Asthma in Pregnancy Flashcards

1
Q

Asthma Symptoms =2 days/week

A

Intermittent Asthma (well controlled)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Asthma Symptoms > 2 days/week

A

Mild Persistent Asthma (not well controlled)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Asthma Symptoms Daily

A

Moderate Persistent (not well controlled)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Multiple symptoms though out the day

A

Severe Persistent Asthma (poorly controlled)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe Predicted Peak Flow for all ashtma categorites (intermittent, mild presistent, moderate persistent, and severe persistent)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment for mild intermittent Asthma

A

Symptoms < 2 days per week

Nighttime awakening 2x per month of less

No interference with normal activity

NO DAILY MEDICATIONS - Albuterol Inhaler PRN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment for mild persistent asthma

A

Symtpoms > 2 days/week (but not daily)

Nighttime awakening 2 x month

Minor limitations to activity

Prefered treatment - low dose inhaled corticosteroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment for moderate persistant asthma

A

DAILY symptoms

Nightime awakening > once per week

Some limitation in activity

Treatment = low dose inhaled corticosteroid + salmeterol *prefered*

OR

medium dose inhaled corticosteroid +/- salmeterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment for severe persistent asthma

A

Symptoms multiple times during day

Nighttime awakening 4x/week or more

Extreme interference w/ normal acitivty

Treatment = high dose coritcosteroid, salmeterol, +/- PO corticosteroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the preferred inhaled corticosteroid in pergnancy?

A

Budesonide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What fetal/maternal morbidity/moratlity is assocaited with severe and poorly controlled asthma?

A

Increased prematurity

Need for C/S

Pre E

Growth Restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you diagnose asthma?

A

Demonstrating airway obstruction on spirometry that is aleast partially reversible (greather than 12% increase in FEV1 after bronchdilator)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the rescue therapy of choice for asthma during pregnancy?

A

Inhaled short acting B2 agonists = inhaled albuterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name two long acting inhaled B2 agonists that should be the preferred “add on” therapy during pregnancy

A

Salmeterol

Formoterol

*Has been shown to be more effective add-on therpay in non-pregnant patients than leukotriene receptor anatgonists or theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe step-wise treatment if asthma is poorly controlled

A

Step 1: Albuterol inhaler PRN, no daily medications

Step 2: Daily low dose inhaled corticosteroid (budesinide)

Step 3: Add salmeterol (long acting B2 agonist)

*could considering going from low dose steroid to medium dose also*

Step 4: Daily high dose corticosteroid + salmeterol +/- PO Steroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mechanism of montelukast

A

Leukotriene receptor antagonist

**limited data on the use of leukotriene receptor antagonists in humans during pregnancy*

17
Q

Mechanism of Theophylline

A

Phosphodiesterase Enzyme Inhibitor

Narrow theraputic index

Requires serum monitoring

18
Q

FEV1 for Intermittent Asthma?

A

> 80%

19
Q

FEV1 for Mild Persistent Asthma?

A

> 80%

20
Q

FEV1 for Moderate Persistent Asthma

A

60-80%

21
Q

FEV1 for Severe Persistent Asthma

A

< 60%

22
Q

Diagnosis of Asthma on PFT?

A

Greater than 12% increase in FEV1 after bronchodilator

23
Q

What happens to the FEV1:FVC ratio in asthma?

A

It will be reduced because asthma is an obstructive process

(FEV1:FVC in a restrictive process will have no change because both values are reduced)

24
Q

Pregnancy morbidity associated with poorly controlled asthma?

A

Prematurity

C/S

Pre E

Growth Restriction

25
Q

During acute exacerbation of Asthma, when is inpatient monitoring required?

A

When patients have a poor response to treatment (FEV 1 remains < 50%)