Asthma Flashcards
How do patients with asthma present?
cough wheezing chest tightness prolonged exhalation SOB
What does the bronchoprovocation test indicate in a patient with asthma?
limitation of airflow
What are the common triggers for asthma?
Atopy:
must mites
cockroaches
seasonal pollens
nonspecific precipitants: exercise URI sinusitis allergic rhinitis aspiration air pollution meds
How do the FEV1 and FEV1/FVC ratio differ in their response to drug therapy between COPD and asthma?
COPD: never with significant disease
asthma: probably
How do you treat asthma short term? (3)
SABA
- albuterol
- levalbuterol
anticholinergics
- ipratropium
systemic corticosteroids
- prednisone
How do you treat asthma long term? (2)
inhaled corticosteroids
-fluticasone, beclomethasone, budesonide
leukotriene modifierse
- montelukast, zafilukast
- zileuton (5 lipooxygenase inhibitor)
What are the signs that a patient is in respiratory arrest?
breathless at rest
silent/mute
drowsy or confused
What are the classifications of intermittent asthma? (5)
symptoms <2 days/week nighttime awakenings: <2 a month SABA use: <2 days/week doesn't interfere with activity lung function is normal, FEV >80% predicted, ratio is normal
What are the classifications of mild asthma? (5)
symptoms >2 days/week but not daily nighttime awakenings: 3-4x a month SABA use: >2 days/week but not daily minor limitation to activity lung function is normal, FEV >80% predicted, ratio is normal
What are the classifications of moderate asthma? (5)
symptoms: daily nighttime awakenings: >1x a week SABA use: daily some limitation to activity 60< FEV <80, ratio is reduced by 5%
What are the classifications of severe asthma? (5)
symptoms: throughout the day nighttime awakenings: often 7x a week SABA use: throughout the day extremely limited in activity FEV < 60%, ratio is reduced by more than 5%
What level of severity of symptoms may be considered the same as persistent even in the absence of impairment levels consistent with persistent asthma?
patients who have had more than 2 exacerbations requiring oral glucocorticoids in the past year
What is the stepwise approach for treating patients with asthma?
step 1 - SABA
step 2 - low dose ICS
step 3 - medium dose ICS or low dose ICS and LABA
step 4 - medium dose ICS and LABA or montelukast
step 5 - high dose ICS and LABA or montelukast
step 6 - high dose ICS and laba and/or oral corticosteroids
What are the mainstays for treating a patient suffering from an acute asthma attack?
oxygen
albuterol
steroids
What is the difference between well controlled and poorly controlled asthma?
poorly controlled asthma is the same as severe asthma while well controlled is intermittent asthma
