Asthma

Question 1

What are the two distinct phases of asthma?

Answer 1

1. Acute airway hyper-responsiveness and reversible bronchoconstriction
2. Refractory bronchoconstriction

Question 2

What is treatment of acute phase of asthma?

Answer 2

β-2 agonists

Question 3

What is treatment of delayed phase of asthma?

Answer 3

Steroids

Question 4

What is an easy way to gauge severity of asthma?

Answer 4

Peak expiratory flow rate or FEV1 (measured at bedside)

Question 5

What is the usual dosing of albuterol for asthma exacerbation?

Answer 5

2. 5-5 mg
   - 3 times in first hour
   - 2 times in second hour
   - Then hourly

Question 6

In a patient with severe asthma exacerbation that can’t tolerate inhalation, what should be done?

Answer 6

Subcutaneous epi or terbutaline

Question 7

What is still often given for patients with severe asthma exacerbation?

Answer 7

2-4 g magnesium sulfate

Can start working in 2-5 minutes but results are short lived

Can cause some hypotension, flushing, and malaise

Question 8

What is a good induction agent for intubation secondary to asthma?

Answer 8

Ketamine because it stimulates release of catecholamines and causes relaxation of smooth muscle (bronchodilation)

Question 9

Steroid course for patients after asthma exacerbation?

Answer 9

5-10 days (can still give inhaled steroids too)