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Pulmonary Conditions and Tobacco Cessation > Asthma > Flashcards

Asthma Flashcards

1
Q

What is the pathophysiology of Asthma?

A

Inflammation
and
Bronchoconstriction

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2
Q

How is Asthma diagnosed?

A

With the use of Spirometry (used in PCP only) and Pulmonary Function Test

Peak flow meter can be used in diagnosis but is mostly used to monitor asthma control

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3
Q

How is Spirometry used?

A 
Check at FEV1 baseline
then
use a short acting bronchodilator (albuterol)
then 
Check FEV1 again

If the FEV1 increases by more than 12% then = Asthma

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4
Q

What are some rescue drug for the treatment of Asthma?

A

***Inhaled low dose ICS + Formoterol (Dulera & Symbicort)

***Inhaled short-acting beta 2 agonist (SABA)

Systemic steroids- for exacerbation or sever asthma

Inhaled epinephrine - OTC

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5
Q

What are some maintenance or controllers drug for the treatment of Asthma?

A

Inhaled corticosteroids (ICS)

Inhaled long acting beta 2 agonist (LABA)

Oral leukotriene receptor antagonists (LTRA)

Theophylline

Inhaled long acting muscarinic antagonists (LAMA)

Monoclonal antibodies

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6
Q

What is the first line controller med for all patient with persistent asthma?

A

Inhaled corticosteroids (ICS)

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7
Q

True or False: All patient regardless of severity of Asthma should have a rescue inhaler.

A

True

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8
Q

What drugs are used in step 1 (intermittent asthma)?

A

SABA as needed

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9
Q

What drugs are used in step 2 (mild persistent asthma)?

A

Low- dose ICS

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10
Q

What drugs are used in step 3 (moderate persistent asthma)?

A

Low-dose ICS + LABA
or
Medium-dose ICS

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11
Q

What drugs are used in step 4 (severe persistent asthma)?

A

Medium-dose ICS + LABA
or
Medium-dose ICS + either LTRA, Therophyllin, or Zileuton

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12
Q

What drugs are used in step 5 (severe persistent asthma)?

A

High-dose ICS + LABA
and
Consider Omalizumab for patients who have allergies

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13
Q

What is drugs are used in step 6 (severe persistent asthma)

A

High-dose ICS + LABA + oral Corticosteroid
and
Consider Omalizumab for patients who have allergies

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14
Q

What are some Beta 2 Agonists used in the rescue treatment of Asthma? (2)

A

Albuterol

Levalbuterol (Xopenex)

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15
Q

Beta 2 Agonists in Asthma ADE

A 
Nervousness
Increased HR
Cough 
Hyperglycemia 
Decreased Potassium
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16
Q

What are some Inhaled Corticosteroid used in the treatment of Asthma? (4)

A

Beclomethasone (QVAR)
Budesonide (Pulmicort)
Fluticasone (Flovent)
Mometasone (Asmanex)

17
Q

What are some Inhaled Corticosteroid + LABA combinations products used in the treatment of Asthma? (4)

A

Fluticasone + Salmeterol (Advair)
Fluticasone + Vilanterol (Breo Ellipta)
Budensonide + Formoterol (Symbicort)
Mometasone + Formoterol (Dulera)

18
Q

Inhaled Corticosteroid ADE

A

Dysphonia (difficulty speaking)
Oral candidiasis (thrush)
Cough

19
Q

True or False: Inhaled Corticosteroid + Formoterol can be used as a rescue inhaler.

A

True

20
Q

Which LABA is used in the treatment of Asthma and comes as a single agent (i.e not in a combo formulation)?

A

Salmeterol (Serevent) only

no other LABA can be used in Asthma without it being in combination with another agent

21
Q

What are some LAMA used in the treatment of Asthma?

A

Tiotropium (Spiriva) only

no other LAMA can be used in Asthma

22
Q

What drug or drug combinations are FDA approved for use in COPD but not in Asthma treatment?

A

SAMA (all)
LAMA + LABA
LAMA + LABA + ICS

23
Q

What are the brand name identifiers for MDI (metered dose inhalers)?

A

HFA
Respimat
or if product doesn’t have a suffix assume its MDI

24
Q

What are the brand name identifiers for DPI (dry powder inhalers)?

A 
Diskus 
Ellipta
Pressair
Handihaler
Neohaler
RespiClick
Flexhaler
25
Q

What is the method of inhalation patients should practice when using a DPI? In other words, how should patients inhale drug?

A

Requires a QUICK and FORCEFUL inhalation

26
Q

What is the method of inhalation patients should practice when using a MDI? In other words, how should patients inhale drug?

A

Requires a SLOW and DEEP inhalation

27
Q

Is shaken or priming needed for DPI?

A

No

except for Flexhalers need priming and only prior to first use

28
Q

What are some Leukotriene modifying agents used in the treatment of Asthma?

A

Montelukast (Singulair)

29
Q

How can patients prevent exercise induced bronchospasm?

A

Take a SABA 5 to 15 minutes before exercise

this should last 2 to 3 hours

30
Q

What is the preferred drugs in the treatment of Asthma in pregancy?

A

SABA
+
ICS: Budesonide (Pulmicort) is preferred

31
Q

What is the monoclonal antibody agent used in the treatment of Asthma?

A

Omalizumab (Xolair) SC

32
Q

Peak flow meter basics….

A
  • Check every morning upon awakening and before the use of an asthma medications
  • Blow out as hard and as fast as possible. Write down the PEFR
  • Repeat step 2 more times with enough rest in b/w
  • Clean once a week
33
Q

Zone of asthma action per Peak flow meter….

A

Green zone: > 80 - 100% of personal best
- Continue routine maintenance plan

Yellow zone: 50 - 80% of personal best

  • Caution, worsening lung function
  • Increase in rescue inhaler use and the addition or increase of other medication

Red zone: < 50% of personal best

  • Medication alert
  • Go to emergency department

Pulmonary Conditions and Tobacco Cessation (4 decks)

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