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Created with Fabric.js 1.4.5 ADVAIR: FLUTICASONE PROPIONATE/ SALMETEROL Fluticasone propionate: is a synthetic trifluorinated corticosteroid with potent anti-inflammatory activity. It has a human glucocorticoid receptor agonist with a high affinity. Corticosteroids have been shown to inhibit multiple cell types and mediator production or secretion involved in the asthmatic response. Mechanism of Action Fluticasone propionate: is a synthetic trifluorinated corticosteroid with potent anti-inflammatory activity.It has a human glucocorticoid receptor agonist with a high affinity. Corticosteroids have been shown to inhibit multiple cell types and mediator production or secretion involved in the asthmatic response. Oral Inhalation (aerosol or powder) Advair Diskus Asthma Adults and Adolescents 12 years + 1 inhalation twice daily (12 h apart) (max, 500/50 twice daily). The recommended starting dosage is based on the patient's asthma severity. Children 4 to 11 y of age 1 inhalation of fluticasone/salmeterol 100/50 (12 h apart).The recommended starting dosage is based on the patient's asthma severity. COPD Adults Inhalation 1 inhalation (250/50) twice daily (12 h apart).Advair HFA Asthma Adults/Adolescents 12 years + 2 inhalations (230/21) twice daily (12 h apart) The recommended starting dosage is based on the patient's asthma severity. Bioavailability: Fluticasone, 5%Onset (salmeterol): Asthma, 30-48 min; COPD, 2 hrOnset (fluticasone): >1-2 weeksPeak plasma time: Fluticasone, 1-2 hr; salmeterol, 20 minPeak plasma concentration: Fluticasone, 110 pg/mL; salmeterol,196-223 pg/mLTime to peak effect (salmeterol): Asthma, 3 hr; COPD, 2-5 hrProtein bound: Fluticasone, 99%; salmeterol, 96%Vd: Fluticasone, 4.2 L/kgMinimally metabolized, because of minimal absorptionFluticasone metabolized in liver by CYP3A4 to metabolitewith negligible activity; salmeterol extensively metabolized by hydroxylation Half-life: Fluticasone, 11-12 hr; salmeterol, 5.5 hrExcretion (fluticasone): Feces (95%), urine (5%)Excretion (salmeterol): Feces (60%), urine (25%) Excretion Metabolism Absorption Distribution Indications/ usage:For the treatment of asthma in patients 4 years and older ( Advair Diskus ) and in patients 12 years and older ( Advair HFA ); maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and/or emphysema ( Advair Diskus ); Contraindications:Primary treatment of status asthmaticus or other acute episodes of asthma or COPD in which intensive measures are required; hypersensitivity to any component of the product; severe hypersensitivity to milk proteins (Advair Diskus). Risk of potentially fatal acute asthmaRisk of localized Candida albicans infectionsRisk of pneumonia and lung infectionRisk of more serious or fatal course of chickenpoxRisk of paradoxical bronchospasmMay decrease growth velocity in childrenRisk of cataracts and glaucomaRisk of systemic eosinophilic conditions Clinical trials:Studies Comparing Advair HFA With Fluticasone Propionate Alone or Salmeterol Alone Special population: patients with hepatic disease
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