Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Asthma > Flashcards

Asthma Flashcards

1
Q

What cells are involved in an asthma attach?

A

mast cells, Eosinophils, neutrophils, T-lymphocytes, macrophages, epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Can asthma be reversed

A

yes spontaneously or with treatment

this is a big difference because you can not reverse COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are Asthma risk factors

A

Innate Immunity
Host factor- genetics
Environment Factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are some symptoms of asthma

A

Wheezing

History of cough thats worse at night, trouble breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When do the symptoms of asthma tend to get worse

A 
Exercise  Viral infection
Inhalant Agents   Irritants
changes in weather
emotional response
Stress
Menstrual cycles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is Asthma diagnosed

A

episodic symptoms of airflow obstruction or hyperresponsiveness
Airflow obstruction is at least partially reversible
FEV1 of >200ml and >or= 12% from baseline measure after SABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the goals of Asthma therapy

A 
Reduce impairment
prevent symptoms
require infrequent use of SABA
maintain norm. pulm function
maintain norm. activity levels
meet pt's and Fams expectations and satisfaction with asthma care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you reduce the risk of asthma with therapy

A

prevent exacerbations and minimize ED visits
prevent loss of lung function
prevent reduced growth lung growth
provide optimal pharmacotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what drugs belong to SABA beta 2 agonist?

A

Albuterol
Levabuterol
Pirbuterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

using a SABA more than 2 days a week indicated what

A

need to begin long term control medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ipratropium

A 
Anticholinergic
not the preferred agent
Can not use in Pts under 12
MDI-2puffs every 6 hours
Take longer to work
More Side effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Albuterol & ipratropium combo dosing for
MDI-metered dose inhaled
Neulizer

A

MDI- 1inh every 6 hours

Neb: 3ml every 6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why are low does inhaled corticosteroids preferred treatment for step 2

A

decreased the number and activity of inflammatory cells (better at reducing inflammation from eosinophils& neutrophils
Inhibit bronchoconstrictor mech.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the side effects of Inhaled steroids

A

cough, dysphonia, oral thrush

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the effects of high does inhaled steroids

A 
Adrenal suppression
Osteoporosis
skin thinning
easy bruising
cataracts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the effects of low dose inhaled steroids

A

growth suppression in children

growth velocity may be altered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are Inhaled corticosteroids

A 
Budesonide
Fluticasone
Mometasone
Ciclesonide
Beclomethasone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are step 2 alternatives to low dose inhaled steroids

age>12

A

Mast cell stabilizers: cromolyn (now only used via nebulizer)
nedocromil
LTRA(more effective)
montelukast, Zafirlukast
Theyophilline( has a lot of side effects) related to caffeine narrow therapeutic index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do mast stabilizers work?

A

stabilize mast cells
block chloride channels
can be used as preventative therapy for exercise unknown allergies
great safety profile but questionable efficacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are LTRA drugs

A

Montelukast or Zafirlukast

they interfere with leukotriene mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are things to watch for with people who are on LTRA

A

Think they start with L so they affect the liver (ALT)
hepatitis
Can cause depression in children (kids want to jump off a mountain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does Zafirlukast interaction and CYP problems

A

food decreases bioavailability
CYP 2C9 inhibitor
increased warfarin levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is theophylline metabolized by?

A

CYP1A2 & CYP3A4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is used for step 3 in asthmatics

age>12

A 
Medium dose ICS (1st)
or 
Low dose ICS & LABA
or 
Low dose ICS+LTRA,theophylline, Zeluton
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is really important about using a LABA

A

it has no anti-inflammatory properties never use as mono therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the black box warning with LABAs

A

increased risk of asthma exacerbation and asthma related death with regular use of LABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are two kinds of LABAs

A

Salmeterol and Formoterol (faster think stars with F like F1 race car)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is so special about mometasone

A

you only need to take it once

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what should be used in Step 4 asthma

age>12

A

medium dose+LABA
or
Med dose ICS+LTRAorTheophylline, or Zileuton or Tiotropium

30
Q

what to use with step 5 asthmatics

Age>12

A

High dose ICS+LABA and consider omalizumab

31
Q

what to use with step 6 asthmatics

Age>12

A

High dose ICS+LABA+ oral steroid and consider omalizumab

32
Q

how does omalizumab work

A

bind to portion of IgE antibody preventing the binding to its high affinity receptor on mast cells and basophils

