Stacie L. Penkova, PharmD, MHSA, BCPS Clinical Pharmacy Manager Critical Care Pharmacy Specialist Drug Information Coordinator Pharmacology Summit
|
|
- Morgan Little
- 8 years ago
- Views:
Transcription
1 Stacie L. Penkova, PharmD, MHSA, BCPS Clinical Pharmacy Manager Critical Care Pharmacy Specialist Drug Information Coordinator Pharmacology Summit July 26, 2014
2 Objectives Classify asthma by severity Prescribe medication regimens by severity Identify medications for: Asthma in pregnancy Asthma in the elderly Exercise induced bronchoconstriction Asthma triggers Comorbities Manage asthma exacerbations Educate on medication therapy
3 Asthma Control & Classification Control determined by considering: Symptoms (nighttime awakenings, normal activity interferences, short-acting β2-agonist (SABA) use) Lung function (FEV 1 & FEV 1 /FVC) Questionnaires (ATAQ, ACT) Risk determined by considering: Exacerbations per year (oral corticosteroid use, hospitalization) Loss of lung function Treatment-related adverse effects (AEs)
4 Asthma Control & Classification
5 Asthma Control & Classification
6 Stepwise Approach
7 Management Components Routine monitoring of symptoms & lung function Patient education to create a partnership between clinical & patient Controlling environmental factors & comorbid conditions Pharmacologic therapy
8 Asthma Treatment Goals Reduce impairment Freedom from frequent/troublesome symptoms of asthma Minimal need of inhaled SABAs Few night-time awakenings Optimization of lung function Maintenance of normal daily activities Satisfaction with asthma care Reduce risk Prevention of recurrent exacerbations Prevention of reduced function Optimization of pharmacotherapy
9 Symptom assessment Monitoring Assessment of impairment Assessment of risk Pulmonary function Office Home
10 Metered-dose inhalers (MDIs) Valved holding chambers (VHCs) Dry powder inhalers (DPIs) Nebulizer Inhalation Devices
11 Treatment of Asthma Asthma Severity Intermittent Mild Persistent Preferred Alternatives Moderate Persistent Preferred Alternatives Severe Persistent Preferred Alternatives Recommended Regimen SABA PRN SABA PRN + Low-dose ICS Montelukast or Theophylline SABA PRN + Low-dose ICS + LABA or Medium-dose ICS Low-dose ICS + leukotriene modifier or theophylline SABA PRN + Medium- or high-dose ICS + LABA Medium-dose ICS + leukotriene modifier or theophylline
12 Short Acting β2 Agonists SABAs Albuterol (Ventolin HFA, ProAir HFA) Levalbuterol (Xopenex HFA) Pirbuterol (Maxair Autohaler) Place in therapy: rapid relief of asthma symptoms Mechanism of Action (MOA): bronchodilator that relaxes bronchial, uterine, and vascular smooth muscle by stimulating beta 2 receptors
13 Short Acting β2 Agonists Pharmacokinetics (PK) Onset - 5 minutes Peak effect minutes Duration hours AEs: paradoxical bronchospasm, tremor, tachycardia, QT prolongation, hyperglycemia, hypokalemia/magnesemia, tolerance Education: technique, adverse effects
14 Inhaled Corticosteroids ICSs Beclomethasone (Qvar) Budesonide (Pulmicort) Ciclesonide (Alvesco) Flunisolide (Aerospan HFA) Fluticasone (Flovent) Mometasone (Asmanex) Place in therapy: mild, moderate, & severe persistent
15 Inhaled Corticosteroids MOA: decreases inflammation by decreasing the number & activity of inflammatory cells, inhibiting bronchoconstrictor mechanisms producing direct smooth muscle relaxation & decreasing airway hyperactivity PK: Onset weeks Peak - unknown Duration - unknown
16 Inhaled Corticosteroids AEs: oral candidiasis, dysphonia, reflex cough, bronchospasm Education: technique, adverse effects, asthma action plan
17
18 Oral Corticosteroids OCSs Methyprednisolone (Medrol) Prednisone (Rayos, Sterapred) Prednisolone (Millipred, Orapred) Hydrocortisone (Cortef) Dexamethasone (Decadron) Place in therapy: asthma exacerbations incompletely responsive to bronchodilators MOA: decreases inflammation, mainly by stabilizing leukocyte lysosomal membranes; suppresses immune response; stimulates bone marrow; influences protein, fat, and carbohydrate metabolism
19 Oral Corticosteroids PK: Onset - variable Peak - variable Duration - variable AEs: insomnia, hypertension, edema, GI irritation, hyperglycemia, osteoporosis, growth suppression, delayed wound healing, hirsutism, rebound inflammation Education: adverse effect, take with food, importance of not stopping medication abruptly
20 Long Acting β2 Agonists LABAs Salmeterol (Serevent) Formoterol (Foradil, Perforomist) Aformoterol (Brovana) Indacterol (Arcapta) Place in therapy: moderate, & severe persistent MOA: selectively activates beta 2 receptors, which results in bronchodilation; also, blocks the release of allergic mediators from mast cells lining the respiratory tract
21 Long Acting β2 Agonists PK: Drug Onset Peak Duration Salmeterol 20 minutes 2 hours 12 hours Formoterol N 5 minutes 15 minutes 12 hours Formoterol I 12 minutes 15 minutes 12 hours Aformoterol 15 minutes 30 minutes 12 hours Indacterol 5 minutes 15 minutes 24 hours AEs: tremor, hypokalemia, tachycardia, tolerance Education: technique, adverse effects, asthma action plan, storage
22 Leukotriene Modifiers Montelukast (Singulair) Zafirlukast (Accolate) Zileuton (Zyflo) Place in therapy: mild, moderate, & severe persistent MOA: reduces early & late phase bronchoconstriction from antigen challenge
