Budesonide/Formoterol Flashcards

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Questions and Answers

What is the brand name for budesonide/formoterol?

Symbicort (correct)

Advair

Dulera

Qvar

What is the drug class of budesonide/formoterol?

Inhaled Corticosteroid/Bronchodilator Combination

What are the dosage forms of budesonide/formoterol?

MDI 80 mcg/4.5 mcg/inhalation and 160 mcg/4.5 mcg/inhalation

What are the common indications and dosing for budesonide/formoterol?

Asthma: 80 mcg/4.5 mcg, 2 puffs BID; COPD: 160 mcg/4.5 mcg, 2 puffs BID Signup and view all the answers

What is the mechanism of action (MOA) of budesonide/formoterol?

Budesonide is an anti-inflammatory with glucocorticoid activity; formoterol is a long-acting beta-adrenergic agonist. Signup and view all the answers

What is the dose adjustment renal for budesonide/formoterol?

NONE Signup and view all the answers

What are contraindications for budesonide/formoterol?

Hypersensitivity to budesonide or formoterol; do not use as primary treatment for status asthmaticus. Signup and view all the answers

What are the black box warnings for budesonide/formoterol?

Asthma deaths among pediatrics; increased risk of hospitalizations. Signup and view all the answers

What are the drug interactions with budesonide/formoterol?

SABAs, beta-blockers, MAOIs, tricyclic antidepressants, azole antifungals, macrolides, CYP3A4/CYP3A5 inducers and inhibitors. Signup and view all the answers

The interaction between budesonide/formoterol and SABAs may potentiate the effect of __________.

formoterol Signup and view all the answers

The interaction between budesonide/formoterol and beta-blockers may decrease the effectiveness of __________.

formoterol Signup and view all the answers

The interaction between budesonide/formoterol and MAOIs and tricyclic antidepressants may potentiate the effect on the __________ system.

cardiovascular Signup and view all the answers

The interaction between budesonide/formoterol and azole antifungals may increase __________ concentrations.

budesonide Signup and view all the answers

CYP3A4/CYP3A5 inducers can increase budesonide metabolism and decrease its effectiveness, thus, __________ should be monitored.

doses Signup and view all the answers

CYP3A4/CYP3A5 inhibitors can decrease budesonide metabolism and increase the risk of __________.

toxicity Signup and view all the answers

What are common adverse reactions with budesonide/formoterol?

Upper respiratory tract infections Signup and view all the answers

What are rare but serious adverse reactions with budesonide/formoterol?

Asthma-related death, bronchospasm, hypokalemia, arrhythmias Signup and view all the answers

What are the efficacy monitoring parameters for budesonide/formoterol?

Monitor PFTs, resolution of asthma symptoms, number of exacerbations, nighttime awakenings, need for rescue albuterol Signup and view all the answers

What are the toxicity monitoring parameters for budesonide/formoterol?

Growth velocity in pediatric patients, alternative therapy or emergency treatment if bronchospasms occur Signup and view all the answers

Study Notes

Drug Overview

Brand name: Symbicort
Drug class: Inhaled Corticosteroid/Bronchodilator Combination

Dosage Forms

Metered-Dose Inhaler (MDI)
Formulations:
- 80 mcg budesonide / 4.5 mcg formoterol per inhalation
- 160 mcg budesonide / 4.5 mcg formoterol per inhalation

Indications and Dosing

Asthma:
- Recommended dose: 80 mcg/4.5 mcg, 2 puffs twice daily (BID)
- Possible increase to 160 mcg/4.5 mcg, 2 puffs BID
Chronic Obstructive Pulmonary Disease (COPD):
- Recommended dose: 160 mcg/4.5 mcg, 2 puffs BID

Mechanism of Action

Budesonide:
- Anti-inflammatory agent with strong glucocorticoid effects and weak mineralocorticoid effects
- Inhibits various cell types and mediators involved in inflammation
Formoterol:
- Long-acting selective beta-adrenergic agonist, leading to bronchodilation

Renal Dose Adjustment

No dose adjustment required for renal impairment

Contraindications

Known hypersensitivity to budesonide or formoterol
Not to be used as primary treatment for status asthmaticus or acute asthma/COPD episodes

Black Box Warnings

Risk of asthma-related deaths in pediatric patients
Increased risk of hospitalizations

Drug Interactions

May interact with:
- Short-acting beta agonists (SABAs)
- Beta-blockers
- Monoamine oxidase inhibitors (MAOi) and tricyclic antidepressants
- Azole antifungals and macrolides
- CYP3A4/CYP3A5 inducers and inhibitors

Specific Interactions and Recommendations

SABAs: May enhance formoterol effects; avoid concurrent use
Beta-blockers: Nonselective beta-blockers can reduce formoterol effectiveness and cause bronchospasms; consider cardioselective options with PFT monitoring
MAOi and tricyclic antidepressants: May augment cardiovascular effects of formoterol; consider alternative therapies
Azole antifungals and macrolides: Can increase budesonide concentration; avoid long-term use
CYP3A4/CYP3A5 inducers: Increase metabolism of budesonide, decreasing effectiveness; monitor and possibly increase budesonide dose
CYP3A4/CYP3A5 inhibitors: Decrease metabolism leading to toxicity; monitor and possibly decrease budesonide dose

Adverse Reactions

Common: Upper respiratory tract infections
Rare but serious:
- Asthma-related deaths
- Bronchospasm
- Hypokalemia
- Arrhythmias

Monitoring Parameters

Efficacy:
- Pulmonary function tests (PFTs)
- Resolution of asthma symptoms
- Frequency of exacerbations
- Nighttime awakenings
- Need for rescue albuterol
Toxicity:
- Monitor growth velocity in pediatric patients on long-term therapy
- Seek alternative treatment or emergency care for paradoxical bronchospasms

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Test your knowledge on budesonide/formoterol with this set of flashcards. Each card covers essential information, including brand names, drug classes, and dosage forms. Perfect for students and professionals in the medical and pharmaceutical fields.