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PRP2 > Asthma > Flashcards

Asthma Flashcards

1
Q

What drug class is Ipatropium?

A

SAMA (SHORT ACTING MUSCARINIC ANTAGONIST)

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2
Q

What drug class is tiotropium?

A

LAMA (LONG ACTING MUSCARINIC ANTAGONIST)

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3
Q

Acute asthma three levels?

A

Moderate
Severe
life threatening

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4
Q

Moderate acute asthma peak flow?

A

Over 50%

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5
Q

Severe acute asthma peak flow?

A

Peak flow 33-50%

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6
Q

Life threatening acute asthma peak flow?

A

Less than 33%

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7
Q

Acute asthma completing sentence differences in severity?

A

If they can complete full sentences then moderate

If unable to complete full sentence then severe

If can’t talk then Life threatening

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8
Q

What oxygen levels in moderate severity?

A

Equal to or more than 92%

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9
Q

What oxygen levels in life threatening severity?

A

Less than 92% SpO2

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10
Q

Respiratory rate for moderate in children?

A

5+ child is 30 or less

1-5 child is 40 or less

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11
Q

Respiratory rate for moderate in children?

A

Over 25 in adults

Over 30 in Child 5+

Over 40 in Child 1-5

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12
Q

Heart rates for severe asthma? Children 1-5? Children 5+?

A

Child 1-5: over 140 Bpm
Child 5+: over 125 BPM

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13
Q

Moderate acute asthma treatment?

A

8-10 puffs of high dose Saba (Salbutamol) through spacer!!

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14
Q

Severe acute asthma treatment?

A

Hospital

8-10 puffs high dose SABA (Salbutamol)
Use oxygen driven nebuliser tho not a spacer like in moderate!

With/without nebulised Ipatropium

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15
Q

Near fatal acute asthma - poor response life threatening? Treatment?

A

IV Aminophylline

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16
Q

After acute Asthma attack what to be given course of? Duration?

A

Oral Prednisolone for 5 days

If inappropriate: IV Hydrocortisone or IM Methylprednisolone

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17
Q

Hypoxaemic pt should be given what after acute asthma attack?

A

Supplementary oxygen reach to SPO2 target: 94-98%

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18
Q

Children over 2 acute asthma moderate treatment?

A

Saba - Salbutamol using PMI and spacer up to 10 puffs

19
Q

Children over 2 acute asthma Severe treatment? Setting?

A

High Dose SABA - Salbutamol via oxygen driven nebuliser

20
Q

Difference between child under 2 and child over 2/ Adult moderate treatment setting?

A

Adult & over 2 can be done in community (10 puffs)

Child under 2 must go hospital immediately!

21
Q

Child over 2 after acute asthma to be given what? Duration?

A

Oral Prednisolone for 3 days

22
Q

Difference in duration of Oral prednisolone in child over 2 and Adult?

A

3 days for child over two years old

5 days - Adult

23
Q

If inadequate response to Salbutamol in child over 2 acute asthma treatment through oxygen driven nebuliser, you can add what?

A

Nebulised Ipatropium

24
Q

If no response to Ipatropium in child over 2?

A

Give IV Magnesium Sulphate

25
Q

Under 2 Acute Asthma treatment in mod & severe?

A

Immediate Oxygen with trial of SABA (Salbutamol)

If needed add Ipatropium

26
Q

Chronic Asthma lifestyle change to do?

A

Lose Weigh

Stop smoking

Incorporate breathing exercises

27
Q

Chronic Asthma First step in adults?

A

Salbutamol (SABA)

28
Q

If not controlled by Saba alone, 2nd step in chronic asthma?

A

Low Dose ICS - inhaled corticosteroids

Eg) Budesonide, Beclometasone, Fluticasone, Mometasone, -ide -one

29
Q

After SABA ALONE what shows that Asthma is not controlled properly? Criteria? 4 criteria?

A

1) Pt used Saba 3 times a week

2) Symptoms for more than 3 times/ wk

3) NIGHT TIME AWAKENING <- MAJOR

4) More than 1 inhaler a month

30
Q

Low dose ICS dose - Eg clenil 100?

A

Two puffs BD = 400mcg

31
Q

If Saba and ICS is not working, next step?
(Salbutamol + Beclometasone)

A

Add LTRA - MONTELUKAST

32
Q

After Saba + ICS + LTRA , next step up?

A

LABA as a fixed dose or MART

Eg) Tiotropium - fixed

Eg) Fostair/Symbicort - MART

**can remove LTRA if not useful!!

33
Q

Final specialist stage after LABA has been added to SABA + ICS + LABA
(+/-LTRA)

A

INCREASE low dose ICS —> HIGH DOSE

Eg Clenil 250

Or start:

Theophylline, Tiotropium, oral corticosteroids or monoclonal antibodies.

34
Q

Main 2 Difference in chronic asthma treatment?

A

Use VERY LOW STRENGTH ICS
EG) Clenil 50mcg TWO puffs BD = 200mcg

If adding LABA must be: 5+

35
Q

If adding LABA to child over 5 chronic asthma treatment, what requirement must be met?

A

LTRA must be replaced by the LABA
(Cannot add on top like in Adults)

36
Q

Tiotropium can be given to which age?

A

12years+

37
Q

Children under 5 step 1 in treatment?

A

SABA

But if using more than 1 device/month
REFER!!!

38
Q

Children under 5 - step 2 difference?

A

8 week trial of very low dose ICS - 50mcg

If doesn’t work - Replace w/ LTRA
MONTELUKAST

39
Q

Child under 5 - step 3 in treatment?

A

Triple therapy can be considered

SABA + ICS + LTRA (If ICS is proving to help a bit)

40
Q

Child under 5 - still not controlled after triple therapy?

A

STOP LTRA (Montelukast) & Refer to Specialist

41
Q

Can you reduce treatment and cure in way of asthma? When can you do this if so?

A

You can when asthma controlled for at least 3months

42
Q

Every 3 months how much can you reduce dose of ICS by?

A

25 - 50% of total dose each time

43
Q

What’s complete control?

A

No day time symptoms

No night time awakenings

No asthma attacks

No need for Rescue meds

No limitations from exercise

Normal lung funct (FEV1 and/or PEF over 80% predicted or best)

Minimum side effects from treatment

PRP2 (74 decks)

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