23 Leukotriene Modifiers PK: Onset - unknown Peak hours Duration - 24 hours AEs: headache, dyspepsia, fatigue, dizziness, liver dysfunction (zafirlukast/zilueton), vasculitis (montelukast/zafirlukast) Education: storage & administration, asthma action plan, adverse effects
24 Combination Therapies LABAs/ICSs Fluticasone/salmeterol (Advair) Budesonide/formoterol (Symbicort) Mometasone/formoterol (Dulera) Fluticasone/vilanterol (Breo Ellipta) SABAs/AC Ipratropium/albuterol (DuoNeb, Combivent)
25 Other Asthma Medications Oral β-agonists Albuterol (VoSpire ER) Metaproterenol (Alupent) Terbutaline (Brethine) Inhaled Cromolyn (Intal) Acetylcysteine (Mucomyst) Racemic epinephrine (S2) Vaccinations Influenza Pneumococcal OTC Ephedrine/guaifenesin (Primatene, Bronkaid) Racepinephrine (Asthmanefrin)
26 Inhaled Anticholinergics Ipratropium (Atrovent) Tiotropium (Spiriva) Aclidinium (Tudorza) Place in therapy: Ipratropium - off label as an alternative reliever medication in patients who cannot take a SABA or in combination with a SABA for treatment of acute bronchoconstriction Tiotropium can be added to improve lung function & symptoms in patients uncontrolled on an ICS; can be added to an ICS and a LABA to improve lung function in poorly controlled severe asthma & increase time to the first severe exacerbation Aclidium - no clinical data are available in asthma
27 Inhaled Anticholinergics MOA: inhibits vagally mediated reflexed by antagonizing acetylcholine at muscarinic receptors on bronchial smooth muscle PK: Onset 5-15 minutes Peak 1-2 hours Duration 3-6 hours AEs: dizziness, headache, palpitations, blurred vision, pharyngitis, nausea, dry mouth, bronchospasm Education: technique, adverse effects
28 Theophylline Methylxanthine Place in therapy: persistent asthma, alone or concurrently with an ICS MOA: inhibits phosphodiesterase, the enzyme that degrades camp, resulting in relation of smooth muscle of the bronchial airways and pulmonary blood vessels
29 Theophylline PK: Route Onset Peak Duration PO IR minutes 1-2 hours Unknown PO ER minutes 4-7 hours Unknown IV 15 minutes minutes Unknown AEs: insomnia, seizures, headache, arrhythmias, nausea, vomiting, tachypnea, lab interactions Education: drug interactions, adverse effects, administration
30 Anti-IgE Antibody Omalizumab (Xolair) Place in therapy: patients 12 years old with moderate to severe persistent asthma not well controlled on an ICS who have well documented specific sensitization to a perennial airborne allergen MOA: inhibits binding of IgE to high affinity receptor on surface of mast cells and basophils, which limits release of allergic response mediators
31 Anti-IgE Antibody PK: Onset unknown Peak 7-8 days Duration unknown AEs: headache, dizziness, fatigue, arthralgia, injection site reactions Education: technique, Black Box Warning, patient medication guide
32 Other Therapies Immunotherapy: in patients with allergic asthma, specific immunotherapy with SQ injections may provide long lasting benefits in reducing asthma symptoms Bronchial thermoplasty: approved in 2010 for use in adults with severe persistent asthma not well controlled on an ICS and a LABA Fiberoptic bronchoscopy on 3 separate occasions 3 weeks apart Walls of the central airways are treated with radiofrequency energy that is converted to heat, resulting in ablation of airway smooth muscle
33 Treatment Failure Attributed to: Lack of adherence to prescribed medications Uncontrolled comorbid conditions Continued exposure to tobacco smoke and other airborne pollutants, allergens, or irritants Aspirin, NSAIDs Β-blockers (oral & ophthalmic) Trained asthma educators can: Improve inhaler technique Create a personalized asthma management plan
34 Exacerbation Management
35 Exercise Induced Bronchoconstriction SABAs Just before exercise Prevent EIB for 2-4 hours LABAs Salmeterol at least 30 minutes before exercise Formoterol at least 5 minutes before exercise Prevent EIB for up to 12 hours Montelukast 2 hours before exercise Prevents EIB in 50% of patients for up to 24 hours
36 Asthma in Pregnancy SABA Albuterol ICSs Budesonide LABAs Montelukast Immunotherapy Omalizumab
37 Asthma in Elderly ICSs adverse effects include skin bruising, cataracts, increased IOP, hyperglycemia, accelerated bone mass loss SABAs & LABAs reduced response if on β- blockers; increased incidence of tachycardia, arrhythmias, tremors Technique problems MDIs, DPIs
38 Triggers & Comorbidities Allergic rhinitis Up to 95% of patients with asthma also suffer from persistent rhinitis GERD Patients with poorly controlled asthma have a higher prevalence of GERD PPI improves pulmonary function and asthma-related QOL Obesity Has been associated with asthma persistence and severity Diminished response to ICSs Weight loss improves lung function and responsiveness to treatment
39 Questions
GEORGIA MEDICAID FEE-FOR-SERVICE ASTHMA and COPD AGENTS PA SUMMARY
GEORGIA MEDICAID FEE-FOR-SERVICE ASTHMA and COPD AGENTS PA SUMMARY Preferred Anticholinergics and Combinations Atrovent HFA (ipratropium) Combivent Respimat (ipratropium/albuterol) Ipratropium neb inhalation
More informationYOU VE BEEN REFERRED TO AN ASTHMA SPECIALIST...
