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504 (Immunology) > Ashtma > Flashcards

Ashtma Flashcards

1
Q

T/F: Asthma is characterized by airway inflammation and airway hyporresponsiveness

A

True

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2
Q

Diagnosis is dependent on what two factors

A

Medical history and spirometry

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3
Q

How should FEV1 change in response to a bronchodilator

A

increase by 12% or greater

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4
Q

What is an exaggerated airway response to repeated stimulation/irritation is known as what

A

Bronchial hyperresponsiveness

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5
Q

What are the two types of asthma

A

Eosinophillic and noneosinophillic

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6
Q

What are the goals of therapy for asthma when it relates to reduced impairment

A

Require infrequent (less than 2 days a week) daytime symptoms and need reliever medications, have less than 2 nighttime awakenings per month from asthma

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7
Q

What is the cornerstone medication class for patients who have asthma

A

Inhaled corticoid steroids

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8
Q

When do full benefits become apparent with asthma patients who use inhaled corticoid steroids

A

3 months

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9
Q

What is used when selecting an ICS dose

A

Patient’s age, patient’s symptoms/impairment, patient’s exacerbation history/risk

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10
Q

Before moving to a different step of therapy what should be asses

A

adherence to the medication, inhaler technique, enviornmental exposures, confirm the symptoms are due to asthma

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11
Q

How long should patients be stable before stepping down

A

at least 3 months

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12
Q

What controller should be given if a patient is on step 1 of asthma treatment

A

no controller

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13
Q

What controller should be given if a patient is on step 2 of asthma treatment

A

Low dose Inhaled corticoid steroid

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14
Q

What controller should be given if a patient is on step 3 of asthma treatment

A

Low dose inhaled corticoid steroid with a long acting beta-2 agonist

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15
Q

What controller should be given if a patient is on step 4 of asthma treatment

A

Medium dose inhaled corticoid steroid with a long acting beta-2 agonist

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16
Q

What controller should be given if a patient is on step 5 of asthma treatment

A

High dose inhaled corticoid steroid with a long acting beta-2 agonist

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17
Q

What controller should be given if a patient is on step 6 of asthma treatment

A

High dose inhaled corticoid steroid with a long acting beta-2 agonist plus add-on therapy

18
Q

When giving patients self-managment education what should always be included

A

Written Asthma Action Plan

19
Q

What are triggers that can worse asthma

A

viral illness, exercise, pollution, stress

20
Q

What medication classes are triggers for asthma

A

Aspirin, NSAIDS, and Beta-blockers

21
Q

What are comorbid conditions that may worsen asthma

A

allergies, GURD, obesity, sleep apnea

22
Q

What the two types of ashthma medications

A

Quick relief medicatons (rescue/reliever) and controller medications (maintenance)

23
Q

Who should use controller medications

A

Daytime symptoms or reliever use greater that 2 days a week, nighttime awakening from asthma greater than 2 days per month

24
Q

What should every patient with ashtma be prescribed

A

Albuterol

25
Q

What are side effects of beta 2 agonists

A

tachycardia, tremor, excitement, nervousness

26
Q

What is the preferred initial and backbone controller medication for patients that are step 2 and higher

A

Inhaled corticosteroids

27
Q

What are the five inhaled corticosteroids used in asthma

A

Beclomethasone, budesonide, ciclesonide, fluticasone, mometasone

28
Q

T/F: Fluticasone is the preffered inhaled corticosteriod for pregnant patients

A

False: Budesonide is preferred in pregnancy

29
Q

What is a huge side effect ICS, how can this be avoided

A

thrush (oral candidasis), rinse out the mouth after use

30
Q

What are the medications that are added to ICS , when

A

LABA, stage 3

31
Q

T/F: LABAs can be used alone in treatment for asthma

A

False: LABAs can never be used alone in asthama

32
Q

What are the LABAs that are used in asthma

A

Formoterol, Salmeterol, Vilanterol

33
Q

Which of the LABAs has the fastest onset, longest duration

A

formoterol, vilanterol

34
Q

When would a LAMA be added to therapy for asthma

A

Step 4 or Step 5

35
Q

What are the monoclonal antibodies used for asthma

A

omalizumab, mepolizumab, reslizumab, benralizumab, dupllumab

36
Q

Which monoclonal antibody is used if there is high IgE levels (30-700 IU/ml)

A

Omalizumab

37
Q

How is dosing determined for Omalizumab

A

patients total baseline IgE level and body weight

38
Q

How should the eosinophil cell count be before using mepolizumab, resiluzmab or benralizumab

A

above 300 (above 400 for reslizumab)

39
Q

What is the only monoclonal antibody that can be administered at home

A

dupilumab

40
Q

When are oral corticosteroids given in asthma patients

A

step 6 as add on therapy

504 (Immunology) (19 decks)

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