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

25
What are side effects of beta 2 agonists
tachycardia, tremor, excitement, nervousness
26
What is the preferred initial and backbone controller medication for patients that are step 2 and higher
Inhaled corticosteroids
27
What are the five inhaled corticosteroids used in asthma
Beclomethasone, budesonide, ciclesonide, fluticasone, mometasone
28
T/F: Fluticasone is the preffered inhaled corticosteriod for pregnant patients
False: Budesonide is preferred in pregnancy
29
What is a huge side effect ICS, how can this be avoided
thrush (oral candidasis), rinse out the mouth after use
30
What are the medications that are added to ICS , when
LABA, stage 3
31
T/F: LABAs can be used alone in treatment for asthma
False: LABAs can never be used alone in asthama
32
What are the LABAs that are used in asthma
Formoterol, Salmeterol, Vilanterol
33
Which of the LABAs has the fastest onset, longest duration
formoterol, vilanterol
34
When would a LAMA be added to therapy for asthma
Step 4 or Step 5
35
What are the monoclonal antibodies used for asthma
omalizumab, mepolizumab, reslizumab, benralizumab, dupllumab
36
Which monoclonal antibody is used if there is high IgE levels (30-700 IU/ml)
Omalizumab
37
How is dosing determined for Omalizumab
patients total baseline IgE level and body weight
38
How should the eosinophil cell count be before using mepolizumab, resiluzmab or benralizumab
above 300 (above 400 for reslizumab)
39
What is the only monoclonal antibody that can be administered at home
dupilumab
40
When are oral corticosteroids given in asthma patients
step 6 as add on therapy