YOU VE BEEN REFERRED TO AN ASTHMA SPECIALIST... ...HERE S WHAT TO EXPECT You have been referred to an allergist because you have or may have asthma. The health professional who referred you wants you to
More informationClassifying Asthma Severity and Initiating Treatment in Children 0 4 Years of Age
Classifying Asthma Severity and Initiating Treatment in Children 0 4 Years of Age Components of Severity Symptoms Intermittent 2 days/week Classification of Asthma Severity (0 4 years of age) Persistent
More informationMedications for Managing COPD in Hospice Patients. Jim Joyner, PharmD, CGP Director of Clinical Operations Outcome Resources
Medications for Managing COPD in Hospice Patients Jim Joyner, PharmD, CGP Director of Clinical Operations Outcome Resources Goal of medications in COPD Decrease symptoms and/or complications Reduce frequency
More informationGlucocorticoids, Inhaled Therapeutic Class Review (TCR)
Glucocorticoids, Inhaled Therapeutic Class Review (TCR) July 31, 2015 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying,
More informationGlucocorticoids, Inhaled Therapeutic Class Review (TCR) February 7, 2012
Glucocorticoids, Inhaled Therapeutic Class Review (TCR) February 7, 2012 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying,
More informationAsthma & COPD Medication List
Asthma & COPD Medication List LONG-TERM CONTROL MEDICATIONS (used for prevention / control of asthma, NOT treatment of acute exacerbations) a. INHALED CORTICOSTEROIDS (ICS) Drug of choice for all levels
More informationCOPD. (Chronic Obstructive Pulmonary Disease) (Emphysema) (Chronic Bronchitis) Education For Our Community
COPD (Chronic Obstructive Pulmonary Disease) (Emphysema) (Chronic Bronchitis) Education For Our Community Chronic Obstructive Pulmonary Disease (COPD) Definition Chronic obstructive pulmonary disease (COPD)
More informationCCHCS Care Guide: Asthma
GOALS SHORTNESS OF BREATH, WHEEZE, COUGH NIGHT TIME AWAKENINGS ACTIVITY INTERFERENCE SABA* USE FOR SYMPTOM CONTROL FEV1* OR PEAK FLOW EXACERBATIONS REQUIRING ORAL STEROIDS < 2 DAYS / WEEK 2 TIMES / MONTH
More informationHow to Manage Asthma in Children
Clinical Guideline for the Diagnosis, Evaluation and Management of Adults and Children with Asthma Color Key n Four Components of Asthma Care n Classifying Asthma Severity, Assessing Asthma Control and
More informationMedications. Patient Education Pulmonary Rehabilitation. A guide to medications for Chronic Obstructive Pulmonary Disease (COPD) Introduction
Patient Education A guide to medications for Chronic Obstructive Pulmonary Disease (COPD) Do you know how each of your inhalers works to help your breathing? Do you know the correct order in which to use
More informationDear Provider: Sincerely,
Asthma Toolkit Dear Provider: L.A. Care is pleased to present this updated asthma toolkit. Our goal is to promote the highest level of asthma care, based on the 2007 National Asthma Education and Prevention
More informationUnderstanding COPD. Carolinas Healthcare System
Understanding COPD Carolinas Healthcare System 2013 This self-directed learning module contains information about the pathophysiology, diagnosis, and treatment of COPD. Target Audience: All RNs and LPNs
More informationAnnotated from the NAEPP/NHLBI Updated Asthma Guidelines and Developed Through Expert Consensus
Asthma Pocket Guide for Primary Care Annotated from the NAEPP/NHLBI Updated Asthma Guidelines and Developed Through Expert Consensus POSITION STATEMENT Despite advances in therapy, asthma remains a disease
More informationAttached is updated information for HEDIS 2015 specifications relating to Respiratory Conditions:
TO: Providers to FHCP Members FROM: FHCP Quality Management RE: Update on HEDIS Quality Measures for 2015 FHCP follows current clinical practice guidelines and we are monitored by HEDIS (Healthcare Effectiveness
More informationmedicineupdate to find out more about this medicine
medicineupdate Asking the right questions about new medicines Seretide for chronic obstructive pulmonary disease What this medicine is 1 What this medicine treats 2 Other medicines available for this condition
More informationAsthma Medications. 2009 WebMD, LLC. All rights reserved. What Is Asthma? What Causes Asthma? What Are the Risks of Asthma?
