3: Adult Asthma Flashcards

1
Q

Should you treat asthma during pregnancy?

A

Yes, beneficial outcomes for both mother and child. Asthma worsens for 1/3 and gets better for 1/3.

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2
Q

Should the PCP or OBGYN manage asthma during pregnancy?

A

PCP has better access to tools for treatment.

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3
Q

Most asthma medications are what pregnancy classification?

A

C

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4
Q

How do you manage an acute exacerbation?

A
  • Rapidly establish severity.
    • Concomitantly measure oxygen saturation; watch patient breathe; see if able to talk while breathing.
  • Check for and correct hypoxemia while figuring out modality to open up lungs.
  • Administer quick-relief medications.
  • Administer oral steroids while waiting for the EMTs.
  • Transferred to the hospital?
    • Yes: Continue to monitor the patient upon discharge.
    • No: Follow up within 2–7 days before treatment has been completed to assess success of treatment.
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5
Q

What exacerbations require steroids?

A

Moderate to severe.

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6
Q

Mild, moderate, severe, or life-threatening exacerbation?

  • Dyspnea interferes with or limits usual activity
  • Peak flow is 40–69% of predicted
  • Relief from frequently inhaled SABA
  • Treatment: oral corticosteroids
  • Relief within 1-2 days
A

Moderate

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7
Q

When do you transfer a patient to the ER?

A
  • Worsening respiratory distress
  • Persistent distress
  • Persistent hypoxemia
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8
Q

Mild, moderate, severe, or life-threatening exacerbation?

  • Dyspnea with activity Pulmonary function is 70% of predicted
  • Prompt relief with short-acting beta agonist (SABA)
A

Mild

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9
Q

What is the steroid dosing for adults outpatient?

A
  • Prednisone/Prednisolone
  • 1-2 mg/kg/day
  • Max 40-80 mg/day
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10
Q

Mild, moderate, severe, or life-threatening exacerbation?

  • Patient is unable to speak and perspiring.
  • Peak flow is less than 25% of predicted.
  • Patient is on continuous nebulizers and no relief from SABAs.
  • Hospitalization is required, potentially in ICU.
  • Treatment: Intravenous corticosteroids are a mainstay, while adjunctive therapies depend on what is popular.
A

Life-threatening

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11
Q

When is treatment failure considered in outpatient care?

A

If there are 3 back-to-back albuterol nebs or duo nebs without complete relief.

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12
Q

Mild, moderate, severe, or life-threatening exacerbation?

  • Dyspnea at rest and difficulty with regular conversation
  • Peak flow less than 40% of predicted or personal best
  • Partial relief from frequently inhaled SABAs
  • Never receive complete relief
  • Treatment: oral corticosteroids or IV corticosteroids in the hospital
  • Relief: symptoms persist for 3 days past the prescription
A

Severe (ER or hospitalize)

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13
Q

What is the preferred ICS in pregnancy?

A

Budesonide

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14
Q

What is the preferred SABA in pregnancy?

A

Albuterol

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15
Q

What is the preferred antihistamine in pregnancy if needed to control asthma and allergies or atopy together?

A

Loratidine or cetirizine (2nd gen)

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