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Board Study Topics > 00 Asthma > Flashcards

00 Asthma Flashcards

1
Q

What is important to tell asthmatics in regards to reducing respiratory infections?

A

Get flu shot each year

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2
Q

What drug classes can be used in asthma for Quick Relief?

A

Short Acting Beta-2 Agonist (SABA), Anticholinergics, Systemic corticosteroids

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3
Q

What drug classes can be used in asthma for Long-Term Control?

A

Corticosteroids (inhaled or systemic), Long Acting Beta-2 Agonists (LABA). Alternates: Leukotriene modifiers, Mast cell stabilizers, Theophylline, Omalizumab

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4
Q

How many symptoms/week can a patient have to be considered intermittent Asthma?

A

2 or less days/week

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5
Q

How much SABA use can a patient have to be considered intermittent Asthma?

A

2 or less days/week

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6
Q

How much interference with normal activity can a patient have to be considered intermittent Asthma?

A

None

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7
Q

How many exacerbations requiring PO corticosteroids can a patient have to be considered intermittent Asthma?

A

0-1/year

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8
Q

How many symptoms or SABA use can a patient have to be considered Persistent MILD Asthma?

A

> 2 days/week but not daily

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9
Q

How many symptoms or SABA use can a patient have to be considered Persistent MODERATE Asthma?

A

Daily

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10
Q

How many symptoms or SABA use can a patient have to be considered Persistent SEVERE Asthma?

A

Throughout the day

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11
Q

What kind of asthma does someone have if they are in Step 1?

A

Intermittent Asthma

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12
Q

What kind of asthma does someone have if they are in Step 2?

A

Mild Persistent Asthma

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13
Q

What kind of asthma does someone have if they are in Step 3 or 4?

A

Moderate Persistent Asthma

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14
Q

What kind of asthma does someone have if they are in Step 5 or 6?

A

Severe Persistent Asthma

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15
Q

What is the treatment of choice for all ages who are in Step 1?

A

SABA PRN

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16
Q

What is the treatment of choice for all ages who are in Step 2?

A

ICS (Low Dose)

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17
Q

What is the treatment of choice for all ages who are in Step 3?

A

ICS (Medium Dose). For ages 5+ you could use ICS (Low Dose) + LABA as another preferred regimen

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18
Q

What is the treatment of choice for all ages who are in Step 4?

A

ICS (Medium Dose) + LABA

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19
Q

What is the treatment of choice for all ages who are in Step 5?

A

ICS (High Dose) + LABA

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20
Q

What is the treatment of choice for all ages who are in Step 6?

A

ICS (High Dose) + LABA + Oral CS

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21
Q

Which beta-blockers can precipitate bronchospasm in patients with asthma, and can decrease SABA’s bronchodilating effect?

A

Non-selective BB’s (Propranolol, Timolol)

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22
Q

What is the generic name of Ventolin HFA?

A

Albuterol (SABA)

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23
Q

What is the generic name of Proventil HFA?

A

Albuterol (SABA)

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24
Q

What is the generic name of Proair HFA?

A

Albuterol (SABA)

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25
Q

How is Albuterol dosed?

A

90mcg/puff. 2 puffs Q4-6h PRN or EIB: 2 puffs 5 mins prior

26
Q

What is the generic name of Xopenex?

A

Levalbuterol HFA (SABA)

27
Q

How is Levalbuterol dosed?

A

45mcg/puff. 2 puffs Q4-6h PRN or EIB: 2 puffs 5 mins prior

28
Q

What are the corticosteroids used for short term control (3-10 days)?

A

Methylprednisolone (Medrol), Prednisolone, Prednisone

29
Q

How are the corticosteroids dosed for short term control (3-10 days)?

A

7.5-60mg daily QAM x5 days, QAM or QOD as needed for control

30
Q

What are the consequences of chronic steroid use?

