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MSRA > Asthma > Flashcards

Asthma Flashcards

1
Q

1 >5yo

Newly-diagnosed asthma

A

Short-acting beta agonist (SABA)

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2
Q

2 >5yo

Not controlled on previous step
OR
Newly-diagnosed asthma with symptoms >= 3 / week or night-time waking

A

SABA + paediatric low-dose inhaled corticosteroid (ICS)

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3
Q

3 >5yo

A

SABA + paediatric low-dose ICS + leukotriene receptor antagonist (LTRA)

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4
Q

4 >5yo

A

SABA + paediatric low-dose ICS + long-acting beta agonist (LABA)

In contrast to the adult guidance, NICE recommend stopping the LTRA at this point if it hasn’t helped

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5
Q

5 >5yo

A

SABA + switch ICS/LABA for a maintenance and reliever therapy (MART), that includes a paediatric low-dose ICS

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6
Q

6 >5yo

A

SABA + paediatric moderate-dose ICS MART

OR consider changing back to a fixed-dose of a moderate-dose ICS and a separate LABA

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7
Q

7 >5yo

A

SABA + one of the following options:
increase ICS to paediatric high-dose, either as part of a fixed-dose regime or as a MART
a trial of an additional drug (for example theophylline)
seeking advice from a healthcare professional with expertise in asthma

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8
Q

Short-acting beta agonist (SABA)

>5yo

A

1

Newly-diagnosed asthma

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9
Q

SABA + paediatric low-dose inhaled corticosteroid (ICS)

>5yo

A

2

Not controlled on previous step
OR
Newly-diagnosed asthma with symptoms >= 3 / week or night-time waking

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10
Q

SABA + paediatric low-dose ICS + leukotriene receptor antagonist (LTRA)
>5yo

A

3

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11
Q

SABA + paediatric low-dose ICS + long-acting beta agonist (LABA)
>5yo

A

4

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12
Q

SABA + switch ICS/LABA for a maintenance and reliever therapy (MART), that includes a paediatric low-dose ICS
>5yo

A

5

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13
Q

SABA + paediatric moderate-dose ICS MART

OR consider changing back to a fixed-dose of a moderate-dose ICS and a separate LABA
>5yo

A

6

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14
Q

SABA + one of the following options:
increase ICS to paediatric high-dose, either as part of a fixed-dose regime or as a MART
a trial of an additional drug (for example theophylline)
seeking advice from a healthcare professional with expertise in asthma
>5yo

A

7

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15
Q

MART

A

ICS + LABA Single Inhaler

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16
Q

Low Dose ICS

A

=<200mcg

17
Q

Moderate Dose ICS

A

200-400mcg

18
Q

High Dose ICS

A

=>400mcg

19
Q

1 <5yo

Newly-diagnosed asthma

A

Short-acting beta agonist (SABA)

20
Q

2 <5yo

Not controlled on previous step
OR
Newly-diagnosed asthma with symptoms >= 3 / week or night-time waking

A

SABA + an 8-week trial of paediatric MODERATE-dose inhaled corticosteroid (ICS)

After 8-weeks stop the ICS and monitor the child’s symptoms:
if symptoms did not resolve during the trial period, review whether an alternative diagnosis is likely
if symptoms resolved then reoccurred within 4 weeks of stopping ICS treatment, restart the ICS at a paediatric low dose as first-line maintenance therapy
if symptoms resolved but reoccurred beyond 4 weeks after stopping ICS treatment, repeat the 8‑week trial of a paediatric moderate dose of ICS

21
Q

3 <5yo

A

SABA + paediatric low-dose ICS + leukotriene receptor antagonist (LTRA)

22
Q

4 <5yo

A

Stop the LTRA and refer to an paediatric asthma specialist

23
Q

Short-acting beta agonist (SABA)

<5yo

A

1

Newly-diagnosed asthma

24
Q

SABA + an 8-week trial of paediatric MODERATE-dose inhaled corticosteroid (ICS)
<5yo

A

2
Not controlled on previous step
OR
Newly-diagnosed asthma with symptoms >= 3 / week or night-time waking

25
Q

SABA + paediatric low-dose ICS + leukotriene receptor antagonist (LTRA)
<5yo

A

3

26
Q

Stop the LTRA and refer to an paediatric asthma specialist

<5yo

A

4

27
Q

<5yo After 8-weeks stop the ICS and monitor the child’s symptoms:
if symptoms did not resolve

A

Review whether an alternative diagnosis is likely

28
Q

<5yo After 8-weeks stop the ICS and monitor the child’s symptoms:
if symptoms resolved then reoccurred within 4 weeks

A

Restart the ICS at a paediatric low dose as first-line maintenance therapy

29
Q

<5yo After 8-weeks stop the ICS and monitor the child’s symptoms:
if symptoms resolved but reoccurred beyond 4 weeks

A

Repeat the 8‑week trial of a paediatric moderate dose of ICS

30
Q

Diagnosis of 5-16yo

A

Bronchodilator Reversibility

FeNO, if normal spirometry or if obstructive spirometry wiht negative BDR

31
Q

Diagnosis of 16+

A

FeNO
Bronchodilator Reversibility with Spirometry
?Occupational

32
Q

Diagnosis of <5

A

Clinical

MSRA (4 decks)

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