution: 90 mcg/puff (200 puff per canister)

    • 0-4: 2p Q 4-6 prn
    • 5-11: 2p Q 4-6 prn
    • >12: 2p Q 4-6 prn
  9. Albuterol TAB
    • Sol: 2mg or 4mg
    • TID or QID
  10. Albuterol DPI
    Sol: 200 or 400 mcg

    4-adult: Q 4-6 hrs
  11. Albuterol Syrup
    • 2-6: 0.1mg/kg TID. DNE 2mg (1tsp) TID
    • 6-14: 2mg (1tsp) TID to QID. DNE 24 mg/day
    • >14: 2mg (1tsp) or 4mg (2tsp) TID to QID. DNE 8mg QID
  12. Pirbuterol facts
    • Maxair
    • Tx of bronchospasm
  13. Pirbuterol MDI
    Sol: 200 mcg/puff. 400 puff per canister

    • 0-4: NA
    • 5-11: NA
    • >12: 2p Q4-6 prn
  14. Levalbuterol facts
    • Xopenex
    • Selective B2
    • Tx of bronchospasm
  15. Levalbuterol MDI
    Sol: 45 mcg/puff. 200 puff per canister

    • 0-4: NA
    • 5-11: 2puff Q 4-6 prn
    • >12: 2puff Q 4-6 prn
  16. Levalbuterol SVN
    Sol: (0.31, 0.63 and 1.25 mg)/3 ml and 1.25 mg/0.5ml

    • 0-4: 0.31 to 1.25 mg Q 4-6 prn
    • 5-11: 0.31 to 0.63 mg Q 8 prn
    • >12: 0.63 to 1.25 mg Q 8 prn
  17. Terbutaline facts
    • Bricanyl Oral and DPI, Brethaire MDI
    • Symptomatic tx of asthma
  18. Terbutaline MDI
    • Sol: 200 mcg/puff
    • 2puff Q 4-6
  19. Terbutaline TAB
    • Sol: 2.5 or 5mg
    • 5mg Q 6
  20. Metaproteronol facts
    • Alupent and Metaprel
    • Symptomatic tx of asthma and reversible bronchospasm
    • Shortest duration of all drugs
  21. Metaproteronol SVN
    • Sol: 5%
    • 0.3ml (15mg) TID to QID
  22. Metaproteronol MDI
    • Sol: 650 mcg/puff
    • 2-3 puff TID to QID
  23. Metaproteronol TAB
    • Sol: 10 or 20 mg
    • 20 mg TID to QID
  24. Metaproteronol Syrup
    Sol: 10 mg/5ml

    1-2 tsp TID to QID
  25. Short acting Catecholamine
    • affect A1, B1 and B2
    • exposure to light, heat, air or alkaline sol oxidizes drug
    • turns from clear to pink then brown
    • epinephrine, racemic epi and bitolterol
  26. Epinephrine facts
    • Adrenaline, AsthmaHaler, Medihaler-Epi, Dysneinhal, Bronkaid
    • Not for routine tx of asthma exacerbations
    • In aerosol and parenteral solution
    • Aerosol strong, NOT FOR INJECTION
  27. Epinephrine SVN
    • Sol: 1% solution
    • 0.25 to 0.5 ml (2.5 to 5.0 mcg) QID
  28. Epinephrine MDI
    • SOL: 0.2 mcg/puff
    • 2puff prn

    OTC: primatine mist. severe side effects. do not take with prescribed inhaler
  29. Racemic Epinephrine facts
    • Micronefrin, Vaponefrin, Asthmanefrin
    • Relief of bronchospasms and mucus production c asthma
  30. Racemic Epinephrine SVN
    • SOL: 2.25% SOL
    • 0.25 to 0.5 ml QID
  31. Bitolterol facts
    • Tornolate
    • relief of reversible bronchospasm
    • MDI and SVN
    • once inhaled, undergoes chemical changes leading to B2
  32. Biltolterol SVN
    1.25 ml (2.5 mcg) BID to QID
  33. Bitolterol MDI
    • SOL: 370 mcg/puff
    • 2 puff Q8
  34. Inhaled Corticosteroids facts
    • Most effective in long term control by red inflammation
    • Once controlled, red to lowest dose to maintain
    • Growth suppression in children
  35. Inhaled Corticosteroid Drugs
    • Fluticasone HFA
    • Budesonide
    • Beclomethasone CFC
    • Beclomethasone HFA
    • Triamcinolone
    • Flunisolide
    • Flunisolide HFA
    • Mometasone
  36. Fluticasone HFA facts
    • Flovent
    • allergies
    • MDI, nasal spray and DPI
    • Prime MDI if not used 7 days or if dropped
  37. Fluticasone Nasal Spray
    • Adults - 2 sprays each nostril daily
    • Ped - 1 spray each nostril daily (not for <4)
  38. Fluticasone MDI
    Sol: (44, 110 and 220 mcg)/puff. 120 puff per canister.

