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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
Severe Persistent Asthma Frequency of Symptoms
Throughout the day
26
Asthma Algorithm Step 1 for Children 5 yo or younger Treatment
None
27
Asthma Algorithm for Children 5 yo or younger Treatment Step 1
Inhaled SABA for acute relief of wheezing episodes
28
Asthma Algorithm for Children 5 yo or younger Treatment Step 2
Inhaled SABA for acute relief of wheezing episodes Daily, low dose inhaled corticosteroid Alternative: Leukotriene receptor antagonist (LTRA), intermittent ICS
29
When to Advance from Step 1 to Step 2 Asthma Treatment in 5 yo patients
When SABA is used more than twice a week over a 30 day period
30
When to Advance from Step 2 to Step 3 Asthma Treatment in 5 yo patients
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
Asthma Algorithm for Children 5 yo or younger Treatment Step 3
Inhaled SABA for acute relief of wheezing episodes Double the dose of the low dose ICS Alternative: Low dose ICS + LTRA
32
When to Advance from Step 3 to Step 4 Asthma Treatment in 5 yo patients
Reassessment in 3 months and if not under control move to step 4
33
Asthma Algorithm for Children 5 yo or younger Treatment Step 4
Continue controller and refer for specialist assessment
34
Asthma Algorithm for Children 6-11 yo Treatment Step 1
Inhaled SABA for acute relief of wheezing episodes Alternative treatment: Low dose ICS taken whenever SABA taken, or daily low dose ICS
35
Asthma Algorithm for Children 6-11 yo Treatment Step 2
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
Asthma Algorithm for Children 6-11 yo Treatment Step 3
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
Asthma Algorithm for Children 6-11 yo Treatment Step 4
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
Asthma Algorithm for Children 6-11 yo Treatment Step 5
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
Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 1
As-needed low dose ICS-formoterol As-needed SABA Alternative treatment: Low dose ICS taken whenever SABA is taken
40
Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 2
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
Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 3
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
Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 4
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
Asthma Algorithm for Adults and Adolescents 12+ yo Treatment Step 5
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
COPD FEV1/FVC ratio
FEV1/FVC <0.70
45
GOLD 1 (Mild) FEV1 level
FEV1 80% or less predicted
46
GOLD 2 (Moderate) FEV1 level
Between 50 and 79% predicted
47
GOLD 3 (Severe) FEV1 level
Between 30 and 49% predicted
48
GOLD 4 (Very Severe) FEV1 level
FEV1 less than 30% predicted
49
mMRC Grade 0 Severity of Breathlessness
I only get breathless with strenuous exercise
50
mMRC Grade 1 Severity of Breathlessness
I get short of breath when hurrying on the level or walking up a slight hill
51
mMRC Grade 2 Severity of Breathlessness
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
mMRC Grade 3 Severity of Breathlessness
I stop for breath after walking about 100 meters or after a few minutes on level
53
mMRC Grade 4 Severity of Breathlessness
I am too breathless to leave the house or I am breathless when dressing or undressing
54
CAT Level for GOLD group A
Less than 10
55
CAT Level for GOLD group B
10 or more
56
CAT Level for GOLD group C
Less than 10
57
CAT Level for GOLD group D
10 or more
58
mMRC for GOLD group A
0-1
59
mMRC for GOLD group B
2 or more
60
mMRC for GOLD group C
0-1
61
mMRC for GOLD group D
2 or more
62
Amount of Exacerbations in GOLD group A
0 to 1
63
Amount of Exacerbations in GOLD group B
0 to 1
64
Amount of Exacerbations in GOLD group C
2 or more exacerbations and/or 1 or more hospitalizations
65
Amount of Exacerbations in GOLD group D
2 or more exacerbations and/or 1 or more hospitalizations
66
GOLD Group A Treatment
PRN LABA/SABA
67
GOLD Group B Treatment
Long-Acting LABA or LAMA
68
GOLD Group C Treatment
LAMA
69
GOLD Group D Treatment
LAMA or LAMA/LABA (if highly symptomatic) or ICS + LABA (if eosinophils count>300cells/uL)

Therapeutics 1 (3 decks)

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