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Pulmonology > Asthma > Flashcards

Asthma Flashcards

1
Q

LTD4

A

Profound bronchoconstrictor released by leukotrienes. 1000x more potent than histamine

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2
Q

Intrinsic Asthma

A

Considered non-immune
Usually no family hx
Occurs later on in life

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3
Q

Extrinsic Asthma

A

Type-1 hypersensitivity rxn
Associated with other allergic manifestations
Serum IgE and Eosinophil count usually elevated

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4
Q

Exercise induces asthma (EIA)

A

An asthma variant
Exercise triggers acute bronchospasm
Beta-agonists 10-15 mins before activity
Avoid activity in cold

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5
Q

Asthma triad

A

Persistent wheeze
Chronic episodic dyspnea
Chronic cough

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6
Q

Samters Triad

A

Asthma
Allergy to ASA
Nasal Polyps
(for aspirin-induced asthma)

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7
Q

Beta 2 Agonists

A

Produce airway dilation
Decrease release of mediators
IMprove mucocililary transport

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8
Q

Short acting Beta 2’s

A 
Most widely used
Beta-2 selective
Albuterol, Proventil, Ventolin
Quick onset, lasts 4-6 hrs
2-4 puffs q4-6 hrs
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9
Q

Beta 2 agonist SE

A 
Tachycardia
Tremor
Hypokalemia
HA
Hyperglycemia
Increased lactic acid
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10
Q

Long-acting Beta-2 agonists

A 
Salmeterol (Serevent)
Formoterol (Foradil)
Levalbuterol (Xopenex)
Not rescue drugs
Slow onset (30 mins), lasts 9-12 hrs
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11
Q

Ipratropium Bromide (Atrovent)

A

Anticholinergic
Main use in combo with beta agonist
Slow acting
minimal side effects

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12
Q

Spiriva

A

Same profile as ipatropium bromide

Longer acting

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13
Q

Theophylline

A

Medium potency bronchodilator

Narrow therapeutic window

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14
Q

Theophylline SE

A

insomnia, nervousness
N/V anorexia
HA
Tachycardia

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15
Q

Corticosteroids

A

Reduce airway inflammation
Use in acute illness
Use in chronic dz

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16
Q

Inhaled steroids

A

reduce airway reactivity
Start inhaled steroids in any pt who is not controlled by bronchodilators
Good alternate to oral glucocorticoids

17
Q

Inhaled steroid SE

A

Thrush
Dysphonia
Systemic effects in larger doses
takes 2-4 weeks for therapeutic affect

18
Q

Inhaled steroid Types

A

Fluticasone (flovent)
Budesonide (pulmicort)
others

19
Q

Mast Cell stabalizers

A 
Cromolyn (intal)
Nedocromil (Tilade)
Inhibit degranulation of mast cells
Most effective for seasonal dz
Prophylaxis 15-20 mins prior to exposure
20
Q

Leukotriene Inhibitors

A 
Montelukast (Singulair)
Zafirlukast (Accolate)
Improvement in FEV1
Decrease need for beta agonist use
Safe in kids 6-14
Effective in combo with steroid or beta agonist
21
Q

Anti-IgE Monoclonal Antibodies

A

Omalizumab (Xolair)
Newer approach to tx of asthma
Inhibits binding of IgE to mast cellsLowers plasma IgE to undetectable levels

Pulmonology (15 decks)

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