Asthma Flashcards
What is asthma
Chronic airway inflammation
Symptoms
increased mucus production, thickened bronchial walls, wheeze, SOB, chest tightness, cough, expiratory airflow limitation
Good control
Daytime symptoms <2 days per week
Need for reliever <2 days
No limitation on activities
No symptoms during the night or on waking
ICS
Inhaled corticosteroid
Salbutamol & terbutaline
SABA (3-4mins, lasts 3-4hours)
MOA for SABAs
agonists of beta 2 adrenergic receptors in the lungs cause bronchodilation by relaxing bronchial smooth muscles, allowing the airways to open
Cautions for SABAs
Elderly- titrate slowly
Hepatic- safe
Children- safe for >2
Pregnancy- safe
BF- safe
Renal- safe
Salmeterol, eformoterol & indacaterol
LABA (preventors)
MOA for LABA
agonists of beta 2 adrenergic receptors activate these receptors in the bronchial smooth muscle to allow for relaxation and bronchodilation
Cautions for LABA
Elderly- titrate slowly
Hepatic- safe
Children- safe for >2
Pregnancy- limited data
BF- salmeterol is safe
Renal- safe
beclomethason, budesonide & fluticasone
ICS (maintenace therapy- can be combined with LABA)
MOA for ICS
immunosuppressant reduces airway inflammation and bronchial hyper reactivity
Cautions for ICS
Elderly- more susceptible to skin thinning and bruising, reduce
Hepatic- safe
Children- avoid high doses
Pregnancy- safe
BF- safe
Renal- safe
Caution- in COPD (pneumonia risk)
ipratropium
SAMA inhaled anticholinergics
MOA for inhaled anticholinergic
antagonists of cholinergic receptors in the bronchial tissue relax smooth muscle to allow bronchodilation
tiotripium
LAMA inhaled anticholinergics
Cautions for inhaled anticholinergic
Elderly- more susceptible to retention
Hepatic- safe
Children- SAMA safe not LAMA
Pregnancy- safe
BF- safe
Renal- safe
Caution- not to use if bladder obstruction/retention
