Asthma

Question 1

Menumonic ASTHMA

Answer 1

I like lazy Saturdays

Question 1

I stands for

Answer 1

inhaled corticosteroids

Question 2

Like stands for

Answer 2

leukotriene modifiers

Question 3

Lazy stands for

Answer 3

long-acting beta-agonist

Question 4

Saturdays stand for

Answer 4

Short-acting beta-agonist

Question 5

What does the Inhaled corticosteroids end in

Answer 5

Steroids often end in the suffix ‘onide’ or ‘-asone’ similar to prednisone or cortisone (naturally occurring corticosteroid).

Question 6

Where do beta agonist work

Answer 6

Beta-2 agonists are bronchodilators that work to relax the smooth muscle bands that tighten around the airways and are divided into two forms, short-acting and long-acting beta-2 agonists. These forms differ by their duration of action with short acting beta-2 agonists working rapidly within 5 minutes to reverse bronchoconstriction and relieve or stop asthma symptoms which makes this a great rescue inhaler. Long-acting beta-2 agonists help keep the airways open for 12 hours or longer and are used on a daily basis to prevent asthma attacks.

Question 7

Example of LABA

Answer 7

Salmeterol or Formoterol

Question 8

Are LABA used alone

Answer 8

No they do not contain inhaled corticosteroids; That is why they are often found in combination with an inhaled corticosteroid like Symbicort which includes budesonide and formoterol or Advair including salmeterol and fluticasone.

Question 9

leukotriene modifiers are used for

Answer 9

Leukotriene modifiers are a great add on therapy in patients with allergies since they block the action of leukotrienes. If you can recall, leukotrienes are a type of proinflammatory chemicals that cause bronchiole smooth muscle contraction as well as recruit other proinflammatory mediators such as histamine and prostaglandin into tissues. By inhibiting leukotrienes, we can see a reduction in airway swelling, smooth muscle contraction, inflammation and nasal congestion often associated with allergies.

Question 10

Examples of leukotiene modifiers

Answer 10

Montelukast
Zafirlukast
Zileuton
They all have the suffix “-luk” in the name reminding you that it is a Leuk-otriene modifier.

Question 11

inhaled anticholinergics

Answer 11

Short-acting inhaled anticholinergics such as “ipratropium” can commonly be used with beta-2 agonists in acute asthma exacerbations. They inhibit acetylcholine from binding onto muscarinic receptors on airway smooth muscle cells (hence why they are called anti-cholinergics) leading to bronchodilation. They have few side effects (mainly just dry mouth that is common with tiotropium) due to the fact that they are inhaled locally and are poorly absorbed into the circulation. Long-acting inhaled anticholinergics (Spiriva or tiotropium) provide modest improvements in asthma exacerbations and are reserved in patients with uncontrolled asthma despite being on an ICS-LABA.

Question 12

step one

Answer 12

ICS- formoterol (LABA) prn

Question 13

step two

Answer 13

daily ICS or as needed ICS-formoterol

Question 14

step three, four, and five

Answer 14

ICS and LABA