asthma Flashcards

1
Q

what is asthma

A

chronic lung disease that inflames and narrows the airways

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2
Q

pathophys of asthma (4)

A
  • bronchial inflammation and bronchoconstriction that affects all levels of the airway
  • increases mucus secretion
  • loss of barrier increases susceptibility to eosinophils, etc
  • loss of enzymes that typicaly breakdown inflammatory mediators
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3
Q

what does PFT measure

A

amount and speed of air

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4
Q
  • Test for airflow limitation & severity
  • Assess for obstruction reversibility
  • Identify restrictive airway pattern

what test does this

A

PFT

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5
Q

you should not use a bronchodilator within ____ of their PFT

A

48hrs

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6
Q

normal FEV1 to FVC ratio

A

at least 80%

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7
Q

FEV1/FVC of obstructive vs restrictive

A
  • obstructive it is reduced
  • restrictive it is normal
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8
Q

give examples of extrinsic/atopic triggers

A

pollen
mold
eggs and berries

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9
Q

give examples of intrinsic/nonatopic triggers

A
  • nonallergic (leukotrienes, etc)
  • environmental
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10
Q

give examples of EIB triggers

A

related to activity
* chlorine
* pollution
* hot/cold dry air

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11
Q

tx of EIB

A
  • SABA 10 to 15mins before exercise
  • controller meds
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12
Q

a way to self-monitor asthma

A

peak flow meter

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13
Q

what is the rule of two used for

A
  • to decide if controller med is needed
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14
Q

state the rule of twos! (4)

A
  • Using a rescue inhaler >2x/week?
  • Wake up w/ sx >2x/month?
  • Refill rescue inhaler > 2x/year?
  • Peak blow at 20% below baseline w/ asthma sx?
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15
Q

what is the pulmonary index score (PIS)?

A

assessment tool for kids with acute asthma exacerbation

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16
Q

what is the pulmonary index score (PIS)?

A

assessment tool for kids with acute asthma exacerbation

17
Q
  • Used w/ MDI to minimize systemic absorption and limit local SE
  • all ICS MDI should be used w/ this device in all patients

what device does this describe?

A

holding chambers

18
Q

what three medications can be a trigger for asthma

A

NSAIDs
BB
Aspirin

19
Q

decreases cellular migration and inhibits fluid release and accumulation of leukocytes –> reduction of inflammatory cells

what medications

A

inhaled ICS

20
Q

inhibits the action of leukotrienes, which are a family of products generated from the metabolism of arachidonic acid in leukocytes

A

leukotriene antagonists (montelukast, zafirlukast)

21
Q

stimulate B-2 receptors in airway cells to produce smooth muscle relaxation and bronchodilation caused by adenylyl cyclase activation to produce cyclic 3’5’ AMP

what medication

A

SABA

22
Q

if you see patient presenting with asthma sx and they also have a nasal polyp, what should you be suspecting

aka Sampters triad?

A

aspirin induced asthma

23
Q

how fast do SABAs work

A

5-10 minutes

24
Q

if a patient with asthma develops influenza A, which flu medication would you want to avoid giving them? why?

A

Zanamivir bc increases risk of bronchospasm

25
Q

green zone corresponds with ____ % of the best peak flow

A

80%

26
Q

yellow zone corresponds with ____ % of the best peak flow

A

50-79%

27
Q

bronchodilator that prevents sx (esp. Nocturnal asthma)

A

LABA (salmeterol, formoterol)

28
Q

anti-inflammatory; All but the mildest exacerbations should be discharged on a short course of this

A

oral steroids

29
Q

Hits B1 and B2→ long term use increases risk of cardiomyopathies!!!!

A

EPI

30
Q

which class is always used in combo with ICS, only if persistent asthma is not controlled w/ ICS

A

LABA

31
Q

Meds for pt w/ asthma + allergic rhinitis. Prophylaxis only

A

leukotriene antagonists

32
Q

side effects of this class includes

  • HA
  • Mild-flu sx
  • Aggressive behav., agitation
  • hepatic issues (which specific med?)
A

Leukotriene antagonist
hepatic– zafirlukast

33
Q

these are SE for?

  • Euphoria, energetic
  • Insomnia
  • hunger
  • cataracts
  • moon face
A

first 3 are short term SE of Oral steroids

34
Q

which med requires serum monitoring to avoid toxicities (5-15 mcg/ml) and multiple drug interactions

A

theophylline

35
Q
  • bronchodilator that improves resp. muscle endurance, PPD inhibitor which inhibits lekotriene synthesis and inflammation
  • nonselective adenosine receptor antagonist
  • requires higher doses in smokers
  • used as long-term prophylaxis in select ppl
A

theophylline