Print Close 2009 WebMD, LLC. All rights reserved. Asthma Medications What Is Asthma? What Causes Asthma? What Are the Risks of Asthma? Medical Treatment Corticosteroid Inhalers Oral and Intravenous Corticosteroids
More informationRSPT 1410 Common Respiratory Drugs
1 RSPT 1410 Wilkins: Chapter 32 2 Classifications Respiratory therapists administer several different class of drugs: (adrenergic) Parasympatholytics (anticholinergic) Mucoactives (mucolytic) Antiasthmatics
More informationCompare the physiologic responses of the respiratory system to emphysema, chronic bronchitis, and asthma
Chapter 31 Drugs Used to Treat Lower Respiratory Disease Learning Objectives Describe the physiology of respirations Compare the physiologic responses of the respiratory system to emphysema, chronic bronchitis,
More informationDrug therapy SHORT-ACTING BETA AGONISTS SHORT-ACTING ANTICHOLINERGICS LONG-ACTING BETA AGONISTS LONG-ACTING ANTICHOLINERGICS
Drug therapy 6 6.1 What is the role of bronchodilators in COPD? 52 SHORT-ACTING BETA AGONISTS 6.2 How do short-acting beta agonists work? 52 6.3 What are the indications for their use? 52 6.4 What is the
More informationOn completion of this chapter you should be able to: discuss the stepwise approach to the pharmacological management of asthma in children
7 Asthma Asthma is a common disease in children and its incidence has been increasing in recent years. Between 10-15% of children have been diagnosed with asthma. It is therefore a condition that pharmacists
More informationChronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD) Chronic obstructive pulmonary disease (COPD) is the name for a group of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways
More informationObjectives. Asthma Management
Objectives Asthma Management BREATHE Conference Allergy and Asthma Specialists PC Christine Malloy MD March 22, 2013 Review the role of inflammation in asthma Discuss the components of the EPR-3 management
More informationPre-Operative Services Teaching Rounds 2 Jan 2011
Pre-Operative Services Teaching Rounds 2 Jan 2011 Deborah Richman MBChB FFA(SA) Director Pre-Operative Services Department of Anesthesia Stony Brook University Medical Center, NY drichman@notes.cc.sunysb.edu
More informationThe asthmatic patient and sedation
The asthmatic patient and sedation Introduction The sedation practitioner is often faced with difficult questions to answer before the administration of sedation. Our guidelines say clearly that we are
More informationCOPD PROTOCOL CELLO. Leiden
COPD PROTOCOL CELLO Leiden May 2011 1 Introduction This protocol includes an explanation of the clinical picture, diagnosis, objectives and medication of COPD. The Cello way of working can be viewed on
More informationControlling Your Asthma Patient Education Guide
Controlling Your Asthma Patient Education Guide A M E R I C A N C O L L E G E O F C H E S T PHYSICIANS AND THE CHEST FOUNDATION Controlling Your Asthma Patient Education Guide Single copies are free. Additional
More informationGuidance to support the stepwise review of combination inhaled corticosteroid therapy for adults ( 18yrs) in asthma
Guidance to support the stepwise review of combination inhaled corticosteroid therapy for adults ( 18yrs) in asthma Important Complete asthma control needs to be achieved for at least 12 weeks before attempting
More informationFrom the Text. Clinical Indications. Clinical Indications. RSPT 2217 Non-steroidal Anti-asthma Agents. RSPT 2317 Non-steroidal Antiasthma Agents
From the Text RSPT 2317 Non-steroidal Antiasthma Agents Gardenhire Chapter 12 Key Terms and Definitions Page 226 Nonsteroidal Antiasthma Meds Table 12-1; page 228 Comparative Features of Antileukotriene
More informationBackground information
Background information Asthma Asthma is a complex disease affecting the lungs that can be managed but cannot be cured. 1 Asthma can be controlled well in most people most of the time, although some people
More informationManagement of Asthma
Federal Bureau of Prisons Clinical Practice Guidelines May 2013 Clinical guidelines are made available to the public for informational purposes only. The Federal Bureau of Prisons (BOP) does not warrant
More informationBreath of Fresh Air. In Case of Emergency. Information, news and advice for improving asthma well-being
Information, news and advice for improving asthma well-being Volume 11, No. 2 Winter 2009 In Case of Emergency Have a plan. A plan to deal with an asthma attack is the best defense against the severe,
More informationUnderstanding COPD. An educational health series from
Understanding COPD An educational health series from Our Mission since 1899 is to heal, to discover, and to educate as a preeminent healthcare institution. We serve by providing the best integrated and
More informationInhaled and Oral Corticosteroids
Inhaled and Oral Corticosteroids Corticosteroids (steroids) are medicines that are used to treat many chronic diseases. Corticosteroids are very good at reducing inflammation (swelling) and mucus production
More informationAECOPD: Management and Prevention
AECOPD: Management and Prevention Neil MacIntyre MD Duke University Medical Center Durham NC AECOPD: Management and Prevention AECOPD: Definitions and impact Acute management of AECOPD Preventing AECOPD.
