BCPP Pulmonary Reviews Questions/Answer 2025/2026
Graded A+
severe persistent asthma age 0-4 - >1 nighttime awakening/week
extreme effect on normal activity
symptoms several times/day
SABA use several times/day
treatment: medium dose ICS
intermittent asthma age >5 - nighttime awakenings <2 days/month
no effect on normal activity
symptoms <2 days/week
SABA use <2 days/week
treatment: SABA PRN
mild persistent asthma age >5 - 3-4 nighttime awakenings/month
minor effect on normal activity
symptoms >2 days/week
SABA use >2 days/week
treatment: low dose ICS
moderate persistent asthma age >5 - >1 nighttime awakening/week
some effect on normal activity
daily symptoms
daily SABA use
treatment: medium dose ICS or low dose ICS + LABA
severe persistent asthma age >5 - nighttime awakenings 7 times/week
extreme effect on normal activity
symptoms several times/day
SABA use several times/day
treatment: medium dose ICS or low dose ICS + LABA
budesonide nebulizer - low dose 0.25-0.5 mg
medium dose 0.5-1 mg
high dose >1 mg
budesonide DPI - low dose 180-360 mcg
medium dose 360-720 mcg
high dose >720 mcg
fluticasone MDI - low dose 88-176 mcg
medium dose 176-352 mcg
high dose >352 mcg
fluticasone DPI - low dose 100-200 mcg
, medium dose 200-400 mcg
high dose >400 mcg
beclomethasone MDI - low dose 80-160 mcg
medium dose 160-320 mcg
high dose >320 mcg
mometasone DPI - low dose 110 mcg
medium dose 220-440 mcg
high dose >440 mcg
cystic fibrosis - dornase alfa >6 years
hypertonic saline >6 years
azithromycin >6 years
CF- inhaled tobramycin dosing - Dose: 300 mg nebulized BID
28 days initial pseudomonas eradication therapy
28 days cycles in patients with persistent pseudomonas
CF- inhaled aztreonam lysine dosing - Dose: 75 mg nebulized TID
28 days cycles in patients with persistent pseudomonas
CF- inhaled colistin dosing - Dose: 75-150 mg of colistin base nebulized BID
use in patients with resistant bacteria
can be used chronically every other month or for acute exacerbation
CF- ivacaftor - CFTR potentiator
approved for patients >2 years
**take with fatty food to increase absorption
**CYP 3A4 substrate
CF- ivacaftor dosing - 2-5 y/o, < 14 kg: 50 mg PO BID
2-5 y/o, >/= 14 kg: 75 mg PO BID
>/= 6 y/o: 150 mg PO BID
CF- ivacaftor ADRs - Increased liver function tests (monitor LFTs every 3 months x 1
year followed by yearly), headache, sore throat, sinus congestion, runny nose, stomach
pain, diarrhea, rash, nausea, dizziness, eye cataracts
CF- ivacaftor/lumacaftor - CFTR modulator
approved for patients >12 years
monitor LFTs every 3 months x 1 year followed by yearly
**causes birth control to be ineffective
**take with fatty food to increase absorption
CF- ivacaftor/lumacaftor dosing - Dose: 2 tablets BID
Graded A+
severe persistent asthma age 0-4 - >1 nighttime awakening/week
extreme effect on normal activity
symptoms several times/day
SABA use several times/day
treatment: medium dose ICS
intermittent asthma age >5 - nighttime awakenings <2 days/month
no effect on normal activity
symptoms <2 days/week
SABA use <2 days/week
treatment: SABA PRN
mild persistent asthma age >5 - 3-4 nighttime awakenings/month
minor effect on normal activity
symptoms >2 days/week
SABA use >2 days/week
treatment: low dose ICS
moderate persistent asthma age >5 - >1 nighttime awakening/week
some effect on normal activity
daily symptoms
daily SABA use
treatment: medium dose ICS or low dose ICS + LABA
severe persistent asthma age >5 - nighttime awakenings 7 times/week
extreme effect on normal activity
symptoms several times/day
SABA use several times/day
treatment: medium dose ICS or low dose ICS + LABA
budesonide nebulizer - low dose 0.25-0.5 mg
medium dose 0.5-1 mg
high dose >1 mg
budesonide DPI - low dose 180-360 mcg
medium dose 360-720 mcg
high dose >720 mcg
fluticasone MDI - low dose 88-176 mcg
medium dose 176-352 mcg
high dose >352 mcg
fluticasone DPI - low dose 100-200 mcg
, medium dose 200-400 mcg
high dose >400 mcg
beclomethasone MDI - low dose 80-160 mcg
medium dose 160-320 mcg
high dose >320 mcg
mometasone DPI - low dose 110 mcg
medium dose 220-440 mcg
high dose >440 mcg
cystic fibrosis - dornase alfa >6 years
hypertonic saline >6 years
azithromycin >6 years
CF- inhaled tobramycin dosing - Dose: 300 mg nebulized BID
28 days initial pseudomonas eradication therapy
28 days cycles in patients with persistent pseudomonas
CF- inhaled aztreonam lysine dosing - Dose: 75 mg nebulized TID
28 days cycles in patients with persistent pseudomonas
CF- inhaled colistin dosing - Dose: 75-150 mg of colistin base nebulized BID
use in patients with resistant bacteria
can be used chronically every other month or for acute exacerbation
CF- ivacaftor - CFTR potentiator
approved for patients >2 years
**take with fatty food to increase absorption
**CYP 3A4 substrate
CF- ivacaftor dosing - 2-5 y/o, < 14 kg: 50 mg PO BID
2-5 y/o, >/= 14 kg: 75 mg PO BID
>/= 6 y/o: 150 mg PO BID
CF- ivacaftor ADRs - Increased liver function tests (monitor LFTs every 3 months x 1
year followed by yearly), headache, sore throat, sinus congestion, runny nose, stomach
pain, diarrhea, rash, nausea, dizziness, eye cataracts
CF- ivacaftor/lumacaftor - CFTR modulator
approved for patients >12 years
monitor LFTs every 3 months x 1 year followed by yearly
**causes birth control to be ineffective
**take with fatty food to increase absorption
CF- ivacaftor/lumacaftor dosing - Dose: 2 tablets BID
