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Resp - mine > asthma > Flashcards

asthma Flashcards

1
Q

whats the treatment for an acute attack

A

(OSHITMMAN)

oxygen = 100% non-rebreather mask
Salbutamol (nebulised)
Hydrocortisone IV or prednisalone (oral)
Ipratropium (nebulised) 
Theophylline IV or aminophylline IV
Magnesium IV
Anaesthetist
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2
Q

is asthma restrictive or obstructive

A

obstructive

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3
Q

what is the main cell found in asthma

A

eosinophil

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4
Q

what would be found in a FBC

A

blood eosinophilia>4%

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5
Q

what would be heard when percussing

A

hyper-resonant

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6
Q

what would you expect from pulmonary function tests

A

decreased FEV1
decreased PEFR
normal FVC

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7
Q

describe FEV1

A

decreased

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8
Q

describe FVC

A

normal

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9
Q

describe PEFR

A

decreased

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10
Q

what investigations are used (6)

A 
spirometry 
peak flow
provocation testing 
exercise testing
skin prick test 
FBC
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11
Q

what is the 1st line of treatment

A

SABA

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12
Q

what is the 2nd line of treatment

A

SABA + ICS

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13
Q

what is the 3rd line of treatment

A

LABA + ICS + SABA

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14
Q

what is the 4th line of treatment

A

add 4th drug e.g
methylxanthines
CysLT1 Receptor Antagonists

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15
Q

what is the 5th line of treatment

A

add oral steroid and refer to a specialist

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16
Q

what is the mechanism of action of SABA

A

Agonist binds to beta-2-adrenoceptor and initiates chain of reactions that causes ATP to be converted into cAMP leading to relaxation of airway smooth muscle

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17
Q

give examples of SABAs

A

salbutamol

terbutaline

18
Q

what are the side effects of SABAs

A

fine tremor, tachycardia, hypokalaemia

19
Q

what is the mechanism of action of LABAs

A

Agonist binds to beta-2-adrenoceptor which initiates chain of reactions that causes ATP to be converted into cAMP leading to relaxation of airway smooth muscle

20
Q

what are the side effects of LABAs

A

may worsen asthma is given as a monotherapy

21
Q

what should LABA be administered with

A

ICS

22
Q

give examples of LABAs

A

salmeterol

formeterol

23
Q

what is particularly useful in nocturnal asthma

A

LABA

24
Q

what is the mechanism of action of ICS

A

anti-inflammatory effects. Act by mediating transcription of specific genes to alter mRNA levels + rate of synthesis of inflammatory/anti- inflammatory mediator proteins

25
Q

give examples of ICS

A

beclometasone

budesonide

26
Q

what is the mechanism of action of methylxanthines

A

anti-inflammatory and limited bronchodilator action. Uncertain mechanisms

27
Q

give examples of methylxanthines

A

theophylline

aminphylline

28
Q

when would methylxanthines be used

A

4th step

29
Q

side effects of methylxanthines

A

many due to narrow therapeutic window

30
Q

when would ICS be used

A

2nd step

31
Q

when would SABA be used

A

1st step

32
Q

when would LABA be used

A

3rd step

33
Q

what is the mechanism of action of CysLT1 Receptor Antagonists

A

act competitively at the CysLT1 receptor cause smooth muscle

contraction, mucous secretion and oedema

34
Q

what are CysLTs derived from?

A

mast cells and infiltrating

inflammatory cells

35
Q

how are CysLTs administered

A

orally

36
Q

give examples of CysLTs

A

montelukast

37
Q

what Ig__ is present in asthma

A

IgE

38
Q

give an example of a monoclonal antibody therapy in asthma

A

Omalizumab

39
Q

what is the mechanism of action of Omalizumab

A

binds to IgE via Fc to prevent FCE receptor attachment

40
Q

how is Omalizumab administered

A

IV

41
Q

what type of hypersensitivity disease is asthma

A

type I

42
Q

what is asthma

A

recurrent and reversible obstruction of the airways in response to a stimuli/substance

Resp - mine (18 decks)

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