    • >12: 88 mcg BID. MD 440 mcg BID. HD > 440 mcg
    • 5-11: 88 mcg BID. MD 352 BID. HD > 352 mcg
    • 0-4: 88 mcg BID. HD > 352 mcg
  39. Fluticasone DPI
    • SOL: (50, 100 and 250 mcg) diskus.
    • Use 50 within 6 wks, and 100 or 250 within 2 mo
    • Red at 5 doses. DNU if no feel or taste.

    • >12: 100 mcg BID. MD 500 mcg QD. HD > 500mcg
    • 4-11: 50 mcg BID. MD 400 mcg QD. HD>400mcg
  40. Budesonide facts
    Rhinocort, Pulmicort, Entocort

    Pulmicort is compatible with albuterol, atrovent and xopenex
  41. Pulmicort Turbohaler DPI
    Sol: 200 mcg/inh, 200 doses

    • >=6: 1-2p QD to BID
    • Prime the first time, not needed to reprime ever
    • May not taste or feel
    • No spacer needed.
    • Red line appears at 20 doses, at bottom when empty.
  42. Pulmicort Respules
    SOL: (0.25, 0.5 and 1.0 mg) 2ml amps, 30/carton

    • 1-8... if pt was on:
    • BD: 0.5 mg QD or BID in 2 doses. HD: 0.5 mg QD
    • ICT: 0.5 mg QD or BID in 2 doses. HD: 1.0 mg QD
    • OCT: 1.0 mg QD or BID in 2 dose. HD: 1.0 mg QD
  43. Pulmicort Flexhaler
    SOL: 90 mcg in 60 inh can, 180 mcg in 120 inh can

    • 6-17: SD 180 mcg BID. MD 360 mcg BID
    • =>18: SD 360 mcg BID. MD 720 mcg BID
    • prime first time, never again
    • countdown in interval of 10
  44. Rhinocort
    • Sol: 32 mcg per inhalation
    • 120 sprays after priming (8 sprays)
    • Not used 2 days, reprime 1 spary
    • Not used 14 days, rinse and reprime 1 spray
  45. Beclamethasone facts
    • Vanceril
    • start bronchodilator therapy before IST
  46. Beclamethasone
    Sol: 42 mcg / puff

    • >12: 1-2 puff TID to QID. DNE 840 mcg
    • 6-12: 2 puff TID to QID. DNE 420 mcg
  47. Beclamethasone HFA facts
    • QVAR
    • prime if not used > 10 days
  48. Beclamathasone HFA
    Sol: 40 and 80 mcg inh, 100 inh per canister

    • If no IST 5-11: 40 mcg BID. HD 80 mcg BID
    • If IST 5-11: 40 mcg BID. MD 80 mcg BID
    • If no IST>12: 40-80 mcg BID. HD 320 BID
    • If IST >12: 40-160 mcg BID, HD 320 BID
  49. Trimicinolone facts
    • Azmacort
    • prime with 2 puff, stays primed 3 days
    • max benefits not seen for 2 weeks
  50. Trimicinolone
    Sol: 75 mcg /puff. 240 puff per canister

    • >12: ;75 mcg 2p TID to QID or 4p BID. MD 16p QD
    • 6-12: ;75 mcg 1-2p TID to QID or 2-4p BID. MD12pQD
  51. Flunisolid facts
    • Aerobid
    • not recommended under 6
    • improvement in 1-4 weeks
  52. Flunisolide
    Sol: 250 mcg/puff. 100 puff canister

    • >15: 2p BID. MD rp BID
    • 6-15: 2p BID.
  53. Flunisolide HFA facts
    • Aerospan
    • improvement 2-4 weeks prime initial and 2 week nonuse
  54. Flunisolide HFA
    SOL: 120 puff per canister

    • 6-11: 80 mcg BID. MD 160 mcg BID.
    • >12: 150 mcg BID. MD 320 mcg BID.
  55. Mometasone facts
    • Nasonex, Asmanex
    • Hay fever and allergies
  56. Mometasone Nasal Spray
    • Nasonex
    • Allergies =>12: 2spray each nostril QD
    • Allergies 3to11: 1spray each nostril QD
    • Sinusitis =>12: 2 spray each nostril QD
  57. Mometasone DPI
    • Asmanex Twisthaler
    • Sol: 220 and 110 mcg (delivers 200 and 100)/ 30 dose
    • Discard after 45 days or at 00 count
    • If c BD: 200 mcg QPM
    • If c ICT: 200 mcg QPM
    • If c OCT: 400 mcg BID

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