A

PREDNISONE: PUD, Redistribution of fat, Electrolyte, Diabetes, Na or water retention, Insomnia/Immunosuppression, Skin thinning, Osteoporosis, Neuro (euphoria/depression), Eyes/cataracts

31
Q

What is the generic name of Atrovent HFA?

A

Ipratropium bromide (Anticholintergic)

32
Q

What are the ADRs with ICS?

A

Hoarseness, cough, dysphonia, throat irritation, oral thrust (candidiasis)

33
Q

How do the potencies of the ICS’s compare (in decreasing order of potency)?

A

“For More Beer, Buy From Target, Cool?”: Fluticasone, Mometasone, Budesonide, Beclomethasone HFA, Flunisolide, Triamcinolone, Ciclesonide”

34
Q

What is the generic name of QVAR HFA?

A

Beclomethasone HFA (ICS)

35
Q

What is the generic name of Pulmicort Flexhaler?

A

Budesonide DPI (ICS)

36
Q

What is the generic name of Pulmicort Respule?

A

Budesonide Neb (ICS)

37
Q

What is the generic name of Alvesco?

A

Ciclesonide HFA (ICS)

38
Q

What is the generic name of Aerospan HFA?

A

Flunisolide HFA (ICS)

39
Q

What is the generic name of Flovent HFA?

A

Fluticasone HFA (ICS)

40
Q

What is the generic name of Asmanex Twisthaler?

A

Mometsone (ICS)

41
Q

Which medication class for asthma carries a BBW and what is it?

A

LABAs: Increased risk of severe asthma episodes or asthma-related deaths. DO NOT use as monotherapy

42
Q

What is the generic name of Serevent Diskus?

A

Salmeterol DPI (LABA)

43
Q

What is the generic name of Advair HFA?

A

Fluticasone + Salmeterol (ICS + LABA)

44
Q

What is the generic name of Symbicort?

A

Budesonide + Formoterol (ICS + LABA)

45
Q

What is the generic name of Dulera?

A

Mometasone + Formoterol (ICS + LABA)

46
Q

What is the generic name of Foradil Aerolizer?

A

Formoterol DPI (LABA)

47
Q

What dosage strengths does Advair HFA come in?

A

45/21, 115/21, 230/21 (1 inhale BID)

48
Q

What dosage strengths does Advair Diskus come in?

A

100/50, 250/50, 500/50 (1 inhale BID)

49
Q

What dosage strengths does Symbicort come in?

A

80/4.5, 160/4.5 (2 puffs BID)

50
Q

What dosage strengths does Dulera come in?

A

100/5, 200/5 (2 puffs BID)

51
Q

What are the age restrictions for the combination ICS + LABA drugs?

A

All require 12+ years, except Advair DISKUS (> 4 years)

52
Q

What is the generic name of Intal?

A

Cromolyn Sodium (Mast Cell Stabilizer), not used much, dosed QID

53
Q

What is the generic name of Singulair?

A

Montelukast (Leukotriene Receptor Antagonist (LTRA))

54
Q

What can you mix the Singulair granules with?

A

CAIR: Carrots, Apple sauce, Ice cream, Rice. Can also use formula/breast milk

55
Q

What is the generic name of Accolate?

A

Zafirlukast (LTRA)

56
Q

What is important to note about taking Accolate (Zafirlukast)?

A

Take on empty stomach (1h before or 2h after meals)

57
Q

What is the generic name of Zyflo?

A

Zileuton (Leukotriene Production Inhibitor (LPI))

58
Q

When is Zyflo (Zileuton) contraindicated?

A

Active liver disease or persistent hepatic function enzyme elevation > 3x the upper limit of normal

59
Q

What is the generic name of Xolair?

A

Omalizumab (monoclonal antibody) - used as last resort

60
Q

If using Metered Dose Inhalers (MDI)s, how should you space the doses between themselves and other medications?

A

Separate SABA puffs by 1 min. No need to wait between ICS puffs. Separate different types of inhalers (e.g. SABA vs. ICS) by 5-10 min. Use bronchodilator first, then maintenance inhalers

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