asthma – Memory Pharm

Inhaled Corticosteroid Combinations

Leave a Comment / Pulmonology / Marlene Hernandez

🧠Memory tips for inhaled corticosteroid combinations!⁠
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🌬️Inhaled corticosteroids are first-line options for treating patients with asthma. But many of these inhalers are brand-name only and some come in combination with long-acting beta 2 agonists or inhaled anticholinergics. ⁠
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🫁Inhaled corticosteroids work by reducing inflammation and swelling in the airways. Reducing inflammation makes it easier to breathe, which minimizes asthma attacks. But these medications have to be taken daily, and it may take several weeks before they’re fully effective.⁠
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🧠Some of these brands are often used on exams and it is helpful to know what their combinations are: ⁠
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TIP – we would never put two corticosteroids together so for example if the question asks about Symbicort – the answer should be ✅️budesonide with formoterol (ICS + LABA) NOT ❌️budesonide with fluticasone (ICS + ICS). ⁠

⁠👉🏻Quiz yourself on how well you know the combinations and some of my memory tips on remembering them!

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Asthma, Management of

📖 Asthma is a common airway disease and has a range of severity, from a very mild, occasional wheeze to acute, life-threatening airway closure. It usually presents in childhood and is associated with other features of atopy, such as eczema and hayfever.⁠ ⁠ 💊 Medical management includes bronchodilators like beta-2 agonists and muscarinic antagonists (salbutamol and ipratropium bromide respectively) and anti-inflammatories such as oral or nebulized steroids. Theophylline was once popular but is rarely used due to its narrow therapeutic index and side effect profile. However, it is still important to note as there are patients still treated with it. ⁠ ⁠ 💊 Patients with life-threatening asthma are managed with high flow oxygen inhalation, systemic steroids, back-to-back nebulizations with short-acting beta 2 agonists, and short-acting muscarinic antagonists, and intravenous magnesium sulfate.⁠ ⁠ 💊 Antibiotics should only be used if an infection is suspected (positive CXR, symptoms of cough and purulent sputum production, fever, high WBC, etc.) and should be withheld if not, to reduce the rise of antimicrobial resistance. ⁠