Brainscape's Knowledge GenomeTM

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


See full index

NAPLEX > Asthma > Flashcards

Asthma Flashcards

0
Q

S/sx of asthma? U

A

Wheezing

Breathlessness

Chest tightness

Coughing

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

What’s asthma?

A

Chronic inflammatory disorder of the airways in which many cells, and cellular elements play a role in particular, mast cells, eosinophils, neutrophils, T lymphocytes, macrophages and epithelial cells

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

List the common triggers of asthma

A

Allergens e.g. Airborne pollens

Drugs e.g aspirin

Environmental e.g. Cold air, fog

Exercise e.g. Cold air

Occupational e.g. Bakers

Respiratory infections e.g. Respiratory syncytial virus (RSV)

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

List drugs that may trigger asthma

A

Aspirin

NSAIDs

Sulfites

Non-selective beta-blocker

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

Classify drugs used to treat asthma? U

A

Controllers

OR

Relievers

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

Define controller asthma meds

A

Drugs taken on a chronic daily basis to keep asthma under control, primarily by reducing inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What’s the primary MOA of controller asthma meds?

A

Primarily by reducing inflammation

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

Define asthma reliever meds

A

Used as needed to quickly reverse bronchoconstriction

OR

Preventively for exercise-induced bronchospasm (EIB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What’s the preferred delivery vehicle of asthma meds?

A

Inhaled forms, which deliver drugs directly into the lungs and have reduced toxicity

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

What’s the most effective and preferred controller asthma med?

A

Inhaled steroids (glucocorticosteroids)

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

What’s the most effective and preferred reliever asthma med for acute bronchospasm and for prevention of EIB in both adults and children and pregnancy?

A

Rapid-acting beta-agonists (primarily Albuterol)

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

What does increased use of reliever asthma meds imply? Solution?

A

Indicates worsening asthma control and indicates the need to reassess tx

Primary tx is an increase in inhaled steroid dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List main classes of asthma rescuers - agents commonly used in asthma exacerbation

A

Short-acting beta2-agonists

Systemic steroids (inj or oral)

Anticholinergic

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

List main classes of controller asthma meds - agents used in long-term maintenance therapy

A

Inhaled steroids

Long-acting beta2-agonists (taken with steroids)

Leukotriene modifying agents

Theophylline

Omalizumab (Xolair)

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

MOA of beta2-agonists?

A

Bind to beta2 receptors causing relaxation of bronchial smooth muscle resulting in bronchodilation - inhaled route is the preferred route of admin

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

List short-acting beta2-agonists (SABAs) - rescue meds

A

Racepinephrine (Asthmanefrin atomizer)

Albuterol (Ventolin HFA, Proventil HFA, ProAir HFA)

Levalbuterol (Xopenex, Xopenex HFA)

Purbuterol (Maxair Autohaler)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What’s the brand name of Albuterol? Rescue asthma med

A

Ventolin HFA, Proventil HFA, ProAir HFA

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

What’s the brand name of Levalbuterol? Rescue asthma meds

A

Xopenex, Xopenex HFA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which of the SABAs should not be used in asthma? Why not?

A

Racepinephrine (Asthmanefrin atomizer)

Bcuz it’s not beta2 selective

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

SE of SABAs?

A

Tremor

Shakiness

Lightheadedness

Cough

Palpitations

Hypokalemia

Tachycardia

Hyperglycemia

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

How to use MDIs?

A

Shake well before use

Prime prior to first use (3-4 sprays into the airway from face) AND again if not used for > 2weeks

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

When do you need to increase maintenance therapy?

A

Using SABAs > 2 days/week

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

What’s the drug of choice for exercise-induced bronchospasm (EIB)?

A

SABAs

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

List agents under long-acting beta2-agonist (LABAs)

A

Salmeterol (Serevent Diskus)

Salmeterol + Fluticasone (Advair Diskus, Advair HFA) -LABA + corticosteroids

Formoterol (Foradil Aerolizer)

Formoterol + Budesonide (Symbicort) - LABA + corticosteroids

NOTE: SABAs and LABAs end with “terol” e,g albuTEROL

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

What’s the brand name of salmeterol + Fluticasone? LABAs + corticosteroids

A

Advair Diskus/ Advair HFA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What’s the brand name of formoterol + Budesonide? LABA + corticosteroid

A

Symbicort

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

What’s the dose of Advair Diskus (Salmeterol + Fluticasone)?

A

100, 250, 500mcg Fluticasone + 50mcg salmeterol

> = 4 yrs

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

What’s the dose of Advair HFA (Salmeterol + Fluticasone)?

A

45, 115, 230 mcg Fluticasone + 21mcg salmeterol

> = 12 yrs

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

What’s the dose of formoterol + Budesonide (Symbicort)? LABAs

A

80, 160mcg Budesonide + 4.5 mcg formoterol

> = 12yrs

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

What’s the black box warning of LABAs?

A

Increased risk of asthma related deaths

Don’t use as monotherapy in pts with persistent asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Howz LABAs used? (Salmeterol, advair Diskus, advair HFA, Symbicort etc

A

As adjunctive therapy in pts are currently receiving but not adequately controlled on long-term asthma control med eg inhaled corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Are LABAs recommended for long-term use in asthma?

