Asthma Flashcards
Symptoms of asthma result from
a
combination of inflammation and
bronchoconstriction
3 Assessment and treatment groups
0-4 y.o.,
5-11 y.o. & 12 y.o. and older
initial visit
classify asthma severity
follow-up visit
assess asthma control and
adjust therapy
two goals of treatment
reduce treatment
reduce risk
how many days a week should a pt need to use SABA
less than 2
how many times a week should a patient awake a night time due to asthma
less than 2
Three components of risk reduction
Prevention of recurrent exacerbations and need for emergency
department or hospital care
– Prevention of reduced lung growth in children, and loss of lung
function in adults
– Optimization of pharmacotherapy with minimal or no adverse
effects
Three lung function tests
– Forced expiratory volume in 1 second (FEV1)
– Forced vital capacity (FVC)
– Peak expiratory flow (PEF)
What test is diagnostic in asthma
FEV1
Severity levels
– Intermittent
– Mild persistent
– Moderate persistent
– Severe persistent
Three categories of asthma control
well-controlled
not well-controlled
very poorly controlled
Asthma control test what is considered a well controlled score
greater than or equal to 19 is well-controlled
5 components of asthma meanagment
• Pharmacologic treatment
• Stepwise approach
• Increase medications until asthma is controlled
• Decreasing medications when possible to
minimize side effects
• Adjustment of the patient’s management
should be considered at every visit.
Step one
patients not already on a controller
medication – classify the severity of the
patient’s asthma (if already on a controller
medications, change in therapy is guided by
assessment of asthma control).
Review initial visit:
classifying asthma severity and
initiating therapy
Follow-up visits
assessing asthma control and
adjusting therapy
Intermittent asthma symptoms occurring
two or fewer days per week
iIntermittent asthma two or fewer
nocturnal awakenings per month
Intermittent asthma use of SABA to relieve stymptoms __ per week
two or fewer days
Intermittent asthma no _____ with
interference with normal activities between exacerbations
Intermittent asthma FEV1 measurements
between exacerbations that are
consistently within the normal range (ie, ≥80 percent of
predicted normal)
Intermittent Asthma FEV1/FVC ratio
between exacerbations that is normal
Intermittent Asthma one or no
exacerbation requiring oral glucocorticoids per year
Mild symptoms
more than twice weekly
mild approximately
three to four nocternal awakengs per month
mild use of SABA more than
two days out of the week
mild only minor ____
interference with normal activities
mild fev1
measurements within normal range (≥80
percent of predicted normal) and normal FEV1/FVC
ratio
mild two or more
exacerbations requiring oral glucorcorticoids per year
Moderate ___ symptoms
daily
moderate nocternal awakenings
more than once per week
moderate ___ need for SABA
daily
Moderate some
limitates in noraml activity
moderate FEV1 between
60 and 80 percent of predicted and FEV1/FVC below normal
Severe symptoms of asthma
throughout the day
severe nocturnal
awakenings nightly
severe need for SABA
several times a day
Severe extreme limitation in
limitation in normal activity
Severe FEV1
<60 percent of predicted
FEV1/FVC for severe
below normal
Intermittent step
step 1
mild persistent step
step 2
moderate persistent stop
step 3
severe persistent step
step 4 or 5