33
Q

what are some adverse effects of omalizumab

A

urticaria and anaphylaxis

34
Q

what are some oral steroids

A

prenisolone, prednisone, methylprenisolone

35
Q

what are some non-pharmacologic treatment

A 
avoid triggers
remove carpet
vacuum
windows closed
air filters
36
Q

what is the first line treatment for exercise induced bronchospasms

A

SABA

37
Q

what is second like for EIB

A

LTRA

38
Q

what is the last line for EIB

A

cromolyn

39
Q

If a patient has asthma and GERD how do you treat them

A

treat the GERD because it is often that if you stop it that will relieve the asthma symptoms

40
Q

what are COPD risk factors

A 
smoking
alpha1 antitrypsin
occupation
air pollution
infection
socioeconomic status
41
Q

what is the hallmark of COPD

A

dyspnea

42
Q

what are some other classic symptoms of COPD

A

chronic cough

sputum production

43
Q

what are the two 24 hour long acting LABA

A

vilanterol

indacterol

44
Q

what is a 12 hour acting LABA

A

arformoterol

45
Q

Why is tiotropium a better anticholinergic

A

more selective and has a higher affinity for muscarinic receptor

46
Q

what has been shown to increase survival in chronic respiratory failure?

A

oxygen

need to have levels >90%

47
Q

In COPD patients who experience exacerbations what is first line treatment

A

oxygen 1st then SABA
2nd line-short acting anticholinergic
steroid

48
Q

what 3 cardinal symptoms must present for use of antibiotics in an exacerbation

A

increased dyspnea
sputum volume
sputum purulence
only need two of the 3 symptoms if purulent sputum is one of them or a person on a ventilator

49
Q

how long do you give the antibiotics for?

A

7-10 days

50
Q

what are the nighttime awakenings for intermittent
ages 5yo>
what is their stage?

A

less than or = 2

Step 1

51
Q

what are the nighttime awakenings for mild
ages 5yo>
what is their stage?

A

3-4x/month

step 2

52
Q

what are the nighttime awakenings for moderate
ages 5yo>
what is their stage?

A

> 1x/week but not nightly

step 3

53
Q

what are the nighttime awakenings for severe
ages 5yo>
what is their stage?

A

7x/week

step 4or5

54
Q

what are the nighttime awakenings for intermittent
ages 0-4yo
what is their stage?

A

0

stage 1

55
Q

what are the nighttime awakenings for mild
ages 0-4yo
what is their stage?

A

1-2x/month

step 2

56
Q

what are the nighttime awakenings for moderate
ages 0-4yo
what is their stage?

A

3-4x/month

step 3

57
Q

what are the nighttime awakenings for severe
ages 0-4yo
what is their stage?

A

> 1x/week

step 3

58
Q

For ages 0-4 what is step 1 asthma treatment

A

SABA

59
Q

For ages 0-4 what is step 2 asthma treatment

A

Low dose ICS

60
Q

For ages 0-4 what is step 3 asthma treatment

A

medium dose ICS

61
Q

For ages 0-4 what is step 4 asthma treatment

A

medium dose ICS & montelukast or LABA

62
Q

For ages 0-4 what is step 5 asthma treatment

A

high dose ICS & montelukast or LABA

63
Q

For ages 0-4 what is step 6 asthma treatment

A

High dose ICS & montelukast/LABA & oral steroids

64
Q

when would you consider stepping down asthma meds

A

when asthma has been controlled for at least 3 months

65
Q

what is the treatment for age 5-11 step 1

A

SABA PRN

66
Q

what is the treatment for age 5-11 step 2

A

Low dose ICS
alternate:
LTRA or theophylline

67
Q

what is the treatment for age 5-11 step 3

A

med dose ICS or low dose ICS+LABA or LTRA or theophylline

68
Q

what is the treatment for age 5-11 step 4

A

med dose ICS+LABA
alternate
med dose ICS+LTRA or theo

69
Q

what is the treatment for age 5-11 step 5

A

high dose ICS+LABA
alternate
high dose ICS+LTRA or theo

70
Q

what is the treatment for age 5-11 step 6

A

high dose ICS+LABA+ oral steroid
alternate
High dose ICS+LTRA/theo+oral steroid

Pharmacology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions