Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
GENERIC NAME: fluticasone propionate and salmeterol
oral inhaler
BRAND NAME: Advair Diskus
DRUG CLASS AND MECHANISM: Advair Diskus is a combination of inhaled
drugs that is used to treat asthma and chronic bronchitis. In
patients with asthma, the airways (bronchioles) through which air moves in and out of the
lungs can be narrowed by accumulation of mucus, spasm of the muscles that
surround these airways, or swelling of the lining of the airways due to
inflammation. Airway narrowing leads to symptoms of shortness of breath,
wheezing, cough, and congestion. Medications used in treating asthma include
those that open airways, called bronchodilators, and those that reduce
inflammation.
Advair Diskus contains a combination of salmeterol, a bronchodilator of the
beta-2 agonist type, and fluticasone propionate, an anti-inflammatory
corticosteroid. Beta-2 agonists are medications that attach to beta-2 receptors
on the smooth muscle cells that surround the airways, causing the muscle cells
to relax and open the airways. Fluticasone propionate is a synthetic (man-made)
corticosteroid of the glucocorticoid family which is related to the natural
hormone, cortisol or hydrocortisone, produced by the adrenal glands.
Glucocorticoid steroids have potent anti-inflammatory actions. In asthmatic
patients, the suppression of inflammation within the airways reduces the
swelling caused by inflammation that narrows the airways. At the same time,
mucus is reduced. When used in lower doses, very little inhaled fluticasone
propionate is absorbed into the body. When higher doses are used, fluticasone is
absorbed and may cause side effects elsewhere in the body.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Advair Diskus is available in three different forms
containing the same amount of salmeterol, 50 mcg, but differing in the amount of
fluticasone propionate. 100/50 provides 100 mcg of fluticasone propionate,
250/50 provides 250 mcg of fluticasone propionate, and 500/50 contains 500 mcg
of fluticasone propionate per inspiration.
STORAGE: Advair Diskus should be stored at 36-86 F (2.2-30 C). It should be
kept away from heat or flames and should not be punctured; it should not be
frozen or placed in direct sunlight.
PRESCRIBED FOR: Advair
Diskus is used for the treatment of asthma or
chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis.
Its action starts within 30 to 60 minutes and can last more than 12 hours.
Advair Diskus is generally not needed in patients whose asthma can be controlled
easily with infrequent administration of short acting inhalers. Advair Diskus
should not be used to treat acute episodes of asthma or COPD.
DOSING: The recommended regimen for asthma in individuals 12 years and
older is one inhalation twice daily (morning and evening) approximately 12 hours
apart. The lowest effective strength should be used and the maximum dose is
500/50 mcg twice daily. For children 4 to 11 years old the recommended treatment
is one inhalation of 100/50 mcg twice daily.
The recommended regimen for COPD is one inhalation of 250/50 mcg twice daily.
Higher doses are not more effective.
The Diskus device is held in one hand with the thumb of the other hand placed
on the thumb-grip. The thumb is then pulled away as far as the device allows
until the mouthpiece seems to click into position. With the Diskus then held
horizontally and with the mouthpiece towards the patient, the lever is then slid
away as far as it can go until it clicks. The patient breathes out as far as
comfortable, then placing his mouth to the mouthpiece, breathes in quickly and
deeply and holds his breath for about ten seconds. The patient then washes his
or her mouth without swallowing after inhalation.
Bronchitis is a disease of the respiratory system in which the bronchial passages become inflamed. There are two types of bronchitis, acute and chronic. Symptoms of acute bronchitis include frequent cough with mucus, lack of energy, wheezing, and possible fever. Treatment may require medication such as bronchial inhalers and predinsone. Supportive treatment is focused on relieving the symptoms with fever reducers, cough suppressants, and rest. Treatment may be more aggressive in patients with pre-existing conditions such as empyema, COPD, or cigarette smoking.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
Emphysema is a progressive disease of the lungs. The primary cause of emphysema is smoking. Alpha 1-antitrypsin deficiency is a rare disorder that has a genetic predisposition to emphysema. Aging, IV drug use, immune deficiencies, and connect tissue illnesses are also risk factors for emphysema. Emphysema is a subtype of COPD (chronic obstructive pulmonary disease, COLD). Symptoms include shortness of breath and wheezing. Management of symptoms may be achieved with medications, quitting smoking, pulmonary rehabilitation, or surgery.
Patients who have infrequent, mild bouts of asthma attacks may use over-the-counter (OTC) medications to treat their asthma symptoms. OTC asthma medicines are limited to epinephrine and ephedrine. These OTC drugs are best used with the guidance of a physician, as there may be side effects and the drugs may not be very effective.
Asthma, the main cause of chronic illness in children, has signs and symptoms in children that include frequent coughing spells, low energy while playing, complaints of chest "hurting," wheezing while breathing, shortness of breath, and feelings of tiredness. Treatment will involve a doctor creating an asthma action plan which will describe the use of asthma medications and when to seek emergency care for the child.
Bronchiectasis is a condition in which the bronchial tubes of the lung become damaged. Inflammation from infection or other causes destroys the smooth muscles of the bronchial tubes. Bronchiectasis is a form of COPD (which includes emphysema and chronic bronchitis). There are three primary types of bronchiectasis: 1) cylindrical bronchiectasis; 2) saccular bronchiectasis; and 3) cystic bronchiectasis. Bronchiectasis may also be acquired or congenital. The most common symptoms of bronchiectasis are recurrent cough and sputum production. There is no cure for bronchiectasis. Treatment is often geared toward controlling the symptoms of bronchiectasis.
There are many unusual symptoms of asthma, including sighing, difficulty sleeping, anxiety, chronic cough, recurrent walking pneumonia, and rapid breathing. These symptoms may vary from individual to individual. These asthma complexities make it difficult to accurately diagnose and treat asthma.
There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC drugs like Primatene Mist and Bronkaid.
Doctors and asthma specialists recognize that asthma has two main
components: airway inflammation and acute bronchoconstriction (constriction of
the airways). Research has shown that reducing and preventing further
inflammation is the key to preventing asthma attacks, hospitalizations, and
death from asthma.
Long-term control asthma medications are taken daily over an extended period
of time to achieve and maintain control of persistent asthma (asthma that
causes symptoms more than twice a week and frequent attacks that affect
activity).
The most effective long-term control asthma medications are those that stop
airway inflammation (anti-inflammatory drugs), but there are others that are
often used along with anti-inflammatory drugs to enhance their effect.
Long-term control asthma medications include:
Corticosteroids (The inhaled form is the anti-inflammatory dru...
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