asthma Flashcards
description
recurrent episodes of dyspnoea
cough and wheeze caused by reversible airway obstruction
causes of airway narrowing
bronchial muscle contraction
mucosal swelling/inflammation caused by mast cell and basophil degranulation resulting in release of inflammatory mediators
increased mucus production
presentation: symptoms
intermittent dyspnoea
wheeze
cough- often nocturnal
severe- can’t complete sentence
presentation- signs (6)
tachypnoea
audible wheeze
hyper inflated chest
hyper resonant percussion notes
diminished air entry
wide-spread polyphonic wheeze
presentation- life threatening
silent chest
cyanosis
bradycardia
tests
PEF
Spirometry
5- step treatment
occasional short acting inhaled B agonist as required
if uses more than once daily- add standard dose inhaled steroid- low dose inhaled corticosteroid
add long acting B agonist- if needed increase dose of inhaled steroid. if no effect of LABA stop and review diagnosis. leukotriene receptor antagonist or oral theophylline may be tried
consider trial of oral beclometasone, theophylline and B2 agonists
add oral prednisolone
treatment- acute
oxygen
nebuliser SABA and ipratropium bromide
prednisolone/hydrocortisone
magnesium sulphate
triggers
Infection Night time or early morning Exercise Animals Cold/damp Dust Strong emotions
relievers
SABAs
LABAs
CysLT1 receptor agonists
Methyxanthines
preventers
Glucocorticoids
Cromoglicate
Humanised Monoclonal IgE Antibodies
Methyxanthines
name some SABAs
salbutamol
albuterol
name some LABAs
salmeterol
formoterol
