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NAPLEX - OUR cards > Asthma > Flashcards

Asthma Flashcards

1
Q

Classic symptoms

A

wheezing
breathlessness
chest tightness
coughing

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2
Q

Asthma is reversible (t/f)

A

TRUE

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3
Q

Factors used to assess severity of asthma

A 
Daytime symptoms
nighttime symptoms
rescue inhaler use
FEV1 and FVC
Exacerbation hx
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4
Q

Recommended vaccines in asthma pts

A 
annual influenza (> 6 mons)
PPSV 23; Prevnar x 1 (age 2- 64)
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5
Q

What is considered frequent use of a rescue inhaler?

A

> 2 days/week

indicates worsening asthma control

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6
Q

Treatment for mild persistent asthma

A

low dose ICS

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7
Q

treatment for moderate persistent asthma

A

medium dose ICS

OR low dose ICS + LABA

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8
Q

Side effects of beta-2 agonist

A 
nervousness
tremor
tachycardia
palpitations
cough
hyperglycemia
hyperkalemia
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9
Q

Levalbuterol is….

A

the R-isomer of albuterol

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10
Q

Dose of SABA for exercise induced bronchospasm

A

2 inhalations 5 mins prior to exercise

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11
Q

LABAs cannot be used alone in asthma, why?

A

Can incr the risk of asthma-related deaths if used alone

must be combined with ICS

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12
Q

Role of ICS in asthma

A

anti-inflammatory effects
reduce hyperresponsiveness
block late phase reactants to allergens

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13
Q

Side effects of ICS

A 
Dysphonia
oral candidiasis
cough
headach 
hoarseness
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14
Q

Which ICS is available as a nebulized solution?

A

Budesonide (available generic)

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15
Q

high doses of prolonged ICS therapy can lead too…

A

adrenal suppression
incr risk of fracture
growth retardation in kids

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16
Q

Only LABA approved for asthma

A

Salmeterol

1 inh BID

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17
Q

Meter dose inhaler identifiers

A

HFA, Respimat, or no abbreviations

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18
Q

Dry powder inhaler identifiers

A

Diskus, ellipta, pressair, neohaler, etc

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19
Q

Most MDIs need to be shaken except for:

A

Qvar
Alvesco
Respimat products

20
Q

Montelukast brand

A

Singulair

21
Q

Singulair MOA

A

leukotriene receptor antagonist

leukotrienes mediate airway inflammation

22
Q

Pediatric dosing of singulair

1-5 y/o and 6-14

A

1-5 y/o: 4 mg qpm

6-14 y/o: 5 mg qpm

23
Q

Zafirlukast

A

Accolate

Leukotriene receptor antagonist

24
Q

Zileuton

A

Zyflo

inhibits leukotriene formation

25
Q

Zafirlukast metabolism

A

major substrate of 2C9

moderate inhibitor of 2C9 (incr theophylline, warfarin, carvedilol, etc)

26
Q

Theophylline MOA

A

blocks phosphodiesterase –> incr cAMP –> bronchodilation

27
Q

side effects of theophylline

A 
n/v
HA
incr HR
insomnia
tremor and nervousness
28
Q

therapeutic levels of theophylline

A

5-15 mcg/ml

measure peak level at steady state

29
Q

Active metabolites of theophylline

A

caffeine

3-methylxanthine

30
Q

IV version of theophylline

A

aminophylline

contains 80% theophylline

31
Q

Theophylline metabolism

A

1A2 major substrate
3A4 minor substrate

A LOT of drug interactions

32
Q

LAMA agent approved in asthma pts 6 or older that are not controlled on ICS/LABA

A

tiotropium (Spiriva)

33
Q

Xolair

A

omalizumab

34
Q

Xolair MOA

A

monoclonal antibody

inhibits IgE binding to mast cells

35
Q

Xolair indication

A

for mod-severe persistent allergic asthma

36
Q

Xolair dosing

A

dose and frequency is base on serum IgE levels and body weight

ususally given q 2 or 4 weeks

37
Q

What class of agents are reserved for severe asthma with an eosinophilic phenotype?

A

interleukin-5 (IL-5) receptor antagonist

38
Q

IL-5 receptor antagonist:

A

Mepolizumab (Nucala) -subcutaneous

Reslizumab (Cinqair) - IV (BBW for anaphylaxis)

39
Q

Singulair can also be used for exercised induced bronchospasm (t/f)

A

True
take 2 hrs prior to exercise
not as effective as SABA

40
Q

How long should a pt wait if they have to use 2 inhalations?

A

60 seconds

41
Q

Spacers can be used with all types of inhalers (t/f)

A

false
only MDIs
not DPIs

42
Q

When should pts use a peak flow meter?

A

Every day

every morning upon awakening and before using any meds

43
Q

When do pts need to prime albuterol inhalers?

A

new inhaler

> 14 days after from last use

44
Q

Breathing technique for MDIs

A

slowly and deeply

45
Q

Breathing technique for DPIs

A

quickly and deeply

46
Q

Common side effects of singulair

A

HA
dizziness
abdominal pain

47
Q

Singulair granules can be taken…

A

directly in the mouth
dissolved in baby formula or breast milk
with applesauce, mashed carrots, rice, ice cream

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