A

No!

Once asthma is controlled, assess pt at regular intervals and step down LABAs until d/c, if possible, without loss of asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Howz Foradil (Formoterol) LABAs stored? (Controller med)

A

Fridge in the pharmacy

Pt can keep at room temp for 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

List drugs under corticosteroids (controller). Are inhaled corticosteroids first line?

A

Beclomethasone HFA (QVAR)

Budesonide (Pulmicort Flexhaler; Respules)

Ciclesonide (Alvesco)

Flunisolide HFA (Aerospan HFA)

Fluticasone (Flovebpnt HFA)

Mometasone (asmanex twisthaler)

NOTE: corticosteroids end with either “nide/lide” and “sone”

Yes. They are first line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What’s the brand name of beclomethasone? Corticosteroids (controller)

A

QVAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What’s the brand name of Fluticasone? Corticosteroids (controller)

A

Flovent HFA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

SE of inhaled corticosteroids?

A

Dysphonia

Oral candidiasis (thrush)

Cough

High risk of fractures and pneumonia (with high dose, long-term use)

Growth retardation (in kids with high doses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How to prevent oral candidiasis (thrush) with corticosteroids?

A

Rinse mouth and throat with warm water and spit out

OR

Use a spacer device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What’s the first line for long-term control for all ages and persistent asthma?

A

Inhaled corticosteroids

Budesonide (Pulmicort)
Beclomethasone HFA (QVAR)
Fluticasone HFA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which of the inhaled corticosteroids has a ‘do not shake before use’?

A

QVAR (beclomethasone)

Alvesco (ciclesonide)

40
Q

How to reduce fracture risk while on corticosteroids? E.g. QVAR, Flovent

A 
Avoid smoking
Exercise
Use lowest effective steroid dose
Recommend Ca and Vit D
Get regular bone density screening
41
Q

Name the 2 types of steroids used in asthma

A

Glucocorticoids - produced by the body as a rxn to stress or given exogenously

Mineralocorticoids (Fludrocortisone) - which regulates Na and H2O balance

42
Q

Clinical Uses of steroids (glucocorticoids)?

A

Primarily to reduce inflammation

43
Q

What’s a steroid taper?

A

A steady reduction in dose for pts using steroids for longer than 14 days.

Not required for inhaled steroid use

44
Q

List the long-term side effect of systemic steroids

A

Cushing syndrome

Hypokalemia

Immunosuppression

Amenorrhea

Acne

Insomnia/nervousness

45
Q

List short-acting oral steroids and dose equivalent

A

Cortisone - 25mg

Hydrocortisone - 20

46
Q

List intermediate-acting oral steroids and dose equivalent

A

Methylprednisolone/Triamcinolone - 4mg

Prednisone/Prednisolone - 5mg

47
Q

List long-acting oral steroids and dose equivalent

A

Betamethasone -0.6mg

Dexamethasone - 0.75mg

48
Q

List mineralcorticoids and dose equivalent

A

Fludrocortisone - no anti-inflammatory effect

49
Q

List oral corticosteroids

A

Cortisone

Hydrocortisone (Solu-CORTEF)

Methylprednisolone (Medrol; Medrol Dosepak; Solu-MEDROL)

Prednisone

Prednisolone (Milipred; Orapred; Prelone)

Triamcinolone (Kenalog)

50
Q

What’s the brand name for hydrocortisone? Oral corticosteroids

A

Solu-CORTEF

51
Q

What’s the brand name for methylprednisolone? Oral corticosteroids

A

Medrol

Medrol Dosepak

Solu-MEDROL

52
Q

What’s the brand name for prednisolone? Oral corticosteroids

A

Milipred

Orapred

Prelone (syrup)

53
Q

What’s the brand name for triamcinolone ?Oral corticosteroids

A

Kenalog

54
Q

List the oral steroids that are prodrugs

A

Cortisone (prodrug for cortisol)

Prednisone (prodrug for Prednisolone)

55
Q

Which oral steroid is most commonly used in children?

A

Prednisolone

56
Q

When should steroids be given? Why?

A

Between 7-8am

To mimic the body’s diurnal release of cortisol

57
Q

If oral steroids is used for 10-14 days, how should it be stopped?

A

Must taper slowly

58
Q

List relative anti-inflammatory potency of oral steroids

A

Betamethasone/Dexamethasone > Fludrocortisone > methylprednisolone/Triamcinolone > prednisone/Prednisolone > hydrocortisone > cortisone

59
Q

Which has the highest mineralcorticoids potency? Effect? Uses?

A

Fludrocortisone

Causes Na and H2O retention

Used for hyponatremia

60
Q

List agents that are Leukotriene modifying agents

A

Zafirlukast (Accolate)

Montelukast (Singulair)

Zileuton (Zyflo, Zyflo CR)

61
Q

What’s the brand name of montelukast? Leukotriene modifying agents

A

Singulair

62
Q

SE of Leukotriene modifying agents

A

Headache

Dizziness

Abdominal pain

Increased LFTs

URTIs

Pharyngitis

Sinusitis

63
Q

What’s the monitoring parameter for Zileuton?

