09 Asthma Gallegos Flashcards
What happens with airway remodeling in asthma?
Inflammation. Mucus hypersecretion. Subepithelial fibrosis. Airway smooth muscle hypertrophy. Angiogenesis. Remodeling usually only happens in chronic uncontrolled asthma
What is Atopy?
A risk factor of asthma. The propensity to produce abnormal amounts of IgE in response to exposure to environmental allergens
What foods should be avoided with Sulfite Sensitivity?
Processed foods, shrimp, beer, or wine if they cause symptoms
What are the key measures of Spirometry?
FVC (forced vital capacity). FEV1 (forced expiratory volume in 1 second)
What FEV1 is considered mild, moderate, or severe?
Mild: 61-80. Moderate: 41-60. Severe < 40
For treatment step-up, what is preferred in Step 1?
SABA PRN
For treatment step-up, what is preferred in Step 2?
Low-dose ICS
For treatment step-up, what is preferred in Step 3?
Low-dose ICS + LABA. OR. Medium-dose ICS
For treatment step-up, what is preferred in Step 4?
Medium-dose ICS + LABA
For treatment step-up, what is preferred in Step 5?
High-dose ICS + LABA and consider Omalizumab for patients who have allergies
For treatment step-up, what is preferred in Step 6?
High-dose ICS + LABA + oral corticosteroid and consider Omalizumab for patients who have allergies
What are the ICS options?
Beclomethasone, Ciclesonide, Flunisolide, Fluticasone, Budesonide, Mometasone
What is the Mast Cell Stabilizer that can be used?
Cromolyn
What are the LTRA options?
Montelukast, Zafirlukast, Zileuton
What is the Methylxanthine option?
Theophylline
What is the “Rules of 2”?
If any of the following are identified, patient may need an adjustment in asthma controller medication (assuming patient is compliant): Daytime symptoms frequency >2/week, Nighttime symptom frequency > 2/month, >2 canisters of SABA/year, 2+ exacerbations/year (/6 months for 0-4 years old). Answering yes to any of these questions may indicate that asthma is not well controlled
What is PEK flow based on?
Gender, age, and height
What are the LABAs that can be used?
Salmeterol, Formoterol