Asthma Flashcards
what is asthma?
reversible obstruction of bronchioles (small airways)
what causes asthma?
allergens that lead to inflammation/narrowing of bronchioles-thick mucus forms= reduced air flow
what are the symptoms of asthma?
wheeze
breathless
cough
what is the assessment to check the severity of asthma? and what does it measure?
peak expiratory flow rate
-measures how quickly you can blow air out of lungs
when is PEFR normally worse?
mornings
what questions should you ask about PEFR?
todays PEFR and best PEFR
what are the mild/severe/LT PEFR levels?
50-75%
33-50%
<33%
How many times a day would a patient use SABA reliever that may suggest unstable conditions?
4/5 times per day
what sort of things would suggest increased severity of chronic asthma?
restriction of activities
worsening symptoms
frequent use of relievers i.e SABA
use of LAMA (ICS), montelukast (help inflammation), theophylline (bronchiodilator), oral corticosteroids
not taking treatment as prescribed
recent infections
what is used for mild intermittent asthma?
SABA reliever
What is used in addition to SABA as a preventer
low dose inhaled corticosteroid (LAMA)
what is added if SABA reliver and LAMA preventer is not sufficient?
LABA
-if not sufficient then increased LAMA dose and stop LABA
-if LABA works but still not sufficient- use LABA and increase LAMA
If saba, lama and laba are insufficient what should you add?
other drug therapies such as montelukast and theophylinne
what should you add if all other drug therapies are not sufficient?
increase LAMA
use oral corticosteroids
what are the symptoms of moderate acute asthma?
PEFR of 50-75%
-no symptoms of acute severe asthma
what is the treatment for moderate acute asthma?
ABCDE
sit pt up
2 puffs of salbutamol (SABA) 100micrograms each
-if no response- administer additional doses through spacer device
-use their own if they have it
what are the symptoms of acute severe asthma?
PEFR of 33-50%
RR- >25
HR- >110
unable to complete sentence in 1 breath
what is the treatment for acute severe asthma?
ABCDE
sit pt up
999
2 puffs salbutamol (2x 100micrograms)
-if no response administer additional doses (up to 10) via spacer
-repeat every 10 mins if necessary
high flow o2- 15l/min
what are the symptoms of life threatening asthma?
any 1 of the following-
PEFR- <33%
RR->30
02 saturation- <92% hypoxia
hypotension
cyanosis
silent chest
what is the treatment for
ABCDE
sit pt up
999
2 puffs salbutamol (2x 100micrograms)
-if no response administer additional doses (up to 10) via spacer
-repeat every 10 mins if necessary
high flow o2- 15l/min
what may be used instead of a spacer for life threatening asthma?
5mg salbutamol nebuliser
when should you call for an ambulance during acute asthma attack?
-if severe/LT
-if pt does not response to 200mg salbutamol
what drug should be avoided in asthmatic patients?
NSAIDS- causes bronchospasms
what are the oral side effects of inhaled therapy?
dry mouth
candidiasis
altered taste
what flow of o2 should be given if patient is given 5mg salbutamol nebuliser?
6l/min
what is the oral side effect of salbutamol?
dry mouth
irritation
what is the oral side effects of inhaled corticosteroids?
xerostomia
candidiasis
altered taste
altered voice-dysphonia
what is the oral side effects of motelukast?
xerostomia
