Adult Asthma

Question 1

At what age is an asthma patient considered an adult?

Answer 1

≥ 12 years old

Question 2

Describe Step 1 of asthma therapy in adults.

Answer 2

SABA PRN

Question 3

Describe Step 2 of asthma therapy in adults.

Answer 3

Preferred: Low dose ICS
Alternative: cromolyn, LTRA, nedocromil, theophylline

Question 4

Describe Step 3 of asthma therapy in adults.

Answer 4

Preferred: Low dose ICS + LABA -or- medium dose ICS
Alternative: low dose ICS + LTRA/theophylline/zileuton

Question 5

Describe Step 4 of asthma therapy in adults.

Answer 5

Preferred: medium dose ICS + LABA
Alternative: medium dose ICS + LTRA/theophylline/ zileuton

Question 6

Describe Step 5 of asthma therapy in adults.

Answer 6

high dose ICS + LABA
-and-
consider omalizumab for patients with allergies

Question 7

Describe Step 6 of asthma therapy in adults.

Answer 7

high dose ICS + LABA + oral corticosteroid
-and-
consider omalizumab for patients with allergies

Question 8

At what step in therapy should a pulmonologist or asthma specialist take over?

Answer 8

step 4

Question 9

What is the therapy of choice for acute exacerbations?

Answer 9

SABA

Question 10

SABAs are not recommended for long term use. (T/F)

Answer 10

True

Question 11

What is the ADR of long term SABA use?

Answer 11

tachyphylaxis - loses efficacy

Question 12

When would systemic corticosteroids be necessary in adult asthma?

Answer 12

acute exacerbations

Question 13

How is status asthmaticus different from an acute exacerbation?

Answer 13

presentation is similar but in SA, patient experiences agitation, AMS, cyanosis, diaphoresis

Question 14

How is the severity of status asthmaticus assessed?

Answer 14

• clinical findings
• peak flow < 200 L/min
• hypoxemia ( PaO₂ < 60, SpO₂ < 90)
• or- hypercapnia (PaCO₂ > 40)

Question 15

What are the treatment cascade for status asthmaticus in adults?

Answer 15

• oxygen
• systemic steroids IV
• SABAs ± ipratropium
• magnesium
• ketamine
• propofol
• inhaled anethesia