Inhalation Devices and Inhaled Corticosteroids Quiz Review

Demographics of Asthma

1 in 13 americans with 8% adults and 7% children

leading chronic disease in children and highest prevalence among AA

Demographics of COPD

6.6% affected by some type of COPD with highest being just chronic bronchitis

Pharmacist Clear communication

increase patient satisfaction
better health outcomes
reduced hospital admissions and ED visits

Pharmacist Collaboration with PCP

patient centric short and long term goals that includes usual medication, self-monitoring of symptoms and lung function, plan if peak flow decreases

Pharmacist Health Literacy

patient is able to control their condition by being able to obtain, process, and understand information about their condition. Includes medication and illness hx, ED visits, exacerbations with frequency.

Nebulizer Technique

with clean hands pour prescribed medication into medication cup

close medication cup with top piece or cap and attach mouthpiece or mask 

connect tubing to compressor and medication cup 

put mouthpiece in mouth between teeth and close lips tightly around it 

turn on compressor and breathe in until all medication is gone from cup 

MDI Closed Mouth Technique (preferred) 

shake the inhaler well and if spacer used attach with canister in vertical position 

breath out fully through mouth away from inhaler 

put mouthpiece in mouth and tighten lips around it 

press canister down then deeply and slowly breathe through mouth 

remove spacer/inhaler from mouth 

hold breath for as long as comfortably possible up to 10 seconds 

wait 30 to 60 seconds then repeat as needed 

MDI Breath Actuated technique

Open cap holding inhaler upright 

exhale fully away from mouthpiece 

place mouthpiece in mouth and close lips to form a good seal 

breath in deeply remove inhaler and hold breath for 5 to 10 seconds then exhale

click the cap closed to deliver the next inhalation 

Soft Mist Inhalers Technique (SMI)

half-turn the base in the direction of the arrows until it clicks

flip the cap until it snaps open

breathe out fully through the mouth away from inhaler 

put mouthpiece into mouth and seal lips around end without covering vents 

inhale deeply and then slowly press dose release button 

hold breath for as long as comfortably possible up to 10 seconds 

close cap of the inhaler 

Dry Powder Inhaler technique

stand or sit up straight and breathe out completely

put mouthpiece into mouth and seal lips around it breathing in quickly and forcibly 

take ___ out of your mouth then hold breath for 5-10 seconds then exhale slowly 

if second dose, reload and repeat above steps 

if capsule device, open chamber and check if powder fully inhaled 

close device and store in a dry place 

Beclomethasone HFA dosing ranges two puffs BID

low 80 to 240 mcg

med 280 to 480 mcg

high 480+ mcg

aka QVAR Redihaler

QVAR Redihaler Doses two puffs BID

40 or 80 mcg/inhalation

aka Beclomethasone HFA

Budesonide DPI Dosing Ranges two puffs BID

low 360 to 540 mcg 

med 630 to 1170 mcg 

high 1200+ mcg 

aka Pulmicort Flexihaler 

Pulmicort Flexihaler Dosing two puffs BID

90 or 180 mcg/inhalation 

aka Budesonide DPI

Pulmicort Repulses Dosing Range daily or BID

low 0.25 mg/2 mL

med 0.5 mg/2 mL

high 1 mg/2 mL

aka Budesonide Nebulizer

Budesonide Nebulizer Dosing daily or BID

0.25 / 0.5 / 1 mg all per 2 mL

aka Pulmicort Repulses

Symbicort two puffs BID

low 160 mcg

med 240 to 320 mcg

high 320+ mcg

aka Budesonide/ Formoterol HFA

Budesonide/ Formoterol HFA two puffs BID

80 or 160 mcg/4.5 mcg inhalation 

aka Symbicort

Alvesco Dosing Ranges two puffs BID

low 160 mcg

med 240 to 320 mcg

high 320+ mcg

aka Ciclesonide HFA

Ciclesonide HFA dosing  two puffs BID

80 or 160 mcg/inhalation 

aka Alvesco

Aerospan Dosing Ranges two puffs BID

low 320 mcg

med 400 to 640 mcg

high 640+ mcg

aka Flunisolide HFA

Flunisolide HFA two puffs BID

80 mcg/inhalation 

aka Aerospan

Arnuity Ellipta Dosing Ranges Daily

low 100 mcg

med N/A

high 200 mcg

aka Fluticasone Furoate DPI

Fluticasone Furoate DPI Dosing daily 

50 or 100 or 200 mcg/blister 

aka Arnuity Ellipta

Breo Ellipta Dosing ranges Daily 

low 100/25 mcg per blister

med N/A

high 200/25 mcg per blister

aka Fluticasone Furoate/Vilanterol DPI 

Fluticasone Furoate/Vilanterol DPI

100 or 200/25 mcg per blister  

aka Breo Ellipta

Flovent HFA two puffs BID

low 176 mcg

med 264 to 440 mcg

high 440+ mcg

aka Fluticasone Propionate HFA

Fluticasone Propionate HFA Dosing two puffs BID

44 or 110 or 220 mcg/inhalation 

aka Flovent HFA

Advair HFA Dosing Range two puffs BID

low 180 to 250/84 mcg

med 320 to 460/84 mcg

high 460/84 + mcg

aka Fluticasone Propionate/Salmeterol HFA

Fluticasone Propionate/Salmeterol HFA two puffs BID

45 or 115 or 230/21 mcg/inhalation 

aka Advair HFA

Advair Diskus Dosing Ranges 

two puffs BID blisters

low 200/100 mcg 

med 350 to 500/100 mcg 

high 500/50 mcg 

aka Fluticasone Propionate/Salmeterol DPI 

Fluticasone Propionate/Salmeterol DPI Dosing

two puffs BID blisters 

100 or 250 or 500/50 mcg/blister

aka Advair Diskus 

Airduo Respiclick DPI dosing

two puffs BID

low 110/28 mcg

med 226/28 mcg

high 264/28 mcg

aka Fluticasone propionate/ salmeterol DPI

Fluticasone Propionate/Salmeterol DPI

two puffs BID inhalation

55 or 113 or 232/14 mcg/inhalation 

aka Airduo Respiclick

Fluticasone Propionate DPI

two puffs BID

low 110 mcg

med 226 mgc

high 464 mcg

aka Armonair Respiclick

Armonair Respiclick DPI

two puffs BID

55 or 113 or 232 mcg/inhalation 

aka Fluticasone propionate DPI

Fluticasone Propionate DPI 

two puffs BID blisters 

low 200 to 300 mcg 

med 350 to 500 mcg 

high 500+ mcg 

aka Flovent Diskus 

Flovent Diskus DPI

two puffs BID

50 or 100 or 250 mcg/blister

aka fluticasone propionate

Asmanex Twisthaler Dosing ranges

two puffs daily

low 220 mcg

med 330 to 440 mcg

high 440+ mcg

aka Mometasone DPI

Mometasone DPI Dosing

two puffs daily

110 or 220 mcg/inhalation 

aka Asmanex Twisthaler

Asmanex HFA

two puffs BID

low N/A

med 400 mcg

high 800 mcg

aka Mometasone HFA

Mometasone HFA

two puffs BID

100 or 200 mcg/inhalation 

aka Asmanex HFA

Dulera HFA

low N/A

med 400/20 mcg 

high 800/20 mcg 

aka Mometasone/Formoterol HFA

Mometasone/Formoterol HFA

100 or 200/5 mcg/inhalation 

aka Dulera