Asthma Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Mx asthma in adults?

A
  1. SABA
  2. SABA + inhaled corticosteroid 200-800mcg/day
  3. Add LABA, continue if good response, increase steroid to 800. Add in leukotriene or theophylline if required
  4. Increase steroids up to 2000mcg/day. Add in leukotriene receptor antagonist, SR theophylline or B2 agonist tablet
  5. Daily steroid tablet, inhaled steroid up to 2000mcg/day. Refer to specialist
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2
Q

What are some e.g. of SABA?

A

Salbutamol, terbutaline, adverse effects

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3
Q

What are adverse effects of SABAs?

A
Fine tremor
Palpitations
Tachycardia
Headaches
Tachyarrhythmias
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4
Q

What are uses of SABAs?

A

Mx asthma
Acute hyperkalaemia
Tocolytic to delay premature labour

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5
Q

How may salbutamol be administered?

A

MDI- 200 micrograms

Nebulised solution- 2.5 or 5mg

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6
Q

How is terbutaline commonly prescribed?

A

Turbuhaler- used for patients with difficulty coordinating

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7
Q

When should inhaled steroids be prescribed in mx of asthma?

A

Patients requiring B2 agonists more than twice a week, nocturnal sx or recent exacerbate requiring systemic steroids in past 2 years

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8
Q

What is the standard inhaled corticosteroid prescribed in asthma?

A

Beclamethasone

Others- budesonide, fluticasone

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9
Q

What are the adverse effects of inhaled corticosteroids in asthma?

A

Oral candida
Adrenal suppression

reduced when inhaled.
Rinse mouth after inhaler to reduce candida risk

Steroid card if on high dose inhalers

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10
Q

What are the most frequent LABAs prescribed in asthma?

A

Salmeterol or formeterol

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11
Q

What is in a seretide inhaler?

A

Combination of salmeterol and fluticasone

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12
Q

What is in a symbicort inhaler?

A

Combination of formeterol and budesonide

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13
Q

What is in a fostair inhaler?

A

Combination of formeterol and beclomethasone

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14
Q

What are examples of leukotriene receptor antagonists?

A

Montelukast

Zafirlukast

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15
Q

How do leukotriene receptor antagonists work?

A

Block leukotrienes- pro-inflammatory mediators

May have synergistic effect with inhaled corticosteroids

May have role in exercise-induced asthma

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16
Q

What condition can be associated with leukotriene receptor antagonists?

A

Churg-Strauss

17
Q

How does theophylline work?

A

Xanthine bronchodilator with narrow therapeutic window

18
Q

Why should oral theophylline be prescribed by brand?

A

They are not bioequivalent

19
Q

What are adverse effects of theophylline?

A

GI disturbance, anxiety, tachycardia and tremor

May be fatal in OD

20
Q

What is omalizumab?

A

Mab that binds to IgE used in allergic asthma

For specialist use only

21
Q

When do you need to titrate oral steroid dose down?

A

If received >40mg prednisolone (or equivalent) daily for more than 1 week

If received more than 3 weeks treatment

Recently received repeated courses (especially if >3 weeks)

Taken a short course within 1 year of stopping long term therapy

22
Q

What is a typical reducing regime of oral steroids?

A

Reduce by 2.5mg every 3-4 days, down to 7.5mg per day

Then reduce more slowly- e.g. 2.5mg every 1-2 weeks

23
Q

Who does not require titration of oral steroids?

A

Those whose disease is unlikely to relapse

Those who have received treatment for 3 weeks or less