Flonase (Fluticasone) RX Flashcards

Fluticasone Overview

• Generic Name: Fluticasone
• Trade Names: Arnuity Ellipta, FLONASE, Flovent HFA, Flovent Diskus, Veramyst (nasal spray)
• Classification: Corticosteroid

Dosage and Administration

• Dosage for Flovent Diskus: 100 mcg twice a day (bid)
• Dosage for Flonase: Start with 2 sprays, then 1 spray per nostril
• Administration Routes: Oral inhalation (INH) and intranasal
• Frequency: Flovent is taken bid, while Flonase is used daily

Pharmacokinetics

• Peak Effects: Occur in several days
• Onset of Action:
  • Oral INH: 24 hours
  • Intranasal: 12 hours
• Duration of Action: 1-2 weeks
• Normal Dosage Range: 100-500 mcg bid

Indications

• Used for chronic asthma management during maintenance therapy, especially for patients requiring oral corticosteroids
• Addresses nasal symptoms from seasonal/perennial allergies and nonallergic rhinitis
• Unlabeled use includes Chronic Obstructive Pulmonary Disease (COPD)

Mechanism of Action

• Acts by decreasing inflammation through inhibition of mast cells, macrophages, and leukotrienes
• Possesses anti-inflammatory and vasoconstrictive properties

Nursing Considerations

• Monitor for adrenal insufficiency and anaphylaxis
• Conduct thorough respiratory assessments, including lung sounds and pulmonary function tests
• Be vigilant for signs of adrenal insufficiency during the transition from systemic to inhalation corticosteroids, such as weakness, fatigue, and hypotension

Side Effects and Adverse Reactions

• Common CNS effects: Fatigue, headache, dizziness
• EENT effects: Pharyngitis, sinusitis, nasal discharge, and blurred vision
• GI Effects: Diarrhea, abdominal pain, vomiting, risk of oral candidiasis
• Metabolic effects: Hyperglycemia, growth retardation in children, Cushingoid features
• Miscellaneous: Increased risk of infections, angioedema, potential for osteoporosis

Contraindications

• Hypersensitivity to fluticasone or milk protein
• Not advisable as primary treatment for status asthmaticus or acute bronchospasm
• Caution in pregnancy, breastfeeding, and in patients with active infections or Cushing syndrome

Patient Education

• Instruct patients to use bronchodilator first before corticosteroid inhalation
• Emphasize that it is not for acute asthmatic attacks
• Advise against smoking and exposure to secondhand smoke or individuals with respiratory infections
• Encourage proper oral hygiene to prevent oral candidiasis

Drug Interactions

• Use with caution when combined with CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) as these medications may increase fluticasone levels
• Isoproterenol may increase cardiac toxicity in asthma patients

Post-Administration Assessment

• Evaluate therapeutic response by monitoring asthma, COPD symptoms, and allergy severity
• Look for any adverse reactions and adjust therapy as needed

Test your knowledge of Flonase, also known as Fluticasone, with these flashcards. Covering definitions, trade names, classification, dosing, and routes of administration, this quiz is perfect for pharmacy students or anyone seeking to learn more about this medication.