Podcast
Questions and Answers
Which of the following are brand names of Fluticasone/Salmeterol?
Which of the following are brand names of Fluticasone/Salmeterol?
- Advair HFA (correct)
- Pulmicort
- Symbicort
- Advair Diskus (correct)
What are the common FDA indications for Fluticasone/Salmeterol?
What are the common FDA indications for Fluticasone/Salmeterol?
- Asthma (correct)
- Diabetes
- Hypertension
- Chronic obstructive pulmonary disease (COPD) (correct)
What is the drug class of Fluticasone/Salmeterol?
What is the drug class of Fluticasone/Salmeterol?
Inhaled Corticosteroid and Long-Acting β2-Adrenergic Agonist Combination
What is the mechanism of action (MOA) of Fluticasone/Salmeterol?
What is the mechanism of action (MOA) of Fluticasone/Salmeterol?
Renal dosing adjustment is required for Fluticasone/Salmeterol.
Renal dosing adjustment is required for Fluticasone/Salmeterol.
Which of the following are available dosage forms for Fluticasone/Salmeterol?
Which of the following are available dosage forms for Fluticasone/Salmeterol?
What is the dosing for asthma treatment with Fluticasone/Salmeterol?
What is the dosing for asthma treatment with Fluticasone/Salmeterol?
What are some common adverse drug reactions (ADRs) associated with Fluticasone/Salmeterol?
What are some common adverse drug reactions (ADRs) associated with Fluticasone/Salmeterol?
What are serious adverse drug reactions (ADRs) associated with Fluticasone/Salmeterol?
What are serious adverse drug reactions (ADRs) associated with Fluticasone/Salmeterol?
What should be monitored in patients using Fluticasone/Salmeterol?
What should be monitored in patients using Fluticasone/Salmeterol?
What is an important counseling point for patients using Fluticasone/Salmeterol?
What is an important counseling point for patients using Fluticasone/Salmeterol?
What type of drug interactions should be considered with Fluticasone/Salmeterol?
What type of drug interactions should be considered with Fluticasone/Salmeterol?
Fluticasone/Salmeterol should not be used as primary treatment for status asthmaticus.
Fluticasone/Salmeterol should not be used as primary treatment for status asthmaticus.
There is a black box warning for increased asthma-related deaths with Fluticasone/Salmeterol.
There is a black box warning for increased asthma-related deaths with Fluticasone/Salmeterol.
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Study Notes
Brand Names
- Advair Diskus and Advair HFA are the brand names for Fluticasone/Salmeterol.
Common FDA Indications
- Approved for the treatment of asthma and chronic obstructive pulmonary disease (COPD).
Drug Class
- Classified as a combination of an Inhaled Corticosteroid and a Long-Acting β2-Adrenergic Agonist.
Mechanism of Action (MOA)
- Fluticasone functions as a synthetic corticosteroid with anti-inflammatory properties, acting as a human glucocorticoid receptor agonist that inhibits various cell types and mediators involved in asthma and COPD.
- Salmeterol, a long-acting β2-adrenergic agonist, stimulates adenylyl cyclase to convert ATP to cyclic AMP, resulting in bronchodilation and reduced mediator release from mast cells.
Renal Dosing Adjustment
- No renal dosing adjustment is required for use.
Available Dosage Forms
- Available as an aerosol powder for inhalation and metered dose inhaler (MDI).
Dosing Information
- For asthma, recommended dose is one disk or two MDI puffs every 12 hours, adjusted according to patient response.
- For COPD, recommended dose is one disk every 12 hours, also adjusted based on patient response.
Common Adverse Drug Reactions (ADRs)
- Frequently reported side effects include headache, pharyngitis, upper respiratory infection, and difficulty speaking.
- Less common side effects may include nausea, oral candidiasis, musculoskeletal pain, throat irritation, bronchitis, and dizziness.
Serious Adverse Drug Reactions
- Potential serious reactions include atrial fibrillation, myocardial infarction, anaphylaxis, osteoporosis, bronchospasm, exacerbation of asthma, and paradoxical bronchospasm.
Monitoring Parameters
- Monitor control of asthma or COPD symptoms, assessed through pulmonary function tests (PFTs).
- Assess for toxicity, focusing on bone mineral density and growth in children, routine ophthalmologic examinations, and signs of adrenal suppression or infection, including oral candidiasis.
Counseling Points
- Instruct on proper inhalation technique, advising to rinse the mouth with water post-use to prevent oral infections.
- Advise monitoring for toxicity signs like adrenal insufficiency and worsening pulmonary function.
Drug Interactions
- Be cautious with CYP3A4/5 inhibitors, as they may interact with Fluticasone/Salmeterol.
Contraindications
- Not to be used in cases of hypersensitivity to any component, including milk proteins.
- Should not be the primary treatment for status asthmaticus or acute episodes of asthma or COPD, and caution is advised with coadministration of posaconazole.
Black Box Warnings
- There is a risk of increased asthma-related deaths associated with this medication.
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