Asthma Case

Question 1

subjective tool for asthma severity

Answer 1

asthma control test

Question 2

step 1 asthma is aka

Answer 2

exercise induced asthma

Question 3

tx for exercise induced asthma

Answer 3

PRN SABA

Question 4

step up tx for non exercise induced asthma

Answer 4

1. PRN low dose ICS
2. PRN low dose ICS/LABA + SABA
3. daily low dose ICS/LABA + SABA
4. daily medium dose ICS/LABA + SABA
5. daily high dose ICS/LABA + SABA

Question 5

ICS/LABA preferred in asthma

Answer 5

symbicort

Question 6

name 3 ICS

Answer 6

beclomethasone (QVAR)
fluticasone (Flovent)
budesonide (Pulmicort)

Question 7

asthma symptoms by steps

Answer 7

1. symptoms less than twice a month
2. symptoms twice a month or more
3. symptoms most days AND night sx once/week
4. symptoms most days AND night sx > once/week

Question 8

what asthma drug has a black box warning for serious neuropsychiatric events

Answer 8

singulair (montelukast)

Question 9

advair is a combo of

Answer 9

fluticasone/salmeterol

Question 10

symbicort is a combo of

Answer 10

budesonide/formoterol

Question 11

7 drug classes used for asthma

Answer 11

SABA/LABA
ICS
leukotriene modifiers
mast cell stabilizers
anticholinergics
anti-IgE antibody
theophylline

Question 12

s.e of SABAs

Answer 12

tremor
palpitations
anxiety
insomnia
nervous
QT prolongation
hyperglycemia
hypoglycemia
hypomagnesemia

Question 13

MOA for corticosteroids

Answer 13

inhibit cytokines via glucocorticoid receptor

Question 14

s.e of ICS

Answer 14

oral candidiasis
dysphonia
reflex cough
bronchospasm

Question 15

initial tx for all asthma dx

Answer 15

PRN ICS

Question 16

most effective long term tx for control of asthma sx

Answer 16

ICS

Question 17

t/f: it is normal to cough after using ICS inhaler

Answer 17

t!

Question 18

2 common LABAs

Answer 18

salmeterol (serevent)
formoterol

Question 19

4 s.e of LABAs

Answer 19

paradoxical bronchospasm
asthma exacerbations
laryngospasms
hypokalemia

Question 20

what drug should never be used as monotherapy for asthma bc it will increase symptoms

Answer 20

LABA

Question 21

3 common ICS/LABA combos

Answer 21

advair
symbicort
dulera

Question 22

s.e of ICS/LABA combo

Answer 22

tremor
muscle cramps
tachycardia
cardiac effects

Question 23

what asthma drug works by inhibiting actions of LTD4 at the CysLTI receptor w.o any agonist activity

Answer 23

leukotriene modifiers

Question 24

common leukotriene inhibitor

Answer 24

singulair

Question 25

5 s.e of leukotriene inhibitors

Answer 25

abd pain
nausea
jaundice
itching
lethargy

Question 26

when should leukotriene inhibitors be used for asthma

Answer 26

only when ICS or ICS/LABA combos are maxed out
last line therapy

Question 27

what asthma drug class isn’t really used anymore

Answer 27

mast cell stabilizers

Question 28

mc cause of asthma tx failure

Answer 28

lack of adherence to meds

Question 29

class of drug that may cause asthma symptoms

Answer 29

NSAIDs

Question 30

class of med that may decrease effectiveness of asthma meds

Answer 30

bb

Question 31

5 migraine prophylactic meds that can be used as alternative in pt’s w. asthma

Answer 31

atenolol or metropolol -> b1 selective blocker
amitryptiline or nortriptyline
verapimil -> non dihydropiridine
valproic acid
topiramate

Question 32

what migraine prophylactic med can decrease effectiveness of OCPs

Answer 32

anticonvulsants

Question 33

3 solutions for thrush from ICS

Answer 33

nystatin -> for all
spacer
rise after using ICS

Question 34

all asthma patients should have what med on hand

Answer 34

SABA - albuterol

Question 35

f/u for asthma pt after adjusting meds

Answer 35

2-4 weeks