Asthma- escalating treatment Flashcards
Adults not acheiving control using low dose ICS should be started on _
note this is long term treatment not acute exacerbation treatment
ICS/LABA
Other options: adding LTRA or increasing to medium dose ICS
note this is long term treatment not acute exacerbation treatment
Adults on an ICS/LABA with poor control or have frequent exacerbations should _
note this is long term treatment not acute exacerbation treatment
be switched to bud/form maintenance and reliever therapy
note this is long term treatment not acute exacerbation treatment
What black box warning occurs for LTRAs
neuropsychiatric side effects like irritability, agressiveness, anxiety, sleep disturbance, SI within 2 weeks of initiation
FYI
fyi
For acute exacerbation treatment in the yellow zone what is not recommended
to double maintenance ICS
lack of evidence that this helps in acute flares
For adults with hx of severe exacerbation in last year and now in yellow zone again with acute flare what is first line?
currently on daily ICS
4-5 fold increase of maintenance ICS dose x7-14 days
For adults with hx of severe exacerbation in last year and now in yellow zone again with acute flare what is first line?
currently on daily bud/form
increase bud/form to max 4 inhalations BID x 7-14 days
When in an acute flare should you add prednisone?
only in patients with recent severe exacerbations who fail to respond to inhaled SABA
If needed, what is the dose of pred for acute asthma flares?
30-50mg/day x 5 days
What constitutes a severe exacerbation?
2
use of oral steroids
ED/hospitalization
In a patient on only PRN SABA that has a severe exacerbation what is indicated for future management
start controller therapy
For all patients experiencing a severe exacerbation what is recommended
a reassessment of asthma management
fyi
fyi
If a patient misses a dose of ICS in the morning what can they do at night?
double up at night
