Asthma

Question 1

Initial steps in asthma medication management

Answer 1

SABA—>bronchodilation

Question 2

Most effective long term prevention

Answer 2

Inhaled steroid

Question 3

Asthma signs of increased intraoperative difficulties

Answer 3

Frequent night wakening, increased medication recently, s/s viral infection

Question 4

Pretreatment med for asthmatics

Answer 4

Corticosteroids —>don’t give drug with histamine release (such as morphine)

Question 5

Medications to avoid in asthmatics

Answer 5

Histamine releasing medications (I.e. morphine)

Histamine 2 receptor blockers—> can cause bronchospasm (block post and presynaptic receptors losing negative feedback, this increasing histamine release)

NSAIDS/Aspirin —> cause bronchospasm

Anticholinesterase reversal agents (neo)—> suggamadex is better, less bronchospasm

Question 6

Induction drug with bronchodilation

Answer 6

Ketamine!

Question 7

Steps when bronchospasm occurs

Answer 7

Deepen anesthesia
Administer 100% O2
Administer B2agonist
Epi in severe cases 
Administer IV corticosteroids
Aminophylline if long term vent is necessary (not good for episodes)