18. Respiratory, Allergy, Cough, and Cold

What is the brand name for albuterol?

ProAir

What is the generic name for ProAir?

Albuterol

What drug class is albuterol?

Short-acting beta-2 agonist (SABA) bronchodilator

What does SABA stand for?

Short-acting beta-2 agonist

Is albuterol a rescue or controller inhaler?

Rescue inhaler

What is albuterol primarily used for in asthma?

Rapid relief of bronchospasm

What common neurologic adverse effect can albuterol cause?

Tremor

What cardiovascular adverse effect can albuterol cause?

Tachycardia

What electrolyte abnormality can occur with high albuterol exposure?

Hypokalemia

What is the brand name for ipratropium?

Atrovent

What is the generic name for Atrovent?

Ipratropium

What drug class is ipratropium?

Short-acting anticholinergic bronchodilator (SAMA)

What does SAMA stand for?

Short-acting muscarinic antagonist

What is the brand name for tiotropium?

Spiriva

What is the generic name for Spiriva?

Tiotropium

What drug class is tiotropium?

Long-acting anticholinergic bronchodilator (LAMA)

What does LAMA stand for?

Long-acting muscarinic antagonist

Which bronchodilator class is especially prominent in COPD?

Anticholinergic bronchodilators

What is the brand name for albuterol/ipratropium?

Combivent, DuoNeb

What is the generic name for Combivent?

Albuterol/ipratropium

What is the generic name for DuoNeb?

Albuterol/ipratropium

What drug classes are combined in albuterol/ipratropium?

SABA plus short-acting anticholinergic bronchodilator

Which component of Combivent/DuoNeb is the SABA?

Albuterol

Which component of Combivent/DuoNeb is the anticholinergic?

Ipratropium

What is the brand name for budesonide/formoterol?

Symbicort

What is the generic name for Symbicort?

Budesonide/formoterol

What drug class is budesonide/formoterol?

Inhaled corticosteroid plus long-acting beta-2 agonist (ICS/LABA)

Which component of Symbicort is the inhaled corticosteroid?

Budesonide

Which component of Symbicort is the LABA?

Formoterol

What is the brand name for fluticasone/salmeterol?

Advair

What is the generic name for Advair?

Fluticasone/salmeterol

What drug class is fluticasone/salmeterol?

Inhaled corticosteroid plus long-acting beta-2 agonist (ICS/LABA)

Which component of Advair is the inhaled corticosteroid?

Fluticasone

Which component of Advair is the LABA?

Salmeterol

What does ICS stand for?

Inhaled corticosteroid

What does LABA stand for?

Long-acting beta-2 agonist

What is the brand name for fluticasone inhaled?

Flovent

What is the generic name for Flovent?

Fluticasone inhaled

What drug class is inhaled fluticasone?

Inhaled corticosteroid (ICS)

Is inhaled fluticasone primarily a rescue or controller medication?

Controller medication

What is the brand name for budesonide inhaled?

Pulmicort

What is the generic name for Pulmicort?

Budesonide inhaled

What drug class is inhaled budesonide?

Inhaled corticosteroid (ICS)

Is inhaled budesonide primarily a rescue or controller medication?

Controller medication

What should patients generally do after using an inhaled corticosteroid?

Rinse the mouth

Why should patients rinse their mouth after an inhaled corticosteroid?

To reduce the risk of oral candidiasis

What fungal infection can inhaled corticosteroids cause in the mouth?

Oral candidiasis

Is LABA monotherapy appropriate for asthma?

No

How are LABAs commonly used in asthma?

Combined with an inhaled corticosteroid

Which combinations in this section contain both an ICS and LABA?

Symbicort and Advair

What is the brand name for montelukast?

Singulair

What is the generic name for Singulair?

Montelukast

What drug class is montelukast?

Leukotriene receptor antagonist

What major boxed warning is associated with montelukast?

Serious neuropsychiatric events

What is the memory key for bronchodilators and inhaled controllers?

Albuterol is a SABA rescue drug; ICS drugs are controllers; LABAs are commonly paired with ICS in asthma; anticholinergics are prominent in COPD

Which drug matches ProAir?

Albuterol — SABA rescue bronchodilator

Which drug matches Atrovent?

Ipratropium — short-acting anticholinergic bronchodilator

Which drug matches Spiriva?

Tiotropium — long-acting anticholinergic bronchodilator

Which drug matches Combivent/DuoNeb?

Albuterol/ipratropium — SABA plus anticholinergic bronchodilator

Which drug matches Symbicort?

Budesonide/formoterol — ICS/LABA

Which drug matches Advair?

Fluticasone/salmeterol — ICS/LABA

Which drug matches Flovent?

Fluticasone inhaled — inhaled corticosteroid

Which drug matches Pulmicort?

Budesonide inhaled — inhaled corticosteroid

Which drug matches Singulair?

Montelukast — leukotriene receptor antagonist

Which respiratory drug is the classic SABA rescue medication?

Albuterol

Which respiratory drugs in this section are inhaled corticosteroid controllers?

Fluticasone and budesonide

Which respiratory drugs are ICS/LABA combinations?

Budesonide/formoterol and fluticasone/salmeterol

Which respiratory drug has a boxed warning for serious neuropsychiatric events?

Montelukast

Which respiratory medication can cause tremor tachycardia and hypokalemia at high exposure?

Albuterol

Which inhaled drug class requires mouth rinsing to reduce oral candidiasis?

Inhaled corticosteroids

What is the brand name for diphenhydramine?

Benadryl

What is the generic name for Benadryl?

Diphenhydramine

What drug class is diphenhydramine?

First-generation antihistamine

What is the brand name for cetirizine?

Zyrtec

What is the generic name for Zyrtec?

Cetirizine

What drug class is cetirizine?

Second-generation antihistamine

What is the brand name for levocetirizine?

Xyzal

What is the generic name for Xyzal?

Levocetirizine

What drug class is levocetirizine?

Second-generation antihistamine

What is the brand name for fexofenadine?

Allegra

What is the generic name for Allegra?

Fexofenadine

What drug class is fexofenadine?

Second-generation antihistamine

What is the brand name for loratadine?

Claritin

What is the generic name for Claritin?

Loratadine

What drug class is loratadine?

Second-generation antihistamine

What is the brand name for hydroxyzine?

Vistaril, Atarax

What is the generic name for Vistaril?

Hydroxyzine

What is the generic name for Atarax?

Hydroxyzine

What drug class is hydroxyzine?

First-generation antihistamine

Which antihistamines in this section are first-generation?

Diphenhydramine and hydroxyzine

Which antihistamines in this section are second-generation?

Cetirizine, levocetirizine, fexofenadine, and loratadine

Which antihistamine generation is generally more sedating?

First-generation antihistamines

Which antihistamine generation has more anticholinergic effects?

First-generation antihistamines

Which antihistamine generation is generally less sedating?

Second-generation antihistamines

What is the memory key for antihistamines?

Diphenhydramine and hydroxyzine are more sedating and anticholinergic first-generation antihistamines; second-generation antihistamines are less sedating overall

Why should multiple sedating antihistamines generally not be stacked?

They can increase CNS depression and sedation

Why should sedating antihistamines be used cautiously with other CNS depressants?

They can increase sedation and CNS depression

What cognitive problem can anticholinergic burden worsen?

Confusion

What urinary problem can anticholinergic burden worsen?

Urinary retention

What GI problem can anticholinergic burden worsen?

Constipation