asthma Flashcards
what are some aggravating comorbidities to asthma? Name 5
GERD
Sleep apnea
obesity
stress/depression
rhinitis/rhinosinusitis
risk factors for severe asthma? list 5
-hx of severe exacerbation
-poorly controlled asthma
-current smoker
-vit D deficiency
-comorbidities
how is asthma diagnosed in a child 5 or younger?
-at least TWO episodes of:
- documented airflow obstruction
- documented reversibility of airflow obstruction
- No clinical evidence of alternative diagnosis
what factor predicts persistant asthma?
atopy
GOOD ASTHMA CONTROL HAS:
Daytime symptoms ____
≤2 days per week
GOOD ASTHMA CONTROL HAS:
Night time symptoms:
<1 per week and mild
GOOD ASTHMA CONTROL HAS:
___ physical activity impact
NO
GOOD ASTHMA CONTROL HAS:
____ absence from work or school
NO
GOOD ASTHMA CONTROL HAS:
___ exacerbations
mild, infrequent
GOOD ASTHMA CONTROL HAS:
Need for ventolin or bud/form __
≤2 per week
GOOD ASTHMA CONTROL HAS:
FEV1 or PEF of ____
≥90% of personal best
what is considered a mild exacerbation of asthma?
one that does not require systemic steroids or ER visit/hospitilization
what med should people with asthma consider avoiding?
NSAIDS
what is symbicort?
combo of budesonide/formoterol
what is the first treatment step for very mild asthma for someone <12?
SABA PRN
what is the first treatment step for very mild asthma for someone >12?
SABA prn OR symbicort PRN (bud/form)
what is the SECOND treatment step (for mild asthma with high risk exacerbation or uncontrolled on saba prn) for <12 yo?
SABA prn PLUS ICS low dose
what is the SECOND treatment step (for mild asthma with high risk exacerbation or uncontrolled on saba prn) for >12 yo?
symbicort PRN (reliever +ics)
OR
ventolin + ICS (flovent) low dose
What step in the asthma treatment plan should you start at if you have symptoms most days?
step 3 - moderate
What is the step 3 (moderate) treatment for <12 yo?
SABA prn + increased dose of ICS
*and refer
What is the step 3 (moderate) treatment for > 12 yo?
reliever PRN + ICS
Preferred: Symbicort BID + ventolin PRN
*and refer
What is step 4 (severe) treatement asthma for <12 yo?
SABRA prn + ICS + LABA/LTRA
what is a mild pram score?
1-3
what is a moderate pram score?
4-7
what is a severe PRAM score?
8-12
management of mild PRAM (1-3) score?
salbutomol q30-60 min
+/- oral steroids
management of a mod PRAM (4-7)?
salbutamol + /- ipratropium PLUS oral steroids
PLUS admission
management of a severe PRAM (8-12)
oral steroid + SABA/iptratropium q20 min, continues nebulized salbutomol, IV access, IV salbutomol, IV magnesium
