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Questions and Answers
What is the brand name of Fluticasone/Salmeterol?
What is the brand name of Fluticasone/Salmeterol?
- Serevent
- Advair (correct)
- Symbicort
- Flovent
What is the generic name for Advair?
What is the generic name for Advair?
Fluticasone/Salmeterol
What is one of the indications for using Fluticasone/Salmeterol?
What is one of the indications for using Fluticasone/Salmeterol?
- Short-term use for cough relief
- Long-term maintenance treatment of asthma (correct)
- Primary treatment of status asthmaticus
- Emergency relief of asthma
How often should Advair Diskus be used for asthma?
How often should Advair Diskus be used for asthma?
What are the strengths available for Advair Diskus?
What are the strengths available for Advair Diskus?
What medication class does Fluticasone/Salmeterol belong to?
What medication class does Fluticasone/Salmeterol belong to?
What is a mechanism of action of Fluticasone?
What is a mechanism of action of Fluticasone?
Salmeterol inhibits the release of mediators of immediate hypersensitivity from mast cells.
Salmeterol inhibits the release of mediators of immediate hypersensitivity from mast cells.
Which of the following are potential side effects of Fluticasone/Salmeterol?
Which of the following are potential side effects of Fluticasone/Salmeterol?
What are contraindications for using Fluticasone/Salmeterol?
What are contraindications for using Fluticasone/Salmeterol?
What should patients avoid after using Fluticasone/Salmeterol?
What should patients avoid after using Fluticasone/Salmeterol?
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Study Notes
Brand and Generic Names
- Brand name: Advair
- Generic name: Fluticasone/Salmeterol
Indications
- Long-term maintenance treatment of asthma for patients aged 4 years and older (Advair Diskus) and 12 years and older (Advair HFA)
- Maintenance treatment for airflow obstruction in COPD patients associated with chronic bronchitis
Dosing Guidelines
- Asthma: One Diskus inhalation or two HFA inhalations twice daily, about 12 hours apart
- Airflow obstruction: One inhalation of Advair 250/50 twice daily, morning and evening
- For patients not currently on corticosteroids, starting dose recommended is Advair Diskus 100/50 twice daily
Strengths and Dosage Forms
- Advair Diskus available strengths: 100/50, 250/50, 500/50 (all values in mcg)
- Advair HFA available strengths: 45/21, 115/21, 230/21 (all values in mcg)
Medication Class
- Classified as an antiasthmatic
Pharmacology and Mechanism of Action
- Fluticasone: Acts on receptor proteins in sensitive cells; forms steroid-receptor complex leading to m-RNA transcription; produces proteins and enzymes for anti-allergy and anti-inflammatory effects
- Salmeterol: Stimulates adenyl cyclase leading to increased c-AMP; causes relaxation of bronchial, uterine, and vascular smooth muscle; inhibits release of mediators from mast cells
Drug Interactions
- Systemic corticosteroids may produce additive effects
- Risk of increased toxicity with sympathomimetics, tricyclic antidepressants, and monoamine oxidase inhibitors
- β-blockers can diminish effectiveness of Salmeterol, with nonselective agents posing a higher risk
Side Effects and Adverse Effects
- Common side effects include upper respiratory tract infection, pharyngitis, headache, nausea, vomiting, sinusitis, bronchitis, cough, rash, and angioedema
Contraindications
- Not for primary treatment of status asthmaticus; long-acting β-2-adrenergic agonists increase risk of asthma-related death
- Caution is needed for transitioning patients from systemic corticosteroids
- Not suitable for rapid relief of bronchospasm; may lead to secondary oral fungal infections
- Caution advised in patients with cardiovascular disorders, hypertension, hyperthyroidism, diabetes, and during pregnancy (Category C)
Patient Counseling Points
- Avoid eye contact; rinse mouth after use
- Contact a healthcare provider for severe or persistent side effects
- If a dose is missed, skip it and resume normal schedule
- Treatment requires regular use for full benefits, which may take up to four weeks to manifest
- Ensure understanding and proper use of Diskus and HFA inhaler
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