University of Pittsburgh Health Sciences eLearning Environment Internet-based Studies in Education and Research
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INTRODUCTION
NABP and DOB Data Collection
PULSE: 6/2/2021 - Inhaled Corticosteroid for PRN usage?
QUIZ
EVALUATION
CERTIFICATE
INTRODUCTION
Credit Hours: Pharmacy 1.00
Target Audience:
Abstract:
Prior to 2019 inhaled corticosteroids were reserved for moderate to severe asthma and were 3rd or 4th line options. Patients with more severe asthma had to carry or have multiple inhalers they had to use throughout the day. It was previously believed that long-acting beta agonists were not appropriate therapy in exacerbations in place of a short acting beta agonist such as albuterol. In 2019 the Global Initiative for Asthma (GINA) put out new guidelines indicating that as needed usage of LABA-ICS was now the preferred reliever therapy for all adults and adolescents with asthma. Short acting beta agonists were moved to secondary reliver options. Additionally, in step 2 of asthma escalation therapy low dose as needed ICS-Formoterol is now a mainstay of mild asthma.
In children ages 6-11 the 2019 guidelines updated recommendations for controller options. For initial intermittent or mild asthma, the new recommendations are to use a low dose ICS whenever a SABA is taken. This is a change from previous recommendations where the preferred reliver was a SABA alone. Overall, the new guidelines are a big shift from traditional recommendations of the past. The new recommendations for adolescents and adults allow patients to have less systemic exposure from corticosteroids when compared to twice daily dosing of inhaled corticosteroids, only carry one inhaler, and has overall increased patient satisfaction.
Who should attend:
- Clinical faculty from the University of Pittsburgh School of Pharmacy
- Clinical staff pharmacists employed by the University of Pittsburgh Medical Center and deployed throughout the hospital campus in unit based roles and centrally in the department of pharmacy's main pharmacy
- Student pharmacy interns currently working within the department of pharmacy
- Certified Pharmacy Technicians
Abstract:
Prior to 2019 inhaled corticosteroids were reserved for moderate to severe asthma and were 3rd or 4th line options. Patients with more severe asthma had to carry or have multiple inhalers they had to use throughout the day. It was previously believed that long-acting beta agonists were not appropriate therapy in exacerbations in place of a short acting beta agonist such as albuterol. In 2019 the Global Initiative for Asthma (GINA) put out new guidelines indicating that as needed usage of LABA-ICS was now the preferred reliever therapy for all adults and adolescents with asthma. Short acting beta agonists were moved to secondary reliver options. Additionally, in step 2 of asthma escalation therapy low dose as needed ICS-Formoterol is now a mainstay of mild asthma.
In children ages 6-11 the 2019 guidelines updated recommendations for controller options. For initial intermittent or mild asthma, the new recommendations are to use a low dose ICS whenever a SABA is taken. This is a change from previous recommendations where the preferred reliver was a SABA alone. Overall, the new guidelines are a big shift from traditional recommendations of the past. The new recommendations for adolescents and adults allow patients to have less systemic exposure from corticosteroids when compared to twice daily dosing of inhaled corticosteroids, only carry one inhaler, and has overall increased patient satisfaction.
Educational Objectives:
Upon successful completion of this continuing pharmacy education program, the participant should be able to:
- Recognize the four categories of asthma classification.
- Define the current place in therapy for ICS/LABA and ICS PRN use.
- Identify the benefits of the 2019 GINA updates on adults & adolescents 12+ and older.
Pharmacy Continuing Education Credits In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.Pharmacy (ACPE): This knowledge-based activity provides 1.0 contact hours of continuing pharmacy education credit. The assigned universal program number(s) is JA4008223-0000-23-095-H01-P Other Healthcare Professionals Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity. |
Suggested Additional Reading:
- National Asthma Education and Prevention Program: Expert panel report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD: National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051) www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on June 03, 2018).
- Yunginger JW, Reed CE, O'Connell EJ, Melton LJ 3rd, O'Fallon WM, Silverstein MD. A community-based study of the epidemiology of asthma. Incidence rates, 1964-1983. Am Rev Respir Dis. 1992 Oct;146(4):888-94. doi: 10.1164/ajrccm/146.4.888. PMID: 1416415
- Adapted from National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma 2007. U.S. Department of Health and Human services. Available at Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (nih.gov)
- Bhakta NR, Choo E. Drugs Used in Asthma & Chronic Obstructive Pulmonary Disease. In: Katzung BG, Vanderah TW. eds. Basic & Clinical Pharmacology, 15e. McGraw-Hill; Accessed May 04, 2021
- Tattersfield AE, Harrison TW, Hubbard RB, et al. Safety of Inhaled Corticosteroids. American Thoracic Society. April 2004; 1(3): 171-175
- Arlt W. Disorders of the Adrenal Cortex. In: Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 20e. McGraw-Hill; Accessed May 04, 2021
- O'Byrne PM, FitzGerald JM, Bateman ED, et al. Inhaled combined budesonide-formoterol as needed in mild asthma. N Engl J Med. 2018;378(20):1865–76.
- Hardy J, Baggott C, Fingleton J, et al. Budesonide-formoterol reliever therapy versus maintenance budesonide plus terbutaline reliever therapy in adults with mild to moderate asthma (PRACTICAL): a 52-week, open-label, multicentre, superiority, randomized controlled trial. Lancet. 2019 Sep 14;394(10202):919-928. doi: 10.1016/S0140-6736(19)31948-8. Epub 2019 Aug 23. Erratum in: Lancet. 2020 May 2;395(10234):1422
Authors:
Garrett Day, PharmD
—
PGY1 Health System Pharmacy Administration and Leadership Pharmacy Resident, Pharmacy and Therapeutics, University of Pittsburgh
No relationships with industry relevant to the content of this educational activity have been disclosed.
No relationships with industry relevant to the content of this educational activity have been disclosed.
No other members of the planning committee, speakers, presenters,
authors, content reviewers and/or anyone else in a position to
control the content of this education activity have relevant
financial relationships with any companies whose primary business
is producing, marketing, selling, re-selling, or distributing
healthcare products used by or on patients.
The certificate issued at the end of this course is not official, it only indicates you obtained a passing grade for this activity.
The ACPE and the National Association of Boards of Pharmacy (NABP) have developed a continuing pharmacy education (CPE) tracking service, CPE Monitor, that will authenticate and store data for completed CPE units received by pharmacists and pharmacy technicians from ACPE-accredited providers.
ACPE credit for participation in any pharmacist and/or technician achieved from this website is entered quarterly. Please allow 60 days from date of completion, for your credits to be added to the CPE Monitor.
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