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Respiratory system SA > Asthma management > Flashcards

Asthma management Flashcards

1
Q

What is the non pharmaceutical response to an acute asthma attack

A

ITU/HDU
Ventilation
ECCO2R
Chest drain if pneumothorax

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2
Q

What is the non pharmaceutical response to chronic asthma

A 
Asthma action plan - patient education/
Inhaler technique 
Vaccines 
Allergic avoidance 
Physiotherapy 
Smoking cessation 
Bronchial Thermoplasty
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3
Q

What is the pharmaceutical drugs administered for asthma

A 
B2 agonist
Steroids 
Anti Muscarinic 
Magnesium 
Oxygen
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4
Q

What drugs need to be avoided for asthmatics

A

B blockers
NSAIDS/ Aspirin
sedatives/ strong opiates

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5
Q

How do Steroids work in treating asthma

A

bind to an intracellular receptor causing changes to gene expression etc. –
changes gene expression of the cell away from inflammation, also prevent inflammatory cells from moving from the blood into the airways

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6
Q

How do B2 agonist work in the treatment of asthma

A

work by binding to the B2 adrenaline receptor causing the muscle to relax

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7
Q

Why is asthma therapy best delivered through inhalation

A
  • Bypass first pass metabolism = FASTER EFFECT
  • Minimal systemic exposure = LOCALISED EFFECT
  • Delivery directly to the target organ = EFFECTIVE
  • Small does is given = ADVERSE EFFECTS ARE LESS SEVERE
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8
Q

What is the three different types of inhalers

A

• Metered dose inhalers: need co-ordination
• Spacers: easier to take and less oro-pharyngeal
deposition
• Dry powder inhalers: less co-ordination required

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9
Q

What medication is used to relive the effects of asthma and taken as required

A

Short acting B2 agonists (SABA)

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10
Q

What is examples of SABA

A
  • Salbutamol: In metered dose inhalers or dry powdered
    inhalers
  • Terbutaline: In dry powdered inhalers
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11
Q

What is the short term side effects of SABA

A
  • Tremor
  • Cramp
  • Headache
  • Flushing
  • Palpitations
  • Angina
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12
Q

What is the long term side effects of SABA

A

Dysphonia - difficulty speaking

oral thrush

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13
Q

What medication is taken daily as to prevent asthma

A

Inhaled Corticosteroids (ICS)

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14
Q

What is examples of Inhaled Corticosteroids (ICS) taken in the treatment for asthma

A
  • Beclomethasone
  • Budesonide
  • Fluticasone
  • Ciclesonide
  • Mometasone
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15
Q

What are side effect for Inhaled Corticosteroids (ICS)

A

minimal

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16
Q

What other drug therapies work for asthma treatment

A

§ ICS and Long Acting B2 Agonists (LABA) = combined inhaler medication.

§ Leukotriene Receptor Antagonist (LTRA) = More effective in those who are allergic

§ Theophyline = Non-specific inhibitor but has many severe side effects

§ Inhaled Long-acting anti-muscarinic (LAMA)

§ Oral B2 agonists = very unpleasant side effects

§ Long term oral steroids = pretty serious, can have some severe side effects

17
Q

What is the side effect of Inhaled Long-acting anti-muscarinic (LAMA

A

can give you dry mouth, headaches

18
Q

What drug treatment is expensive and seen as a last resort in the treatment of asthma

A

Immune suppressive drugs

19
Q

How does Immune suppressive drugs work in the treatment of asthma

A

contain monoclonal antibodies against IgE/cytokines responsible for inflammatory reactions

20
Q

If child has the symptoms of asthma but no wheeze is present what is the alternative diagnosis’s

A

o Bronchitis – infection of bronchi – wet sounding cough –bacteria intake
makes mucociliary escalator stop working.
o Pertussis – whooping cough – patient vomits, haematoma o Habitual cough – single loud cough in 8-12 year old
o Tracheomalacia – lifelong, loud cough

21
Q

What is the paediatric treatment for asthma upon diagnosis

A

Give SABA and start on low dose Inhaled corticosteriods (max dose 800MG) -review after 2 months

22
Q

What is the further treatment steps for paediatric asthma

A

Add on preventers LABA/ LTRA and if needed increase ICS

23
Q

What is the mechanism for LTRA

A

combination of both bronchodilator and anti-inflammatory effects

24
Q

What preventers works best in paediatric asthma

A

LABA

25
Q

What non pharmaceutical interventions take place in paediatric asthma

A

Stop tobacco smoke exposure, remove environmental triggers

26
Q

In paediatric asthma how must LABA be administrated

A

must be given with ICS and can only be used as a fixed dose inhaler

27
Q

What is the best choice treatment in paediatric asthma

A

ICS - minimal side effects

28
Q

What is the only LTRA drug that can be administrated in paediatric asthma

A

montelukast

29
Q

What is the two delivery system in the treatment of paediatric asthma

A
  • MDI/spacer – USE A SPACER over nebuliser

- Dry powder device (under 8s cannot use them)

30
Q

How do measure control in paediatric asthma

A 
With SANE 
• Short acting beta agonist/week 
• Absence school/nursery
• Nocturnal symptoms/week
• Excertional symptoms/week
31
Q

What is the steps in finding appropriate treatment in paediatric asthma

A

Step 1: Short acting beta agonists (SABA) – NEVER GIVEN ORALLY
Step 2: Regular preventer = low dose inhaled corticosteroids - MAX DOSE 800MG Step 3: Add on preventers (either LABA or LTRA) or increase ICS dose… LABA proven to work better in kids than LTRA
Step 4: Experimental medicine

32
Q

How does paediatric treatment of asthma differ from adult treatment

A

Max dose ICS 800 microg
No oral B2 tablet
LTRA first line preventer in <5s

33
Q

How does steroid treatment differ between acute or chronic asthma

A

acute - oral steroids

chronic - Inhaled steroids

34
Q

What is the licensing of dry powder devices

A

Licensed in over 5s, under 8s cannot use them

35
Q

What is bronchial thermoplasty

A

delivery of controlled, therapeutic radiofrequency energy to the airway wall, thus heating the tissue and reducing the amount of smooth muscle present in the airway wall

Respiratory system SA (37 decks)

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