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Therapeutics 1 > Asthma/COPD Staging > Flashcards

Asthma/COPD Staging Flashcards

1
Q

Asthma Classifications

A

Intermittent and Persistent (mild, moderate, severe)

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2
Q

Intermittent Asthma Nighttime Awakenings

A

2 or less a month

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3
Q

Intermittent Asthma Beta2-agonist Use

A

2 or less a week

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4
Q

Intermittent Asthma Normal Activity Interference

A

None

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5
Q

Intermittent Asthma Lung Function

A

FEV1 normal between exacerbations

FEV1 > 80% of predicted

FEV1/FVC normal

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6
Q

Intermittent Asthma Exacerbations Requiring Oral Steroids

A

0 or 1 a year

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7
Q

Mild Persistent Asthma Nighttime Awakenings

A

3-4 times a month

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8
Q

Mild Persistent Asthma Short-Acting Beta2-Agonist Use

A

More than 2 days a week, but not daily

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9
Q

Mild Persistent Asthma Interference with Normal Activity

A

Minor

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10
Q

Mild Persistent Asthma Lung Function

A

FEV1 > 80% of predicted

FEV1/FVC normal

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11
Q

Mild Persistent Asthma Exacerbations Requiring Oral Steroids

A

2 or more a year

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12
Q

Moderate Persistent Asthma Nighttime Awakenings

A

> 1 time a week

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13
Q

Moderate Persistent Asthma Short-Acting Beta2-Agonist Use

A

Daily

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14
Q

Moderate Persistent Asthma Interference with Normal Activity

A

Some limitation

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15
Q

Moderate Persistent Asthma Lung Function

A

FEV1 > 60% to < 80% of predicted

FEV1/FVC reduced 5%

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16
Q

Moderate Persistent Asthma Exacerbations Requiring Oral Steroids

A

2 or more a year

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17
Q

Severe Persistent Asthma Nighttime Awakenings

A

Often 7 times a week

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18
Q

Severe Persistent Asthma Short-Acting Beta2-agonist Use

A

Several times a day

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19
Q

Severe Persistent Asthma Interference with Normal Activity

A

Extremely limited

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20
Q

Severe Persistent Asthma Lung Function

A

FEV1 > 60% or predicted

FEV1/FVC reduced 5%

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21
Q

Severe Persistent Asthma Exacerbations Requiring Oral Steroids

A

2 or more a year

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22
Q

Intermittent Asthma Frequency of Symptoms

A

2 or less days a week

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23
Q

Mild Persistent Asthma Frequency of Symptoms

A

More than 2 days a week

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24
Q

Moderate Persistent Asthma Frequency of Symptoms

A

Daily

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25
Q

Severe Persistent Asthma Frequency of Symptoms

A

Throughout the day

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26
Q

Asthma Algorithm Step 1 for Children 5 yo or younger Treatment

A

None

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27
Q

Asthma Algorithm for Children 5 yo or younger Treatment Step 1

A

Inhaled SABA for acute relief of wheezing episodes

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28
Q

Asthma Algorithm for Children 5 yo or younger Treatment Step 2

A

Inhaled SABA for acute relief of wheezing episodes

Daily, low dose inhaled corticosteroid

Alternative: Leukotriene receptor antagonist (LTRA), intermittent ICS

29
Q

When to Advance from Step 1 to Step 2 Asthma Treatment in 5 yo patients

A

When SABA is used more than twice a week over a 30 day period

30
Q

When to Advance from Step 2 to Step 3 Asthma Treatment in 5 yo patients

A

Step 2 therapy should be trialed for 3 months tp properly assess effectiveness. If good control is not received it is reasonable to try alternative therapy before advancing to step 3

31
Q

Asthma Algorithm for Children 5 yo or younger Treatment Step 3

A

Inhaled SABA for acute relief of wheezing episodes

Double the dose of the low dose ICS

Alternative: Low dose ICS + LTRA

32
Q

When to Advance from Step 3 to Step 4 Asthma Treatment in 5 yo patients

A

Reassessment in 3 months and if not under control move to step 4

33
Q

Asthma Algorithm for Children 5 yo or younger Treatment Step 4

A

Continue controller and refer for specialist assessment

34
Q

Asthma Algorithm for Children 6-11 yo Treatment Step 1

A

Inhaled SABA for acute relief of wheezing episodes

Alternative treatment: Low dose ICS taken whenever SABA taken, or daily low dose ICS

35
Q

Asthma Algorithm for Children 6-11 yo Treatment Step 2

A

Inhaled SABA for acute relief of wheezing episodes

Daily low dose ICS

Alternative treatment: leukotriene receptor agonist or low dose ICS take whenever SABA taken

