Respiratory Medications and Inhalers: PTCB Drug Review

Respiratory Drugs on the PTCE

Asthma and COPD affect millions of Americans, making respiratory medications a high-frequency topic on the PTCE. Understanding drug classes, inhaler devices, and patient counseling points is essential.

Short-Acting Beta-2 Agonists (SABAs)

Albuterol (ProAir, Ventolin, Proventil) is the primary rescue inhaler. Onset within 5 minutes, duration 4-6 hours. Used for acute bronchospasm. Side effects: tremor, tachycardia, nervousness. Counsel patients to rinse the mouth after use to prevent oral thrush with any inhaler, though this is most critical with ICS.

Long-Acting Beta-2 Agonists (LABAs)

Examples: salmeterol (Serevent), formoterol (Foradil). Used for maintenance therapy, never for acute attacks. Black box warning: Increased risk of asthma-related death when used without an inhaled corticosteroid. Always prescribed with ICS in asthma.

Inhaled Corticosteroids (ICS)

The cornerstone of asthma maintenance therapy. Examples: fluticasone (Flovent), budesonide (Pulmicort), beclomethasone (QVAR), mometasone (Asmanex). Side effects: Oral thrush (candidiasis) and hoarseness. Critical counseling: Rinse mouth with water and spit after each use.

Combination Inhalers

Fluticasone/salmeterol (Advair) - ICS + LABA
Budesonide/formoterol (Symbicort) - ICS + LABA
Fluticasone/vilanterol (Breo Ellipta) - ICS + LABA, once daily

Anticholinergics (Muscarinic Antagonists)

Ipratropium (Atrovent) - Short-acting, used in COPD
Tiotropium (Spiriva) - Long-acting, once-daily maintenance for COPD
Umeclidinium (Incruse Ellipta) - Long-acting LAMA

Other Respiratory Drugs

Montelukast (Singulair) - Leukotriene receptor antagonist. Oral tablet taken at bedtime. Black box warning for neuropsychiatric effects. Theophylline - Narrow therapeutic index bronchodilator with drug interactions and toxicity concerns.

Know the inhaler brand-generic pairs cold for the PTCE. Combination products are especially popular test questions.