Asthma Flashcards
how to diagnose asthma
spirometry
define fev1
how much air can be forcefully exhaled in 1 second
define fvc
after taking a deep breath, the max volume of air that is exhaled
FEV1/FVC
the % of total air capacity “vital capacity” that can be forcefully exhaled in one second
Based on rescue inhaler use classify intermittent asthma
< 2days/wk
Based on rescue inhaler use classify mild persistent asthma
> 2 days/week but not daily or > 1x/day
Based on rescue inhaler use classify moderate persistant asthma
Daily use
Based on rescue inhaler use classify severe persistant asthma
several times per day
step 1 treatment for asthma
PRN low-dose ICS + formoterol
or
Low dose ICS when SABA is taken
Step 2 treatment for asthma
daily low dose ICS
or
prn low dose ICS + formoterol
Step 3 treatment for asthma
Low dose ICS
+ LABA
Step 4 treatment for asthma
Mediu dose ICS
+ LABA
Step 5 treatment for asthma
High dose ICS
+LABA
beta-2 agnoist MOA
bind to beta-2 receptors causing relaxation of bronchial smooth muscle which leads to bronchodilation
Name a SABA
albuterol
Name a LABA
salmeterol
Why do LABAs need to be combined with an ICS
increased risk of asthma-related deaths
budesonide + formoterol brand name
symbicort
fluticasone + salmeterol brand name
Advair
Fluticasone + vilanterol brand name
Breo Elipta
mometasone + formoterol brand name
Dulera
major SE of ICS
thrush
Leukotriene receptor antagonists (LTRA) MOA
inhibit leukotriene mediators of airway inflammation this reduces airway edema, contriction and inflammation
Montelukast inhibits which leukotrienes
D4
zafirlukast inhibits which leukotrienes
LTD4
LTE4
Zileuton MOA
5-lipoxygenase inhibitor, inhibits leukotriene formation
List LTRAs
montelukast
zafirlukast
zileuton
Theophylline MOA
blocks phosphodiesterase, causing an increase in cyclic adenosine monophosphate (cAMP) and release of epinephrine from adrenal medulla cells this results in bronchodilation
aminophylline to theophylline conversion
aminophylline contains 80% theophylline
“ATM” amino -> theo multiply
theo to amino divide by 0.8
omalizumab MOA
inhibits IgE binding to the IgE receptor on mast cells and basophils
Treatment for exercise induced bronchospasm
SABA
define peak expiratory flow rate (PEFR)
max flow rate from a forceful exhalation, starting from fully inflated lungs
