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Endo/Pulm Quiz 1 - Coggle Diagram
Endo/Pulm Quiz 1
albuterol (ProAir HFA, Proventil HFA,
Ventolin HFA, ProAir Respiclick)
rare ADRs: paradoxical bronchospasm, pulmonary edema, atrial fibrillation
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common ADRs: nausea, pharyngitis, rhinitis, throat irritation, URTIs
interactions: other short-acting sympathomimetics (may potentiate albuterol effect and increase risk of CV adverse effects), nonselective BBs (may decrease effectiveness of albuterol and produce bronchospasm), non-K sparing diuretics (may potentiate hypokalemia), digoxin (may decrease digoxin levels), MAOI and TCAs (may potentiate albuterol effect on CV system)
indications: asthma (acute exacerbation), asthma (bronchospasm), exercise-induced asthma prevention
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counseling: instruct patient on inhaler technique, including priming and shaking well before using; wash mouthpiece and air dry at least once weekly; part of ER tab may pass into stool; contact prescriber if more albuterol is needed to control symptoms than usual as may indicate acute asthma exacerbation; do not use more frequently than recommended; DPI does not require shaking or priming but does require deep inhalation for use
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montelukast (Singulair)
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rare ADRs: allergic granulomatous angitis, cholestatic hepatitis, aggressive behavior, altered behavior, suicidal thoughts
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toxicity: seek medical attention if change in behavior/mood, including suicidal thinking or neuropsychiatric symptoms
indications: asthma, exercise-induced bronchoconstriction, seasonal allergic rhiniits
counseling: not indicated for acute asthma attacks; report increased use of short-acting inhaled bronchodilators and advise patients not to D/C or decrease dose of other asthma medications unless instructed by health-care professional; patients with asthma or allergic rhinitis should be taken in the evening
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budesonide (Pulmicort Respules,
Pulmicort Flexhaler)
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interactions: azalea antifungals/macrolides (increased budesonide concentrations), CYP3A4/5 inducers/inhibitors
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rare ADRs: cataracts, decreased body growth, decreased bone mineral density
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counseling: advise patient on proper inhalation technique; gently sir nebulizer suspension before use; use entire vial of inhalation suspension immediately after opening to avoid contamination; delivery over 5-15 min using jet nebulizer with mouthpiece or facemarks; after administration rinse mouth with water and spit, and wash face to minimize risk of developing oral candidiasis; provide strip of 5 small plastic containers with sealed caps; each container holds 1 dose; strip of containers sealed inside foil pouch; keep any unused containers inside the pouch; once the foil pouch is opened, the containers will only be good for 2 weeks
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fluticasone/salmeterol (Advair Diskus,
Advair HFA)
common ADRs: HA, pharyngitis, URTI, difficulty speaking
rare ADRs: atrial fibrillation, MI, anaphylaxis, osteoporosis, bronchospasm, exacerbation of asthma, paradoxical bronchospasm
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efficacy: control of asthma or COPD symptoms, as measured by PFTs, frequency of asthma or COPD exacerbations or need for rescue use inhaler
indications: asthma, COPD
toxicity: BMD and growth and development in children should be monitored; routine ophthalmologic examinations should be performed; monitor for S/S of adrenal suppression or infection
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counseling: proper administration technique for specific inhaled product prescribed; rinse mouth with water after use to prevent oral infections; monitor for signs of toxicity, especially adrenal insufficiency, oral candidiasis, and worsening pulmonary function
fluticasone oral inhaler (Arnuity Ellipta,
Flovent HFA, Flovent Diskus)
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rare ADRs: severe hypersensitivity, glaucoma cataracts, pneumonia, secondary hypocortisolism, osteoporosis
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efficacy: control of asthma as measured by PFTs, frequency of asthma exacerbations and need for rescue inhaler use
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toxicity: BMD and growth and development in children should be monitored; routine ophthalmologic examinations should be performed; monitor for S/S of adrenal suppression or infection
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counseling: proper administration technique for specific inhaled product prescribed; instruct on rinsing mouth with water after each use to prevent oral infections; monitor for signs of toxicity, especially adrenal insufficiency, oral candidiasis, and worsening pulmonary function