Asthma Management in Adults Flashcards
what are 4 main asthma symptoms
coughing
wheezing
chest tightness
SOB
How would you diagnose asthma in an adult
symptoms
signs they may show
investigations
what investigations could be done to help diagnose asthma
peak flow
spirometry
blood tests for IgE, inhaledd allergens
CXR in some patients
what are the goals of asthma treatment
no daytime symptoms no night time awakening no asthma attacks no limitation on activity normal lung function
what is step 1 in asthma treatment for adults
start on inhaled short acting B2 agonist
what is stage 2 of asthma treatment for adults
add inhaled steroid of 200-800mcg a day
what is step 3 (initial add on therapy) of asthma treatment in adults
add inhaled long acting B2 agonist
in step 3 of asthma treatment if a patient responds well to the added LABA what is the next course of treatment
to continue with the LABA
in step 3 of asthma treatment what would be the next action if the patient benefited from the LABA but asthma control was still inadequate
continune LABA and increase inhaled steroid dose to 800mcg a day
in step 3 of asthma treatment what would happen next if the patient had to response to the :LABA
stop the LABA
increase inhaled steroid to 800mcg per day
hat is step 4 of asthma treatment in adults
consider trials of medication
e.g increase inhaled steroid use to 2000, addition of 4 th druglike leukkotriene receptor agonist
what is step 5 asthma treatment of adults
use daily steroid TABLET
maintain high dose of inhaled steroid
may refer patient to a speacilist
what are 2 short acting B2 agonists
salbutamol
terbutaline
when B2 stimulants are taken orally what are some common side effects
tremor cramp headache flushing palpitations angina
when would a patient start using ICS for asthma
if using inhaled B2 agonist x3> a week
waking 1 night a week
sub-normal exercise tolerance
what are the advantages of ICS being inhaled as a route of administration
low dose required
delivered to the site of action
minimal side effects
For long term steroid use, what route of administration is associated with far more side effects
oral administration
what are 4 examples of LABA
flutiform
fostair
seretide
symbicort
what are 2 LTRA (lekotriene receptor antagonists)
Montelukast
zafirlukast
what are the problems with using Theophylline
has many side effects
narrow therapeutic window
can interact with many drugs
what is the function of LTRA
in response to antigens mast cells release leukotrienes that stimulate bronchoconstriction,inflammation and mucous production
what is the protocol for acute asthma
Oral predisolone for 7 days
SABA (relievers) upto 2 hourly
