Asthma Medication Flashcards

A pregnant patient in her third trimester has moderate persistent asthma. Which ICS is considered the preferred agent due to the most safety data in pregnancy?

Answer: Budesonide

Budesonide has the most human pregnancy safety data and is the preferred ICS during pregnancy per NAEPP guidelines.

Which adverse effect is MOST associated with long-term systemic corticosteroid use in pediatric asthma patients?

Answer: Growth suppression

Long-term systemic corticosteroids in children can suppress the hypothalamic-pituitary axis and impair linear growth.

Dupilumab (Dupixent) targets which cytokine pathway making it effective in eosinophilic and type 2 asthma?

Answer: IL-4/IL-13 via IL-4Rα blockade

Dupilumab blocks IL-4Rα, inhibiting both IL-4 and IL-13 signaling, key drivers of type 2 inflammation.

When stepping DOWN asthma therapy per GINA/NAEPP guidelines, what minimum period of symptom control should be achieved before reducing medication?

Answer: 3 months

GINA recommends at least 3 months of good asthma control before considering step-down of controller therapy.

A patient takes salmeterol (Serevent) as monotherapy without an ICS. What is the primary safety concern?

Answer: Increased risk of asthma-related death (black box warning)

LABA monotherapy (without ICS) carries an FDA black box warning for increased risk of asthma-related death.

Which inhaler device requires NO coordination between actuation and inhalation, making it useful for patients who struggle with MDI technique?

Answer: Dry powder inhaler (DPI)

Dry powder inhalers (DPIs) are breath-actuated, so drug delivery depends on the patient's inspiratory effort rather than manual coordination.

Oral montelukast carries an FDA Boxed Warning added in 2020 regarding which serious adverse effect?

Answer: Neuropsychiatric events including suicidal ideation

The 2020 FDA Boxed Warning for montelukast warns about serious neuropsychiatric events including agitation, depression, and suicidal thinking.