Asthma and tobacco cessation Flashcards
who is predisposed to have asthma
those with a family history of asthma, those with atopy, smokers and those exposed to second hand smoke, high body mass index, and severe viral respiratory infections in first 3 years of life
environmental triggers
cold air, dust mites, cockroaches, animal dander, molds, fungi, smoke, pollen, seafood/shellfish
drugs or chemical triggers
aspirin, NSAIDs, beta blockers, food or drug preservatives, household cleaning agents, perfumes, occupational exposure to certain chemical/irritants
conditions or event triggers
GERD, allergic rhinitis, panic attacks, smoking, emotional stress, exercise, viral respiratory infections
green PEF
focuses on maintenance medication adherence
yellow PEF
take short acting inhaled beta agonist
red PEF
take beta-agonist and go to ED
self exclusions for asthma
- only used for short term in pts who symptoms are mild, intermittent, and of short duration
- should have previous diagnosis of asthma
- no concurrent symptoms whose symptoms may be similar to asthma
- contraindication for bronchodilators: pregnancy, hyperthyroidism, cardiac arrhythmias, heart disease, uncontrolled hypertension
- age requirements
bronchodilator
product is asthmanefrin
bronchodilator use
takes 10-15 minutes, delivers medication in a mist that can be inhaled
bronchodilator age requirements
must be four y/o or older
dosing for bronchodilator
1-3 inhalations every 3 hours as needed, no more than 12 inhalations in 24 hours
side effects of bronchodilator
nervousness, tachycardia
bronchodilator + expectorant products
bronkaid, Primatene asthma
bronchodilator + expectorant age requirement
12 years of age or older
bronchodilator + expectorant dosing
12.5-25mg every 4 prn, no more than 150mg in 24 hours
bronchodilator + expectorant side effects
tachycardia, hypertension, tremor, nervousness/anxiety; less common arrhythmias, seizures, hypokalemia, angina, hyperglycemia
vaccinations for asthma patients
flu and PPSV23
5 A’s for treating tobacco dependence
Ask about tobacco use and any previous quit attempts Advise to quit Assess willingness to make quit attempt Assist in quit attempt Arrange follow-up
exclusions for tobacco cessation
- serious heart disease, including recent MI, irregular heartbeat, severe angina
- HTN not controlled with meds
- active peptic ulcer disease
- pregnancy or breast feeding
- < 18 years of age
nicotine gum strengths
TTFC < 30 minutes of waking up = 4mg gum
TTFC > 30 minutes of waking up = 2 mg gum
dosing for gum
1 piece ever 1-2 hours while awake for the first 6 weeks
- no more than 24 pieces per day up to 12 weeks
eating and drinking with gum
do not eat or drink anything except water 15 minutes before or while using gum
ADE for nicotine gum
unpleasant taste, mouth irritation, jaw fatigue, hypersalivation, hiccups, dyspepsia
nicotine lozenge strengths
same as gum
no more than _______ lozenges per day
20, no more than 4 in 6 hours, up to 12 weeks
which has greater absorption, gum or lozenge?
lozenge has greater absorption and nicotine delivery
nicotine patch strengths
7, 14, 21 mg patches
More than ten cigarettes a day patch dosing
21 for 4-6 weeks, 14 for 2 weeks, then 7 for 2 weeks
less than or equal to ten cigarettes a day patch dosing
14 for 6 weeks, then 7 for 2 weeks
patches and MRIs
remove prior to MRI, burns
side effects of nicotine patches
erythema, burning, pruritis