More informationEMS Information Bulletin- #060
BUREAU OF EMERGENCY MEDICAL SERVICES EMS Information Bulletin- #060 DATE: October 27, 2008 SUBJECT: TO: FROM: Continuous Positive Airway Pressure for Basic Life Support Pennsylvania EMS Organizations &
More informationUnderstanding asthma. Oxford Self-help guide. Oxford
Understanding asthma Oxford Self-help guide Oxford Living with asthma Years ago, asthma was a debilitating condition that in many cases seriously limited what a person could do. Fortunately as a result
More informationunderstanding the professional guidelines
SEVERE ASTHMA understanding the professional guidelines This guide includes information on what the European Respiratory Society (ERS) and the American Thoracic Society (ATS) have said about severe asthma.
More informationTraining Manual & Speaker s Guide
Training Manual & Speaker s Guide Based on National Asthma Education and Prevention Program (NAEPP) Guidelines including the NAEPP s Guidelines Implementation Panel (GIP) Priority Messages. Funded in part
More informationThe Annual Direct Care of Asthma
The Annual Direct Care of Asthma The annual direct health care cost of asthma in the United States is approximately $11.5 billion; indirect costs (e.g. lost productivity) add another $4.6 billion for a
More informationFinancial Disclosure. Pharmacy Technician Objectives: Definition: Pediatric Asthma Incidence, Pathogenesis, Severity and Treatment
Pediatric Asthma Incidence, Pathogenesis, Severity and Treatment Roger Hefflinger, Pharm.D. Clinical Associate Professor Family Medicine Residency of Idaho Idaho State University College of Pharmacy Financial
More informationPATIENT INFORMATION ABOUT TREATMENTS FOR ASTHMA AND ALLERGIC RHINITIS, PRESCRIPTIONS & OVER THE COUNTER MEDICINE
PATIENT INFORMATION ABOUT TREATMENTS FOR ASTHMA AND ALLERGIC RHINITIS, PRESCRIPTIONS & OVER THE COUNTER MEDICINE The content of this booklet was developed by Allergy UK. MSD reviewed this booklet to comment
More informationRSPT 2317 Non-steroidal anti-asthma agents
RSPT 2317 Non-steroidal Anti-asthma Agents Mechanisms of Inflammation in Asthma Mechanisms of Inflammation in Asthma Asthma is a chronic inflammatory disorder of the airways It is divided into extrinsic
More informationPOCKET GUIDE FOR ASTHMA MANAGEMENT AND PREVENTION
POCKET GUIDE FOR ASTHMA MANAGEMENT AND PREVENTION (for Adults and Children Older than 5 Years) A Pocket Guide for Physicians and Nurses Updated 2015 BASED ON THE GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND
More informationMEDICATION INFORMATION: CONTROLLER MEDICATIONS
FRANK J. TWAROG, M.D., Ph.D. CURTIS T. MOODY, M.D. ADULT AND PEDIATRIC ASTHMA AND ALLERGIES Brookline Concord (617) 735-8750 (978) 369-3567 MEDICATION INFORMATION: CONTROLLER MEDICATIONS Asthma medications
More informationRESPIRATORY MEDICATIONS
RESPIRATORY MEDICATIONS Purpose: To define and describe medications administered by Respiratory Therapy to patients. Sympathetic receptors: 1. Alpha receptors: - found primarily in blood vessels - stimulation
More informationMedicines Use Review Supporting Information for Asthma Patients
Medicines Use Review Supporting Information for Asthma Patients What is asthma? Asthma is a chronic inflammatory disorder of the airways. The inflammation causes an associated increase in airway hyper-responsiveness,
More informationProtocol in depth Asthma/COPD. daniel.dunham@clemc.us
Protocol in depth Asthma/COPD daniel.dunham@clemc.us Asthma/COPD Narrowing of airways (an H4 histamine response causing inflammation and mucous production), leading to wheezing on inspiration and exhalation.
