Asthma Flashcards
What is a blue inhaler?
Salbutamol - beta agonist
Define asthma?
Reversible airway obstruction that cause intermittent wheezing
= Reversible obstructive airway disease
What is a mast cell?
Inflammatory cell that release histamine in response to inflammatory response
Mechanism of mast cell releasing histamine?
- Allergen cross link to receptor IgE
- Intracellular response - trigger mast cell
- catalysis intracellular process
- secondary messenger = mast cell degranulation
- histamine release
What does release of histamine cause?
Smooth muscle constriction = bronchoconstriction
Mucus hyper secretion - block bronchi
Mucus plug formation
Mucosal oedema
Name different types of asthma?
- Extrinsic = atopic –> pollen, house dust mite faeces
- Intrinsic = cold, exercise, stress
- Aspirin induced
- Occupation - latex, animal, vapour
What is a wheeze?
When do you get wheeze with asthma?
Polyphonic whistle sound
Wheeze on expirations
What is atopy?
Predisposition to developing hypersensitivity type reaction
asthma, eczema
What is SOB?
Shortness of breath = dyspnoea
Laboured breathing - use of accessory muscles and increased breathing rate
What drives breathing? - does this ever change?
Most people CO2 drive respiration
People w/ COPD have hypoxic drive (dangerous to overload with oxygen - 1 in 200 have it and takes 4 hours to knock out)
What is normal respiratory rate?
What rate would be classical asthma
12-16breath/min
Tachypnoea >20 breath/min
Asthma >25
Symptom of severe asthma?
Peak flow less 50% predicted, can’t complete sentence, RR>25, HR>110
Symptom life threatening asthma?
Cyanosis, exhaustion, RR less 8
What is FEV1 and FVC?
FEV1= forced expiratory vol in 1 second - after full inspiration FVC = forced vital capacity
How measure breathing?
Spirometer and peak flow meter
What expect to see in obstructive lung disease (FEV1/FVC)
Reduced FEV1 normal FVC
FEV1:FVC less 70%
How diagnose asthma?
Show FEV1:FVC less 70%
- need to show reversible
How to manage asthma w/ inhalers?
- Reliever - manage attack by using short acting beta agonist
- Preventer - don’t relieve attack - use long acting beta agonist
What is the blue, brown and green inhaler?
Blue - salbutamol
Brown = steroid
Green = long acting
When is ipratropium bromide used?
Acute attack - can be brown colour
How does salbutamol work?
B2 agonist - stimulate B2 adrenoreceptor relaxing smooth muscle
Explain step wise approach asthma?
- Short acting beta agonist
- Steroid inhaler
- Long acting beta agonist
- Increase steroid dose/ montelukast
- Oral steroid - short term
Assessing control asthma in dental setting?
Medication take
Admission A+E/ICU
Frequency of attack
Functional limitation
Emergency management of acute asthma?
- ABC
- Salbutamol
- Oxygen
- Ambulance - hypoxic, feature severe asthma
How is asthma tx in hospital?
- High flow oxygen
- Nebulised
- Prednisolone - prevent late T cell response
- No response - escalate Mg
