Asthma 4 - Long term Mx Flashcards
Aim - for no ? Sx, no night time ?, no need for ? meds, and no limits to ?
daytime
waking
rescue
activity
1 - ? - eg salb or ?, ? inhalers
for all in whom asthma is ?
2 - ? + low dose ? eg ?, budesonide or ? - 200-?mg, brown/? inhalers
for all pts with ? asthma
SABA
terbutaline
blue
suspected
SABA ICS beclametasone fluticasone 400 red confirmed
3 - ? + ? + ? eg ? often combo with a steroid inhaled eg fostair, ? , simbacort
3a) if no response from this, ? it and incr ? to a ? dose
3b) if some benefit, but more control needed, continue ? and increase ? to a ? dose
3c) consider also adding ? (?, often first added drug), ? or ? for extra control
SABA _ ICS + LABA salmeterol seretide stop ICS medium LABA ICS medium LTRA montelukast theophylline LAMA
4 - ? ICS to ? dose - ensure a 4th drug has been added, and ?
5 - specialist mgmt may include oral ? ?, oral ?, or anti ? drugs eg omalizumab
consider increasing level of treatment if SABA is needed ? times per week or more, or if Sx are ?
increase
highest
refer
B2 agonists
corticosteroids
IgE
3
persistent
B2 agonists
- relax bronchial ?? leading to bronchodilation
- SE - B1 in the ? : ? and B2 in ? muscle: ?, cramps, ? (due to uptake)
- SABA work for 4-?h whereas LABA work for >?h
SM heart tachy skel tremor hypokal 6 12
ICS
- reduce ? due to anti-infl effects
- SE : oral ? and ?, plus systemic effects of steroid
- advise to ? ? after use
exacerbations
thrush/candidiasis
pneumonia
rinse mouth
LTRA
- eg montelukast
- block ? action in airways, benefitting actions of ?
- SE - ?, ? dist, and rarely Churg-Strauss syndrome (systemic ?)
montelukast LT ICS thirst GI vasculitis
Theo/aminophylline
- prescribe by ? ? as efficacy variable, and there is a ? ? ?
- relax SM and also reduce ?
- SE - ?-related -and like caffeine- in high doses people can get ?, insomnia, nausea, ? and ?
brand name narrow therapeutic window exacerbations dose headache tachy arrhythmias