More informationEVIDENCE-BASED BEST PRACTICES FOR THE MANAGEMENT OF ASTHMA IN PEDIATRIC PRIMARY CARE IN SOUTH CAROLINA
EVIDENCE-BASED BEST PRACTICES FOR THE MANAGEMENT OF ASTHMA IN PEDIATRIC PRIMARY CARE IN SOUTH CAROLINA Sarah Ball, PharmD Mike Bowman, MD Sandra Garner, PharmD Nancy Hahn, PharmD Sophie Robert, PharmD
More informationPediatric. Updated 2008
A S T H M A P R O V I D E R M A N U A L Pediatric Updated 2008 Asthma 2 Causes of Asthma 3 Utah Prevalence 3 Diagnosis 7 Managing Asthma 9 Education for Partnership in Care 11 Control of Environmental
More informationMEDICATION GUIDE. SYMBICORT 80/4.5 (budesonide 80 mcg and formoterol fumarate dihydrate 4.5 mcg) Inhalation Aerosol
MEDICATION GUIDE SYMBICORT 80/4.5 (budesonide 80 mcg and formoterol fumarate dihydrate 4.5 mcg) Inhalation Aerosol SYMBICORT 160/4.5 (budesonide 160 mcg and formoterol fumarate dihydrate 4.5 mcg) Inhalation
More informationAsthma. Micah Long, MD
Asthma Micah Long, MD Goals Define the two components of asthma. Describe the method of action and uses for: Steroids (inhaled and IV) Quick Beta Agonists (Nebs and MDIs) The "Others" Magnesium, Epi IM,
More information5. Aerosol Drug Delivery Devices: Pressurized Metered-Dose Inhalers
Table of Contents Introduction 1. Aerosol Drug Delivery: the Basics 2. Aerosol Drugs: the Major Categories 3. Aerosol Drug Delivery Devices: Small-Volume Nebulizers 4. Aerosol Drug Delivery Devices: Inhalers
More informationLiving Well With COPD Chronic Bronchitis and Emphysema
Living Well With COPD Chronic Bronchitis and Emphysema Your Patient workbook AMERICAN COLLEGE OF CHEST PHYSICIANS AND THE CHEST FOUNDATION Living Well With COPD Chronic Bronchitis and Emphysema your patient
More informationInetCE 146-000-01-001-H01
The National Asthma Education Prevention Program (NAEPP II) Guidelines for the Treatment of Asthma: Implications for the Pharmacist (Manuscript Updated December 2000) InetCE 146-000-01-001-H01 Theresa
More informationDRUG UTILISATION STUDY IN BRONCHIAL ASTHMA IN A TERTIARY CARE HOSPITAL
International Journal of Pharmaceutical Applications ISSN 0976-2639, Online ISSN 2278 6023 Vol 3, Issue 2, 2012, pp 297-305 http://www.bipublication.com DRUG UTILISATION STUDY IN BRONCHIAL ASTHMA IN A
More informationDavid J. Lederer, MD, MS
COPD: Definition Chronic Obstructive Pulmonary Disease Chronic airflow obstruction due to chronic bronchitis and/or pulmonary emphysema David J. Lederer, MD, MS Associate Medical Director, Lung Transplant
More informationProf. Florian Gantner. Vice President Respiratory Diseases Research Boehringer Ingelheim
Prof. Florian Gantner Vice President Respiratory Diseases Research Boehringer Ingelheim Research and Development in Practice: COPD Chronic Obstructive Pulmonary Disease (COPD) Facts Main cause of COPD
More informationAETNA BETTER HEALTH Prior Authorization guidelines for Step Therapy
AETNA BETTER HEALTH Prior Authorization guidelines for Step Therapy Definition A form of automated Prior Authorization whereby one or more prerequisite medications, which may or may not be in the same
More informationProduced by the American Association for Respiratory Care Copyright 2013 by the American Association for Respiratory Care
Produced by the American Association for Respiratory Care Copyright 2013 by the American Association for Respiratory Care Supported by an educational grant from Philips Respironics Foreword (Second Edition)
More informationPathway for Diagnosing COPD
Pathway for Diagnosing Visit 1 Registry Clients at Risk Patient presents with symptoms suggestive of Exertional breathlessness Chronic cough Regular sputum production Frequent bronchitis ; wheeze Occupational
More informationDrugs for treatment of respiratory diseases. Huifang Tang Department of pharmacology Zhejiang University, school of medicine tanghuifang@zju.edu.
Drugs for treatment of respiratory diseases Huifang Tang Department of pharmacology Zhejiang University, school of medicine tanghuifang@zju.edu.cn Antiasthmatic drugs Immunological and non-immunological
More informationInformation for Behavioral Health Providers in Primary Care. Asthma
What is Asthma? Information for Behavioral Health Providers in Primary Care Asthma Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods
More information4 Pharmacological management
4 Pharmacological management The aim of asthma management is control of the disease. Control of asthma is defined as: no daytime symptoms no night time awakening due to asthma no need for rescue medication
More informationPrevention of Acute COPD exacerbations
December 3, 2015 Prevention of Acute COPD exacerbations George Pyrgos MD 1 Disclosures No funding received for this presentation I have previously conducted clinical trials with Boehringer Ingelheim. Principal
More informationThe Right Medicines Can Help You Get Control of Asthma. BlueCare SM TennCareSelect
The Right Medicines Can Help You Get Control of Asthma BlueCare SM TennCareSelect WHEEZING. COUGHING. SHORTNESS OF BREATH. CHEST TIGHTNESS. If you or a family member has asthma, you know these symptoms
More information- Canine Chronic Bronchitis cannot be cured, but can be controlled
MD-096A-0211 1 2 - The symptoms of asthma can mimic other diseases such as heartworm, pneumonia and congestive heart failure (Padrid, Use of Inhaled Medications to Treat Respiratory Diseases in Dogs and
More informationCOPD MANAGEMENT PROTOCOL STANFORD COORDINATED CARE
I. PURPOSE To establish guidelines f the collabative management of patients with a diagnosis of chronic obstructive pulmonary disease (COPD) who are not adequately controlled and to define the roles and
More informationFrom the Text. History & Development. History & Development. Clinical Indications. Clinical Indications. RSPT 2317 Sympathomimetics - Part 1
RSPT 2217 Adrenergic Bronchodilators (Sympathomimetics) Gardenhire Chapter 6 From the Text Key Terms and Definitions Page 104 Current Adrenergic Bronchodilators Table 6-1; page 106 Effects & Characteristics
More informationLiving Well With COPD Chronic Bronchitis and Emphysema
Living Well With COPD Chronic Bronchitis and Emphysema YOUR PATIENT GUIDE AMERICAN COLLEGE OF CHEST PHYSICIANS AND THE CHEST FOUNDATION Living Well With COPD Chronic Bronchitis and Emphysema YOUR PATIENT
More informationAsthma Intervention. An Independent Licensee of the Blue Cross and Blue Shield Association.
