Asthma

Question 1

What are signs and symptoms of asthma?

Answer 1

Wheezing
Worsens at night
Worsens with triggers
Episodic in nature
Reversible with beta agonist

Question 2

Intermittent asthma is considered what?

What do you prescribe?

Answer 2

Less than 2 attacks a week of symptoms

Less than 2x monthly awakening at night

No interference in daily life

Give SABA PRN (up to 3 treatments at 20 minute intervals recommended)

Question 3

Mild asthma is considered what? How do you treat it?

Answer 3

More than 2 attacks weekly but not daily

Awaken 3-4 times a month

Minor limitation on daily life

PFT still normal

Prescribe SABA and ICS (low dose) then step 3 ICS (low with SABA and LABA)

Question 4

Moderate asthma is considered what? What do you prescribe?

Answer 4

daily symptoms, awaken 1 or more days weekly with some limitations on daily activity

PFTs befinning to decrease at around 60%

ICS LABA and SABA

Question 5

A mild exacerbation where there is some dyspnea on exertion and >70% PEF should be given what?

Answer 5

SABA (consider steroid)

Question 6

Moderate asthma exacerbation where the patient has dyspnea with usual activity and a PEF or 40-69% should get what treatments?

Answer 6

SABA and oral steroids

Question 7

A severe asthma exacerbation where the patient has dyspnea at rest and less the. 40% PEF should get what?

Answer 7

SABA, IV steroids, admitted

Question 8

Of the patient is unable to speak due to asthma exacerbation and a PEF

Answer 8

SABA, IV steroids, ICU admission

The IV prednisone dose is 60-80 Q8-12

2gm of mag to bronchodilate if severe

Question 9

When should a patient be admitted?

Answer 9

After 3 neb treatments in an hour and the patient has returned to 70%baseline unless other factor make the patient higher risk