Asthma Flashcards
Pathology of asthma
Is persistent but variable inflammation of airways. Airflow is limited because inflammation results and bronco constriction, airway hyperresponsiveness, and edema of the airway
Define asthma
Chronic inflammatory disorder of the airways that results in recurrent episodes of airflow obstruction that is usually reversible
Mechanism of action of asthma
Often exposure to a trigger, such as an allergen or irritant initiates the inflammatory cascade. Respiratory infections are also precipitating factors of an acute asthma attack. Asthma is not a psycho somatic disease
Triggers of asthma
Genetics and ones immunoresponse, common allergens, exasperated after physical exertion called exercise-induced asthma, air pollutants, cigarette or woodsmoke, other exhausts, occupational asthma is after exposure to agents in the workplace. Often have a history of allergic rhinitis, GER D and certain drugs
Clinical manifestations of asthma
Wheezing, cough, dyspnea, and chest tightness, particularly at night early in the morning. Expiration maybe prolonged. Usually reveals signs of hypoxemia
Classification of asthma
Intermittent, mild persistent, moderate persistent, or severe persistent, based upon current impairment of the patient and the risk for exacerbations
Severe acute asthma
Can result in complications such as severe hypoxia, silent chest, and peak flow less than 25% of personal best
Diagnosing asthma
Diagnosis is made based upon the presence of various indicators such as clinical manifestations, health history, pulmonary function test, and peak flow variability
Goal of asthma treatment
Achieve and maintain control of the disease. Established guidelines give direction on the classification of severity of asthma at initial diagnosis and help determine which types of medications are best suited to controlled asthma symptoms
StepWise approach to drug therapy of asthma
Based initially on the asthma severity and then on level control. Persistent asthma requires day long term controller therapy in addition to appropriate medications to manage acute symptoms. Even persons with intermittent asthma should always carry rescue medication
Ossification of asthma medicines
Long-term control medications to achieve and maintain control of persistent asthma; quick release rescue medications to treat symptoms of exacerbation
CorticoSteroids for asthma
Due to chronic inflammation steroids are more effective in improving as my control than any other long-term drug. ICS agents, such as Flovent and pulmicort, are first line therapy for patients
Oral administered corticosteroids for asthma
Indicated for acute exacerbation; maintenance doses of oral corticosteroids may be necessary to control asthma and a minority of patients with severe chronic asthma
Short acting inhaled beta-2 Adrenergic agonists
Includes albuterol; are most effective for relieving acute bronchospasm. Also used for acute exacerbations of asthma
Long acting inhaled beta to Adrenergic agonist
Include Serevent and foradil, never used to be used as monotherapy due to increased risk of death. However they are quite safe when combined with ICS, such as advair or Symbicort
Leukotriene modifiers and asthma
Can be used in milder asthma successfully as ad on therapy to reduce the dose of inhale corticosteroids
Xolair for asthma
Anti-IGE drug; use for difficult to treat moderate to severe asthma unable to be controlled by inhaled corticosteroids
Theophylline for asthma
Preparations are less effective long term control bronchodilators as compared with beta-2 and carry a high incidence of side effects
Anti-cholinergic agents for asthma
Not using as much treatment except for Atrovent, which is only used in the ED for acute attacks
Overall goals for asthma
Have as much control as evidenced by minimal symptoms during the day and night, acceptable activity levels, maintenance greater than 80% of personal best peak expiratory flow rate or forced expiratory volume in one second, no adverse effects of therapy, no recurrent exacerbations, adequate knowledge to participate in and carry out management
Education factors and asthma
One of the major educational factors is correct administration of drugs; teaching should include information about medications, including the name, purpose, dosage, method of administration, schedule, side effects, appropriate action if side effects occur, properly using clean devices, and consequences of breathing if not taking medications as prescribed
Types of inhalation devices for asthma
Metered dose inhalers, dry powder inhalers, and nebulizers
Nonprescription combination drugs and asthma
Several nonprescription drugs are available over-the-counter; responsibility is informing about the dangers associated with drugs
Goal for asthma care
Maximize the ability of patient to safely manage acute asthma episode Sophia and asthma action plan developed in conjunction with the healthcare provider. Important nursing goal during an acute asthma attack is to decrease the patient sense of panic
