Asthma Flashcards
What condition is characterised by reversible airflow obstruction?
Asthma
What percentage of children have asthma?
5-10%
what percentage of adults have asthma?
2-5%
Which is a normal asthmatic likely to have more issues with, inspiration or expiration and why?
Expiration.
Because breathing out is a passive process compared to the powerful muscles which are able to suck in air on inspiration and overcome asthma obstruction.
which antibody triggers a B-cell/T-cell interaction causing degranulation of mast cells?
IgE
what is the consequence of degranulation of mast cells in the airway?
Narrowing of airway, oedema and excess mucous secretion
What are the three features of asthma (triad) which cause airway narrowing?
- Bronchial Smooth muscle constriction
- Mucosal oedema
- Excessive mucous secretion
What drug is an anti-IgE drug, which prevents its production, causing mast cells to degranulate?
Omalizumab
What are the three most common symptoms of asthma?
- Cough
- Wheeze
- Shortness of breath
What is meant by diurnal variation in regards to asthma symptoms?
Asthma symptoms that worsen overnight and in the early morning
What would you expect to happen to someone’s PEFR measurement if they have difficulties breathing out and their lungs fill with air?
PEFR would decrease
What are the five main triggers for asthma?
- Unknown
- Infections
- Environmental stimuli (dust, smoke, etc.)
- Cold air
- Atopy
Define, the genetic tendency to develop allergic disease
Atopy
What test can be used to see what allergens individuals have?
Skin prick test
what is meant by asthma biphasic response?
This is a two phase anaphylactic event. After someone has an asthma attack and recovers, they tend to have a response some hours later
what are the two core drugs used to treat mild/moderate asthma?
- Intermittent short-acting beta-adrenergic agonist
- Low dose inhaled corticosteroid
Which drug helps to relieve symptoms of asthma?
Short-acting beta-2 adrenergic antagonist
Which drug helps to prevent further asthma attacks?
Inhaled corticosteroid
If asthma become moderate/ more severe, what drugs would be used in treatment?
- High dose inhaled corticosteroid
- Regular long-acting beta-adrenergic agonist
Give three examples of adjuvant therapy for severe asthma
- Regular montelucast
- Pulsed oral steroid (prednisolone)
- Biologic therapy
What does “nebulised” mean?
To turn a liquid drug into a very fine spray, so it can be breathed in by a patient
Which muscle type is relaxed by beta-adrenergic agonists?
Bronchial smooth muscle
By relaxing bronchial smooth muscle, what does this reduce?
- Bronchoconstriction
- Resting bronchial tone
Which type of beta-adrenergic agonist MUST be used alongside a steroid inhaler?
Long lasting
When should low dose corticosteroids be introduced into treatment in someone with mild/moderate asthma?
Use if short acting beta-2 adrenergic agonist has to be used >3 times each week
what is the main risks when taking any steroid?
Adrenal suppression and osteoporosis
what is a “spacer”?
A spacer is a device used to increase the ease of administering aerosolised medication from a enter-dosed inhaler.
When is a spacer recommend for use in adults with asthma?
If their daily dose exceeds 800 micrograms
If an adult has an acute asthma attack in the dental chair, how should you manage this patient?
Use a short-acting beta-2 adrenergic antagonist via a large-volume spacer. Give four puffs initially, followed by 2 puffs every 2 minutes. Max 10 puffs.
If a child has an acute asthma attack in the dental chair, how should you manage this patient?
Use a short-acting beta-2 adrenergic antagonist via a large-volume spacer. Give a puff every 30-60 seconds. 10 puffs max.
