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Respiratory System DO > Asthma Management Adults > Flashcards

Asthma Management Adults Flashcards

1
Q

What are the 4 main reasons as to why asthma is important

A

Common
Manageable
Dangerous
Expensive

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2
Q

How many people are currently on treatment for asthma

A

5.4 million

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3
Q

Is the incidence higher in children or adults

A

Children

But it is increasing in adults

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4
Q

How many hospital admissions for asthma are avoidable

A

75%

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5
Q

How many people die every year due to asthma

A

1200

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6
Q

How many asthma deaths are preventable

A

90%

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7
Q

How much does it cost the NHS for 60,000 admissions per year

A

£1 Billion

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8
Q

Is an older or younger patient more likely to die from asthma

A

Older

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9
Q

What do the airways of the lung consist of

A

Cartilaginous bronchi
Membranous bronchi
Gas-exchanging bronchi (respiratory bronchioles and alveolar ducts)

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10
Q

What does the cartilaginous bronchi and membranous bronchi mostly function as

A

Anatomic dead space

Can also contribute to airway resistance

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11
Q

What are the smallest non-gas exchanging airways

A

Terminal bronchioles

Approximately 0.5 mm in diameter

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12
Q

When are airways considered small

A

When they are less than 2mm diameter

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13
Q

What is mucosa composed of

A

Epithelial cells that are capable of specialised mucous production and a transport apparatus

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14
Q

State the 4 cellular elements of asthma

A

Mast cells
Basophils, esoinphils, neutrophils and macrophages
Stretch and irritant receptors
Cholinergic motor nerves

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15
Q

What are mast cells involved in

A

The complex control of releasing histamine and other mediators

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16
Q

What are basophils, esoinphils, neutrophils and macrophages responsible for

A

The extensive mediator release in the early and late stages of bronchial asthma

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17
Q

What do cholinergic motor nerves innervate

A

Smooth muscle and glandular units

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18
Q

What three things does asthma involve

A

Airway inflammation
Airflow obstruction
Bronchial hyperresponsiveness

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19
Q

What are the symptoms of asthma

A 
Shortness of breath
Wheeze
Cough (irritable and dry)
Chest tightness
Diurnal variability - timing
Episodic - reversible
Atopy
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20
Q

What are the signs of asthma

A

Wheeze on auscultation
Eczema/hayfever
Obstructed spirometry
PEF changes

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21
Q

What is an important indication of asthma

A

Response to treatment

22
Q

What is the aim of asthma management

A

Control of the disease

23
Q

What are the 6 factors that define the complete control of asthma

A 
No daytime symptoms 
	No night-time awakening due to asthma 
No need for rescue medication 
No asthma attacks 
No limitations on activity including exercise & normal lung function
Minimal side effects from medication
24
Q

What is normal lung function defined as

A

In practical terms FEV1 and/or PEF>80% predicted or best

25
Q

Name 5 types of non-pharmacological management methods

A 
Patient education and self-management plans
Exercise
Smoking cessation
Weight management
Flu/pneumococcal vaccinations
26
Q

Why is non-pharmacological management importnat

A

It can make a bigger difference that medication

27
Q

What 3 sections are present in the asthma action plan

A

What they need to do to keep on top of their asthma
The indications that their asthma is getting worse
When they are having an asthma attack

28
Q

Name the 3 types of pharmacological management methods there are

A

Inhaled therapy
Oral therapy
Specialist treatments

29
Q

What do inhalers provide

A

Small dose of drugs

30
Q

Where do inhalers deliver the drug

A

Directly to the target organ

31
Q

What are the target organs in the asthma

A

Airways and lungs

32
Q

What are the benefits of inhalers

A

Onset of the effect of inhalers is quick
They cause minimal systemic exposure
Systemic adverse effects are less severe and less frequent

33
Q

What is a pMDI

A

Metered dose inhaler

34
Q

What is a pMDI

A

A device that generate aerosols and requires a low inspiratory flow

35
Q

What are the disadvantages of pMDI

A

Requires co-ordination

Elderly and young children cannot use it effectively

36
Q

What can be attached to pMDI’s to increase efficiency

A

Spacers

37
Q

Give three advantages of using spacers

A

Low oro-pharyngeal deposition of the aerosol
Decrease in the bad taste associated with oral deposition
Reduces risk of oral candidiasis and dysphonia with steroids

38
Q

How many tidal breaths is sufficient to deliver 2 puffs of salbutamol with a spacer

A

10

39
Q

What is DPI

A

Dry powder inhaler

40
Q

What generates the aerosol with a DPI

A

Patient

41
Q

What does DPI require

A

High inspiratory flow

Less coordination

42
Q

What are the 5 steps of asthma treatment

A

1) Regular preventer (inhaled corticosteriods)
2) Initial add-on therapy (ICS and long acting β-2 agonist)
3) Additional add-on therapies
4) High dose therapies
5) Continuous or frequent use of oral steroids

43
Q

What are Short acting β2 agonists (SABA)

A

Relivers

44
Q

What two types of relievers are there

A

Salbutamol (MDI, DPI)

Terbutaline (DPI)

45
Q

Which SABA is used more often

A

Salbutamol

46
Q

What are the side effects of salbutamol

A

Tachycardia
Increase in lactate
Shaking

47
Q

What do SABAs do

A

Reduce inflammation

48
Q

Give examples of inhaled corticosteriods

A 
Beclomethasone
Budesonide
Fluticasone 
Ciclesonide
Mometasone
49
Q

When should ICS be used

A

When the patient feels well as it keeps them well

50
Q

Give examples of ICS and LABAs

A 
Fostair (pMDI & DPI) -
 Beclomethasone with formoterol
Symbicort (DPI) -
 Budesonide with formoterol
Flutiform (pMDI) -
 Fluticasone propionate with formoterol
Seretide (pMDI & DPI) -
 Fluticasone propionate with salmeterol
Relvar Ellipta (DPI) -
 Fluticasone fumarate with vilanterol
51
Q

Which LABA is only used once daily

A

Relvar

Respiratory System DO (33 decks)

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