Asthma Case Flashcards
subjective tool for asthma severity
asthma control test
step 1 asthma is aka
exercise induced asthma
tx for exercise induced asthma
PRN SABA
step up tx for non exercise induced asthma
- PRN low dose ICS
- PRN low dose ICS/LABA + SABA
- daily low dose ICS/LABA + SABA
- daily medium dose ICS/LABA + SABA
- daily high dose ICS/LABA + SABA
ICS/LABA preferred in asthma
symbicort
name 3 ICS
beclomethasone (QVAR)
fluticasone (Flovent)
budesonide (Pulmicort)
asthma symptoms by steps
- symptoms less than twice a month
- symptoms twice a month or more
- symptoms most days AND night sx once/week
- symptoms most days AND night sx > once/week
what asthma drug has a black box warning for serious neuropsychiatric events
singulair (montelukast)
advair is a combo of
fluticasone/salmeterol
symbicort is a combo of
budesonide/formoterol
7 drug classes used for asthma
SABA/LABA
ICS
leukotriene modifiers
mast cell stabilizers
anticholinergics
anti-IgE antibody
theophylline
s.e of SABAs
tremor
palpitations
anxiety
insomnia
nervous
QT prolongation
hyperglycemia
hypoglycemia
hypomagnesemia
MOA for corticosteroids
inhibit cytokines via glucocorticoid receptor
s.e of ICS
oral candidiasis
dysphonia
reflex cough
bronchospasm
initial tx for all asthma dx
PRN ICS
most effective long term tx for control of asthma sx
ICS
t/f: it is normal to cough after using ICS inhaler
t!
2 common LABAs
salmeterol (serevent)
formoterol
4 s.e of LABAs
paradoxical bronchospasm
asthma exacerbations
laryngospasms
hypokalemia
what drug should never be used as monotherapy for asthma bc it will increase symptoms
LABA
3 common ICS/LABA combos
advair
symbicort
dulera
s.e of ICS/LABA combo
tremor
muscle cramps
tachycardia
cardiac effects
what asthma drug works by inhibiting actions of LTD4 at the CysLTI receptor w.o any agonist activity
leukotriene modifiers
common leukotriene inhibitor
singulair
5 s.e of leukotriene inhibitors
abd pain
nausea
jaundice
itching
lethargy
when should leukotriene inhibitors be used for asthma
only when ICS or ICS/LABA combos are maxed out
last line therapy
what asthma drug class isn’t really used anymore
mast cell stabilizers
mc cause of asthma tx failure
lack of adherence to meds
class of drug that may cause asthma symptoms
NSAIDs
class of med that may decrease effectiveness of asthma meds
bb
5 migraine prophylactic meds that can be used as alternative in pt’s w. asthma
atenolol or metropolol -> b1 selective blocker
amitryptiline or nortriptyline
verapimil -> non dihydropiridine
valproic acid
topiramate
what migraine prophylactic med can decrease effectiveness of OCPs
anticonvulsants
3 solutions for thrush from ICS
nystatin -> for all
spacer
rise after using ICS
all asthma patients should have what med on hand
SABA - albuterol
f/u for asthma pt after adjusting meds
2-4 weeks
