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Medicine > Asthma > Flashcards

Asthma Flashcards

1
Q

Long-acting β2-agonist

A

Salmeterol

Formoterol

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2
Q

Short-acting β2-agonist

A

Salbutamol

Terbutaline

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3
Q

Methylxanthines

A

Theophylline

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4
Q

Leukotriene Receptor Antagonists

A

Montelukast

Zafirlukast

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5
Q

Inhaled Corticosteroids

A

Beclomethasone

Budesonide

Fluticasone

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6
Q

Adverse Effects of β2-agonists

A

Tremor

Tachycardia

Arrhythmias

Palpitations

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7
Q

Spacer Devices

A

Improve inhaler technique

Reduce drug deposition in oropharynx

Lower risk of oral candidiasis

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8
Q

Side Effects of Theophylline

A

Nervousness

Arrhythmias

Seizures

Low therapeutic index

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9
Q

Uses of Short-acting β2-agonists

A

Mild to moderate asthma

Acute asthma attacks

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10
Q

Long-acting β2-agonist

A

Salmeterol
Formoterol

Indications: Long-term control of asthma and COPD
Duration: 12-24 hours

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11
Q

Short-acting β2-agonist

A

Salbutamol
Terbutaline

Indications: Quick relief of asthma symptoms
Duration: 4-6 hours

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12
Q

Methylxanthines

A

Theophylline

Mechanism: Phosphodiesterase inhibition
Indications: Asthma and COPD, adjunct therapy
Side effects: Nausea, arrhythmias, seizures

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13
Q

Leukotriene Receptor Antagonists

A

Montelukast
Zafirlukast

Mechanism: Blockade of leukotriene receptors
Indications: Asthma management, allergic rhinitis

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14
Q

Inhaled Corticosteroids

A

Beclomethasone
Budesonide
Fluticasone

Indications: Long-term asthma control
Side effects: Oral candidiasis, dysphonia

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15
Q

Adverse Effects of β2-agonists

A

Tremor
Tachycardia
Hypokalemia
Palpitations

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16
Q

Spacer Devices

A

Purpose: Enhance drug delivery to the lungs
Benefits: Reduces oropharyngeal deposition, improves inhalation technique
Decreases risk of oral candidiasis

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17
Q

Side Effects of Theophylline

A

Common: Nausea, vomiting
Serious: Arrhythmias, seizures
Monitoring: Requires serum level monitoring due to narrow therapeutic index

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18
Q

Uses of Short-acting β2-agonists

A

Indications: Mild to moderate asthma, exercise-induced bronchospasm
Recommended: Use before exercise

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19
Q

Long-acting β2-agonists and Asthma

A

Not for monotherapy
Must be combined with inhaled corticosteroids

20
Q

Muscarinic Antagonists (Anticholinergics)

A

Ipratropium
Tiotropium

Indications: COPD, adjunct therapy in asthma

Mechanism: Block muscarinic receptors to reduce bronchoconstriction

Side effects: Dry mouth, urinary retention

21
Q

Systemic Corticosteroids

A

Prednisone
Methylprednisolone

Indications: Acute asthma exacerbations, severe COPD

Side effects: Hyperglycemia, osteoporosis, weight gain, mood changes

22
Q

Cromones

A

Cromolyn sodium
Nedocromil

Mechanism: Inhibit mast cell degranulation

Indications: Asthma prevention, allergic conjunctivitis

Rarely used today

23
Q

Omalizumab

A

Mechanism: Anti-IgE monoclonal antibody

Indications: Moderate to severe allergic asthma not controlled by inhaled corticosteroids

Side effects: Risk of anaphylaxis

24
Q

Theophylline Toxicity Symptoms

A

Vomiting
Seizures
Arrhythmias
Tachycardia
Hypotension

25
Q

Side Effects of Inhaled Corticosteroids

A

Oral candidiasis
Dysphonia
Long-term: Potential adrenal suppression

26
Q

Combination Therapy in Asthma

A

Inhaled corticosteroids + Long-acting β2-agonists

Example: Fluticasone + Salmeterol

Indications: Moderate to severe asthma

27
Q

Stepwise Management of Asthma

A

Step 1: SABA (Short-acting β2-agonist) as needed
Step 2: Low-dose ICS (Inhaled corticosteroids)
Step 3: ICS + LABA (Long-acting β2-agonist)
Step 4: Medium/High-dose ICS + LABA