Asthma Intervention 1. Primary disease education Member will have an increased understanding of asthma and the classification by severity, the risks and the complications. Define asthma Explain how lungs
More informationDRUG TREATMENT OF ASTHMA Asrar B. Malik, Ph.D. 312-996-7635 abmalik@uic.edu
DRUG TREATMENT OF ASTHMA Asrar B. Malik, Ph.D. 312-996-7635 abmalik@uic.edu DRUGS USEFUL IN ASTHMA LEARNING OBJECTIVES 1. Know the working definitions of asthma and basic pathology of the disease. 2. Understand
More informationCOPD Intervention. Components:
COPD Intervention 1. Primary disease education Member will have an increased understanding of chronic obstructive pulmonary disease, the causes, risks and complications. Explain COPD Explain how COPD is
More informationChapter 20. Drugs Used in Asthma
Nitric Oxide (INOmax) Inhalation: 100, 800 ppm gas Katzung PHARMACOLOGY, 9e > Section IV. Drugs with Important Actions on Smooth Muscle > Chapter 19. Nitric Oxide, Donors, & Inhibitors > Chapter 20. Drugs
More informationCOPD and Asthma Differential Diagnosis
COPD and Asthma Differential Diagnosis Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death in America. Learning Objectives Use tools to effectively diagnose chronic obstructive
More informationRES/006/APR16/AR. Speaker : Dr. Pither Sandy Tulak SpP
RES/006/APR16/AR Speaker : Dr. Pither Sandy Tulak SpP Definition of Asthma (GINA 2015) Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families
More information9/16/2014. Anti-Immunoglobulin E (IgE) Omalizumab (Xolair ) Dosing Guidance
Disclosure Statement of Financial Interest New Therapies for Asthma Including Omalizumab and Anti-Cytokine Therapies Marsha Dangler, PharmD, BCACP Clinical Pharmacy Specialist James H. Quillen VA Medical
More informationManaging Asthma Long Term
Managing Asthma Long Term TARGET POPULATION Eligibility Inclusion Criterion Exclusion Criterion RECOMMENDATIONS F I G U R E 4 2 a. CLASSIFYING ASTHMA SEVERITY AND INITIATING TREATME N T IN CHILDREN 0 4
More informationAn Overview of Asthma - Diagnosis and Treatment
An Overview of Asthma - Diagnosis and Treatment Asthma is a common chronic disorder of the airways that is complex and characterized by variable and recurring symptoms, airflow obstruction, bronchial hyperresponsiveness,
More informationINSIDE: Your Asthma Journey Step By Step
8229 Boone Blvd. Suite 260 Vienna, VA 22182 800.878.4403 www.aanma.org info@aanma.org Understanding Asthma: Building Blocks For Better Breathing Allergy & Asthma Today Special Edition is published by Allergy
More informationMedication Guide DULERA [dew-lair-ah] 100 mcg/5 mcg DULERA 200 mcg/5 mcg
Medication Guide DULERA [dew-lair-ah] 100 mcg/5 mcg (mometasone furoate 100 mcg and formoterol fumarate dihydrate 5 mcg inhalation aerosol) DULERA 200 mcg/5 mcg (mometasone furoate 200 mcg and formoterol
More informationUnderstanding Asthma Patients in the Dental Office
Understanding Asthma Patients in the Dental Office Barbara Fried, RDH, MBA Continuing Education Units: 1 hour Online Course: www.dentalcare.com/en-us/dental-education/continuing-education/ce408/ce408.aspx
More informationMontelukast Sodium Singulair, Merck. Development and Pharmacology: 1
Montelukast Sodium Singulair, Merck Development and Pharmacology: 1 Asthma is a chronic inflammatory disease of the airways that is complicated by episodes of acute inflammation. Even patients with mild
More informationExercise-induced bronchoconstriction. Diagnosis and Management
: Diagnosis and Management MICHAEL A. KRAFCZYK, MD, St. Luke s Hospital and Health Network Primary Care Sports Medicine Fellowship Program, Bethlehem, Pennsylvania CHAD A. ASPLUND, MD, Eisenhower Army
More informationCOPD Prescribing Guidelines
South Staffordshire Area Prescribing Group COPD Prescribing Guidelines Inhaler choices in this guideline are different from previous versions produced by the APG. It is not expected patients controlled
More informationEvaluating Steroid Inhalers Used to Treat: Asthma and Chronic Lung Disease. Comparing Effectiveness, Safety, and Price