36
Q

Asthma Algorithm for Children 6-11 yo Treatment Step 3

A

Inhaled SABA for acute relief of wheezing episodes

Low dose ICS-formoterol for patients prescribed maintenance and reliever therapy

Low dose ICS/LABA

Medium Dose ICS

Alternative treatment: Low dose ICS + LTRA

(Check inhaler technique and adherence)

37
Q

Asthma Algorithm for Children 6-11 yo Treatment Step 4

A

Inhaled SABA for acute relief of wheezing episodes

Low dose ICS-formoterol for patients prescribed maintenance and reliever therapy

Referral to a specialist should be considered

Medium dose ICS/LABA

Alternative treatment: High dose ICS/LABA, or add-on tiotropium or add-on LTRA

38
Q

Asthma Algorithm for Children 6-11 yo Treatment Step 5

A

Inhaled SABA for acute relief of wheezing episodes

Low dose ICS-formoterol for patients prescribed maintenance and reliever therapy

Referral to a specialist is required + add-on therapy

Alternative treatment: Add-on anti-IL5, or add-on low dose OCS, but consider side effects

39
Q

Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 1

A

As-needed low dose ICS-formoterol

As-needed SABA

Alternative treatment: Low dose ICS taken whenever SABA is taken

40
Q

Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 2

A

Daily low dose ICS or as needed low dose ICS-formoterol

As needed SABA

Alternative treatment: Leukotriene receptor antagonist, or low dose ICS taken whenever SABA taken

41
Q

Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 3

A

Low dose ICS/LABA

As needed SABA

As needed low dose ICS-formoterol for patients prescribed maintenance and reliever therapy

Alternative treatment: Medium dose ICS, or low dos ICS+LTRA

42
Q

Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 4

A

Medium dose ICS/LABA

As needed SABA

As needed low dose ICS-formoterol for patients prescribed maintenance and reliever therapy

Alternative treatment: high dose ICS, add on tiotropium or add on LTRA

43
Q

Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 5

A

Patients reaching this step should be referred to a specialist + add-on therapy

High dose ICS/LABA

As needed low dose ICS-formoterol for patients prescribed maintenance and reliever therapy

As needed SABA

Alternative treatment: Add low dose OCS, but consider side effects

44
Q

COPD FEV1/FVC ratio

A

FEV1/FVC <0.70

45
Q

GOLD 1 (Mild) FEV1 level

A

FEV1 80% or less predicted

46
Q

GOLD 2 (Moderate) FEV1 level

A

Between 50 and 79% predicted

47
Q

GOLD 3 (Severe) FEV1 level

A

Between 30 and 49% predicted

48
Q

GOLD 4 (Very Severe) FEV1 level

A

FEV1 less than 30% predicted

49
Q

mMRC Grade 0 Severity of Breathlessness

A

I only get breathless with strenuous exercise

50
Q

mMRC Grade 1 Severity of Breathlessness

A

I get short of breath when hurrying on the level or walking up a slight hill

51
Q

mMRC Grade 2 Severity of Breathlessness

A

I walk slower than people of the same age because of breathlessness, or I have to stop for breath when walking my own pace on level

52
Q

mMRC Grade 3 Severity of Breathlessness

A

I stop for breath after walking about 100 meters or after a few minutes on level

53
Q

mMRC Grade 4 Severity of Breathlessness

A

I am too breathless to leave the house or I am breathless when dressing or undressing

54
Q

CAT Level for GOLD group A

A

Less than 10

55
Q

CAT Level for GOLD group B

A

10 or more

56
Q

CAT Level for GOLD group C

A

Less than 10

57
Q

CAT Level for GOLD group D

A

10 or more

58
Q

mMRC for GOLD group A

A

0-1

59
Q

mMRC for GOLD group B

A

2 or more

60
Q

mMRC for GOLD group C

A

0-1

61
Q

mMRC for GOLD group D

A

2 or more

62
Q

Amount of Exacerbations in GOLD group A

A

0 to 1

63
Q

Amount of Exacerbations in GOLD group B

A

0 to 1

64
Q

Amount of Exacerbations in GOLD group C

A

2 or more exacerbations and/or 1 or more hospitalizations

65
Q

Amount of Exacerbations in GOLD group D

A

2 or more exacerbations and/or 1 or more hospitalizations

66
Q

GOLD Group A Treatment

A

PRN LABA/SABA

67
Q

GOLD Group B Treatment

A

Long-Acting LABA or LAMA

68
Q

GOLD Group C Treatment

A

LAMA

69
Q

GOLD Group D Treatment

A

LAMA or LAMA/LABA (if highly symptomatic) or ICS + LABA (if eosinophils count>300cells/uL)

Therapeutics 1 (3 decks)

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