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Therapeutics > asthma therapeutic treatment algorithims > Flashcards

asthma therapeutic treatment algorithims Flashcards

1
Q

2 classifications of asthma

A

Intermittent and persistent

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2
Q

3 classifications of persistent asthma

A

Mild
Moderate
Severe

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3
Q

Factors that classify asthma as intermittent

A
  • Frequency of symptoms ≤ 2 days/week
  • nighttime awakenings ≤ 2x/ month
  • SABA use ≤ 2 days/week
  • no interference with normal activity
  • Lung function- FEV > 80%
  • exacerbations requiring oral steroids 0 or 1 / year
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4
Q

factors that classify asthma as mild persistent

A
  • frequency of symptoms > 2 days/week
  • nighttime awakenings- 3-4 / month
  • SABA use- > 2 days / week but not daily and < 1 X/day
  • minor interference with normal activity
  • lung function- FEV1 >80%
    exacerbations requiring oral steroids ≥ 2/year
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5
Q

factors that classify asthma as moderate persistent?

A

Frequency of symptoms- daily
nighttime awakenings > 1 X per week
SABA use- daily
interference with normal activity- some limitation
lung function- 60%<FEV<80%
FEV/FVC is down 5%
exacerbations requiring oral steroids≥2/year

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6
Q

factors that classify asthma as persistent asthma

A

frequency of symptoms- throughout the day
nighttime awakenings- 7x per week
SABA- several times per day
interference wiwth normal activity- extremely limited
Lung function>60 % of predicted
FEV/FVC reduced 5%
exacerbations requiring oral steroids ≥ 2/year

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7
Q

frequency of symptoms in intermittent asthma

A

less than or equal to 2x per week

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8
Q

night time awakenings in intermittent asthma

A

less than or equal to 2x per month

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9
Q

SABA use in intermittent asthma

A

less than or equal to 2 days/week

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10
Q

lung function in intermittent asthma

A

everything normal

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11
Q

exacerbations requiring oral steroids in intermittent asthma

A

0 or 1 / year

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12
Q

frequency of symptoms in mild asthma

A

> 2 days per week

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13
Q

nighttime awakenings in mild asthma

A

3-4 x/ month

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14
Q

SABA use in mild asthma

A

> 2x per week, but not daily, and less than 1x per day

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15
Q

exacerbations requiring oral steroids in mild asthma

A

2 or more times per year

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16
Q

frequency of symptoms of moderate asthma

A

daily

17
Q

nighttime awakenings of moderate asthma

A

more than once a week

18
Q

SABA use of moderate asthma

A

Daily

19
Q

lung function of moderate asthma

A

FEV between 60 and 80 percent
FEV/FVC down 5%

20
Q

exacerbations requiring oral steroids in moderate asthma

A

2 or more per year

21
Q

frequency of symptoms in severe asthma

A

throughout the day

22
Q

nighttime awakenings in severe asthma

A

often, 7X/ week

23
Q

SABA use in severe asthma

A

several times per day

24
Q

interference with normal activity in severe asthma

A

extremely limited

25
Q

lung function in severe asthma

A

FEV less than 60%
FEV/FVC down 5%

26
Q

exacerbations requiring oral steroids in severe asthma

A

2 or more per year

27
Q

algorithim to treat children 5 and under

A

step1- none/SABA as needed for reliever
step 2- ICS low dose
step 3- If uncontrolled, double low dose ICS
step 4- controller and SABA
(LABA not used for children under 5)

28
Q

algorithim to treat children 5 and under (alternate)

A

step1- n/a
step 2- leukotriene modifier or intermittent ICS
step 3- low dose ICS+ leukotriene modifier,
step 4- increase ICS frequency
(LABA not used for children under 5)

29
Q

algorithim to treat 6 years and older

A

step 1- non controller, SABA prn
step 2- low dose ICS+ SABA prn
step 3- if 12 years or older, low ICS/LABA
if 6-11 years, medium dose ICS
SABA as reliever
step 4- med or high dose ICS
step 5- add tiotropium for 12 and older and antibody treatment

30
Q

Algorithm to treat 6 and older (alternate)

A

Step 1- N/A

step 2- leukotriene modifier or theophyline if 12 and older (not recommended because of narrow therapeutic index and drug-drig interactions

step 3- Low ICS+ leukotriene modifier
or med/high ICS

step 4- add tiotropium or med/high ICS + leukotriene modifier

step 5- low dose oral corticosteroid

31
Q

three action plan assesments

A

green yellow red

32
Q

green assessment symptoms

A

No symptoms (little SOB, cough, wheezing, chest tightness or nighttime awakenings)
can do usual activities
peakflow>80% personal best

33
Q

Yellow assessment symptoms

A

Some symptoms
peak flow 50-79%

34
Q

red assessment symptoms

A

Severe symptoms (SOB inhibiting walking or talking)
- no improvement in SABA or >24 hrs in yellowpeak flow less than 50%

35
Q

green zone action plan

A

Continue maintenance inhalers
albuterol before exercise
trigger avoidance
preventative therapy

36
Q

Yellow zone action plan

A

take albuterol every 20 mins for 1 hour
IF symptoms and peak flow are in green zone, continue monitoring
if not, SABA + oral steroid bursts
call MD

37
Q

asthma action plan red

A

Albuterol and oral steroid, give 15 minutes for responding and call ambulance

38
Q

first line of treatment for severe acute asthma

A

systemic corticosteroids
inhaled albuterol
epinephrine incase of anaphylaxis

Therapeutics (46 decks)

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