28
Q

Mechanism of Action of Leukotriene Antagonists

A

Inhibit leukotrienes that cause bronchoconstriction, edema, and inflammation

Prevent airway narrowing

29
Q

Nebulizer vs Inhaler

A

Nebulizer: Delivers medication in mist form over several minutes
Inhaler: Delivers short bursts of medication, faster and more portable

30
Q

ICS Dose Adjustment

A

Adjust based on asthma control

Step-up if symptoms persist

Step-down if stable for 3 months

31
Q

Asthma Reliever vs Controller Medications

A

Reliever: Short-acting β2-agonists for immediate symptom relief

Controller: ICS, LABA, and leukotriene antagonists for long-term management

32
Q

Oral Corticosteroid Use in Asthma

A

Short-term for severe exacerbations

Must taper to avoid adrenal insufficiency

33
Q

Mast Cell Stabilizers

A

Cromolyn sodium

Prevents asthma by inhibiting mast cell degranulation

Rarely used due to limited effectiveness

34
Q

Biologic Therapies in Asthma

A

Omalizumab: Anti-IgE
Mepolizumab: Anti-IL-5
Benralizumab: Anti-IL-5 receptor
Indications: Severe asthma with specific phenotypes

Example: These biologic therapies target specific pathways in asthma management.

35
Q

Short-acting β2-agonists (SABA)

A

Albuterol
Levalbuterol
Indications: Acute asthma relief
Mechanism: Stimulate β2 receptors to relax bronchial smooth muscle
Side effects: Tremor, tachycardia

Example: SABA are commonly used for quick relief of asthma symptoms.

36
Q

Magnesium Sulfate in Asthma

A

Use: Severe asthma exacerbations unresponsive to standard therapy
Mechanism: Smooth muscle relaxation, bronchodilation
Administered IV in emergency settings

Example: Magnesium sulfate is a key intervention in severe asthma attacks.

37
Q

Step-Down Therapy in Asthma

A

Consider step-down when asthma is controlled for at least 3 months
Gradually reduce ICS dose while monitoring symptoms
Goal: Maintain control with the lowest effective dose

Example: Step-down therapy helps prevent overmedication in controlled asthma.

38
Q

Indications for Oral Corticosteroids in Asthma

A

Severe asthma exacerbations
Poor response to inhaled medications
Maintenance in severe chronic asthma (rare)

Example: Oral corticosteroids are reserved for severe asthma cases.

39
Q

Bronchial Thermoplasty

A

Non-pharmacological treatment for severe asthma
Uses radiofrequency energy to reduce smooth muscle in the airways
Helps reduce frequency of asthma attacks

Example: Bronchial thermoplasty is a novel approach for severe asthma management.

40
Q

Common Triggers for Asthma Exacerbations

A

Allergens: Dust mites, pet dander, pollen
Irritants: Smoke, pollution, cold air
Respiratory infections
Exercise

Example: Identifying triggers is crucial in managing asthma exacerbations.

41
Q

Mepolizumab

A

Anti-IL-5 monoclonal antibody
Indications: Severe eosinophilic asthma
Reduces exacerbations in patients with high eosinophil counts

Example: Mepolizumab targets eosinophil-related inflammation in asthma.

42
Q

Inhaler Technique

A

Shake well before use
Exhale fully before inhaling the medication
Hold breath for 10 seconds after inhalation
Use a spacer to improve medication delivery if needed

Example: Proper inhaler technique ensures optimal drug delivery.

43
Q

Spacers for Inhalers

A

Improve medication delivery to lungs
Reduce risk of oral side effects from inhaled corticosteroids
Especially useful in children and the elderly

Example: Spacers help enhance the effectiveness of inhaled medications.

44
Q

ICS and Bone Health

A

Long-term use of inhaled corticosteroids can lead to decreased bone density
Monitor bone health in patients on chronic high-dose ICS therapy
Consider calcium and vitamin D supplementation

Example: ICS use requires monitoring for potential bone health effects.

45
Q

Exercise-induced Bronchospasm

A

Symptoms: Shortness of breath, wheezing, coughing during/after exercise
Management: Pre-treatment with SABA or leukotriene antagonist

Example: Exercise-induced bronchospasm can be managed with appropriate pre-treatment.

46
Q

SMART Therapy in Asthma

A

Single Maintenance and Reliever Therapy (SMART)
Combination of ICS and formoterol (LABA) used for both maintenance and relief
Reduces need for SABA in patients

Example: SMART therapy simplifies asthma management with a single inhaler.

Medicine (7 decks)

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