A

LFTs Q month for 1st 3 months

Q 2-3 months for the rest of the 1st year

64
Q

Howz zafirlukast (Accolate) taken?

A

1 hr BEFORE or 2 hrs AFTER meals

65
Q

MOA of Theophylline?

A

Blocks phophodiesterase causing increase cAMP, resulting in bronchodilation

66
Q

Uses of theophylline?

A

As add-on therapy

Not most effective, has high drug interaction and SE limits it’s use

67
Q

What’s the therapeutic range of theophylline? Howz it measured?

A

5-15 mcg/mL

Measure oral level (after 3 days of dosing)

68
Q

SE of theophylline?

A

Nausea

Loose stools

69
Q

How do you calculate the dose if using IV aminophylline?

A

Divide by 0.8

70
Q

List drugs that may increase theophylline levels. By what mechanisms?

A

Due to 1A2 inhibition

Cipro

Fluvoxamine

Propranolol

Zafirlukast

Zileuton

71
Q

List other drugs that may increase theophylline levels. By what mechanisms?

A

Due to 3A4 inhibition

Clarithromycin

Conivaptan

Erythromycin

72
Q

List other factors that may increase theophylline levels.

A

Alcohol

Allopurinol

Antithyroid agents

Disulfiram

Estrogen containing oral contraceptives

Methotrexate

Pentoxifylline

Propafenone

Verapamil

73
Q

List conditions that may increase theophylline levels.

A

Acute pulmonary edema

CHF

Cirrhosis or liver dx

Cor-pulmonale

Fever

Hypothyroidism/ Shock may reduce theophylline clearance

74
Q

List drugs that may reduce theophylline levels

A

Cbz

Foes phenytoin

Phenobarbital

Phenytoin

Primidone

Rifampin

Ritonavir

High protein diet

Hyperthyroidism and cystic fibrosis can increase theophylline level

75
Q

What meds do theophylline reduce their levels?

A

Lithium (by increasing renal excretion of lithium)

Zafirlukast

76
Q

Uses of anticholinergics in asthma?

A

Mainly used with other meds in the emergency dept for bronchodilation in acute attacks

77
Q

List agents under anticholinergics

A

Omalizumab (Xolair)

78
Q

What’s the brand name of omalizumab? Anticholinergics

A

Xolair

79
Q

How’s omalizumab (Xolair) anticholinergic used?

A

Dose and freq based on pre- tx total IgE serum levels and body weight - given SC Q2 or 4 weeks

Drugs should ALWAYS be given in the Doctor’s office

80
Q

What’s the blackbox warning of omalizumab (Xolair)?

A

Anaphylaxis

81
Q

Howz asthma meds used in exercise induced bronchospasm (EIB)?

A

Pretreat b4 exercise with SABAs, LABAs, or montelukast (Singulair)

82
Q

What’s the drug of choice in EIB?

A

SABAs

83
Q

How are SABAs taken in EIB? Duration?

A

Albuterol, Levalbuterol etc drug if choice in EIB

5-15 mins before exercise

Lasts 2-3 hrs

84
Q

How are LABAs taken in EIB? Duration?

A

Formoterol - 15 mins b4 exercise

Salmeterol - 30 mins b4 exercise

85
Q

Should LABAs used as monotherapy in persistent asthma?

A

No

86
Q

What’s the preferred SABAs for use during pregnancy?

A

Albuterol

87
Q

What’s the preferred inhaled corticosteroid in pregnancy?

A

Budesonide

88
Q

Look at pages 698 - 700 in book

A

Make sure you look!

89
Q

What’s the technique to using peak flow meters?

A

Use every morning, once u wake up

Move indicator to bottom of numbered scale. Stand up straight. Exhale comfortably

Inhale as deeply as you can. Place lips firmly around mouthpiece, creating a tight seal

Blow out as HARD and as FAST as possible. Write down PEFR

Repeat steps 2 more times, allowing enough rest in btw. Record highest value

90
Q

List the zones of a peak flow meter reading (PEFR)

A

Green zone (80-100% of personal best)

Yellow zone (50-80% of personal best)

Red zone (<50% of personal best)

91
Q

Which zone indicates medical alert and pt needs to seek medical attention?

A

Red zone (< 50%)

92
Q

Is it okay to change the brand of peak flow meter?

A

No. It’s best to use same brand

93
Q

Read page 702 - 707

A

Have you read them?

94
Q

What’s the most likely SE to occur while using Foradil?

A

Palpitations

95
Q

Pt is on 3mg dexamethasone, convert to prednisone?

A

20mg

96
Q

T/F? Advair Diskus treat both airway constriction and inflammation

A

True

97
Q

What’s the dose of montelukast for children; 2-4y/o and 5 yrs and above?

A

> = 5 y/o 5mg chewable tablet once daily (in the evening)

2-4 y/o - 4mg chewable tablet once daily (in the evening)

98
Q

Sweetener used in Montelukast chewable tab (& other children chewable)?

A

Phenylalanine

NAPLEX (73 decks)

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