Evaluating Steroid Inhalers Used to Treat: Asthma and Chronic Lung Disease Comparing Effectiveness, Safety, and Price Our Recommendations Inhaled steroids are effective and safe medicines used to treat
More informationSTAYING ASTHMA FREE. All you need to know about preventers. www.spacetobreathe.co.nz
STAYING ASTHMA FREE All you need to know about preventers www.spacetobreathe.co.nz HELPING YOUR CHILD BREATHE MORE EASILY GETTING TO KNOW THE PREVENTER What is a preventer? When do you use it? How do they
More informationSMO: Anaphylaxis and Allergic Reactions
REGION I EMERGENCY MEDICAL SERVICES STANDING MEDICAL ORDERS EMT Basic SMO: Anaphylaxis and Allergic Reactions Overview: Allergic reactions can vary in severity from a mild reaction consisting of hives
More informationA VNSNY SELF-CARE GUIDE
A VNSNY SELF-CARE GUIDE For the Management of: Chronic Obstructive Pulmonary Disease (COPD) Visiting Nurse Service of New York A PATIENT SELF-CARE GUIDE FOR THE MANAGEMENT OF: Chronic Obstructive Pulmonary
More information5. Treatment of Asthma in Children
Treatment of sthma in hildren 5. Treatment of sthma in hildren 5.1 Maintenance Treatment 5.1.1 rugs Inhaled Glucocorticoids. Persistent wheezing in children under the age of three can be controlled with
More informationBefore prescribing for COPD management, the patient should have had appropriate assessment, including spirometry, as per NICE guidelines.
Formulary Guidance for Management of COPD patients Before prescribing for COPD management, the patient should have had appropriate assessment, including spirometry, as per NICE guidelines. For inhaler
More informationTreatment of Asthma. Talk to your doctor about the various medications available to treat asthma.
Please call 911 if you think you have a medical emergency. Treatment of Asthma The goals of asthma therapy are to prevent your child from having chronic and troublesome symptoms, to maintain your child's
More informationAsthma, COPD and Diabetes Preferred Drug List Medications
GPI Name Dexamethasone Tab 0.5 MG Dexamethasone Tab 0.75 MG Dexamethasone Tab 1 MG Dexamethasone Tab 1.5 MG Dexamethasone Tab 2 MG Dexamethasone Tab 4 MG Dexamethasone Tab 6 MG Dexamethasone Elixir 0.5
More informationChronic Obstructive Pulmonary Disease
COPD Guideline Team Team Leader Davoren A Chick, MD General Medicine Team Members Paul J Grant, MD General Medicine Meilan K Han, MD, MS Pulmonary Medicine R Van Harrison, PhD Medical Education Elisa B
More informationHypersensitivity. TYPE I Hypersensitivity Classic allergy. Allergens. Characteristics of allergens. Allergens. Mediated by IgE attached to Mast cells.
Gel and Coombs classification of hypersensitivities. Hypersensitivity Robert Beatty Type I Type II Type III Type IV MCB150 IgE Mediated IgG/IgM Mediated IgG Mediated T cell Classic Allergy rbc lysis Immune
More informationMedications for COPD: A Review of Effectiveness
Medications for COPD: A Review of Effectiveness GIL C. GRIMES, MD; JOHN L. MANNING, MD; PARITA PATEL, MD; and R. MARC VIA, MD Texas A&M University Health Science Center, Temple, Texas Chronic obstructive
More informationBronchodilators in COPD
TSANZSRS Gold Coast 2015 Can average outcomes in COPD clinical trials guide treatment strategies? Long live the FEV1? Christine McDonald Dept of Respiratory and Sleep Medicine Austin Health Institute for
More informationPOCKET GUIDE FOR ASTHMA MANAGEMENT AND PREVENTION
POCKET GUIDE FOR ASTHMA MANAGEMENT AND PREVENTION (for Adults and Children Older than 5 Years A Pocket Guide for Physicians and Nurses Updated 2011 BASED ON THE GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND
More informationUnited States. 2013 Land Line And Cell Phone Codebook Report. CHILD Asthma Call-Back Survey
ACBS_2013_CHILD_PUBLIC_LLCP United States 2013 Land Line And Cell Phone Codebook Report CHILD Asthma Call-Back Survey April 29, 2015 STATE FIPS CODE Column: 1-2 Description: STATE FIPS CODE. SAS Variable
More informationII. ASTHMA BASICS. Overview of Asthma. Why do I need to know about asthma?
II. ASTHMA BASICS Overview of Asthma Why do I need to know about asthma? In the United States, asthma is the most common chronic childhood illness. Asthma affects an estimated 4.8 million children nationally,
More information