Asthma/COPD

Question 1

Asthma

Answer 1

Chronic inflammatory conditions of the airways and is characterized by hyperreactive airways, bronchoconstriction and reversibility of the airway constriction.

Question 2

Signs and symptoms of asthma

Answer 2

• Cough
• Wheeze
• Dyspnea
• Chest tightness

Question 3

Reliever

Answer 3

Short-acting bronchodilators with rapid onset of action providing acute symptomatic
relief.

Question 4

Controller

Answer 4

Drugs with anti-inflammatory and/or sustained bronchodilator action.

Question 5

What is the mainstay of asthma management?

Answer 5

Inhaled corticosteroids are the mainstay of asthma management.

Question 6

Outline the management of chronic asthma

Answer 6

Inhaled corticosteroids are the mainstay of asthma management
* Spacer device
* All patients get reliever- salbutamol

• Check inhaler technique

1. Start beclomethasone 200mcg 12 hourly
2. If not controlled increase dose to beclomethasone 400mcg 12 hourly
3. If still not controlled, add LABA eg switch to salmeterol + fluticasone 50/250
   1 puff 12 hrly
4. If still not controlled, referral to specialist:
   * (leukotriene receptor antagonist, tiotropium bromide, theophylline)

Question 7

Step up and step down??

Question 8

Short acting β2-agonists

Answer 8

Drugs of choice for the relief of bronchospasm during acute exacerbations
* Metered dose inhaler with spacer
* nebulizer

May only be used as the sole therapy for MILD INTERMITTENT ASTHMA
* In CHRONIC PERSISTENT ASTHMA they should only be used as needed
* Oral β2-agonists have a slower onset of action and risk of systemic side
effects is higher- not recommended

Question 9

Anticholinergics: types, MOA and adverse