Asthma treatment

Question 1

in what way can asthma be managed without use of drugs

Answer 1

control of extrinsic factors, i.e. avioding specific allergens, stopping smoking etc.

Question 2

what short-acting relievers are used in asthma

Answer 2

inhaled short-acting B2 agonists(SABA)

Question 3

give an example of a short-acting B agonist

Answer 3

salbutamol

Question 4

what long-acting relievers/disease controllers are used in asthma (4)

Answer 4

inhaled long-acting B2 agonists(LABA), inhaled corticosteroids, sodium etanoglycate, leukotrine receptor antagonists(LTRA)

Question 5

give an example of an inhaled LABA and inhaled corticosteroid used in asthma

Answer 5

LABA = salmetarol
corticosteroid = fluticasone

Question 6

give an example of an inhaled antimuscarinic and an oral corticosteroid used in asthma

Answer 6

antimuscarinic = ipratropium

oral corticosteroid = prednisolone

Question 7

in the step-by-step management of asthma, how is step 1, occasional symptoms less frequent than daily, treated and what is the predicted PEFR

Answer 7

predicted PEFR = 100%

treatment = as required SABA(eg salbutamol), if used more than once daily then step 2 of treatment

Question 8

how is step 2 of asthma, daily symptoms treated and what is the predicted PEFR

Answer 8

predicted PEFR = >80%

treatment = inhaled corticosteriods, anti-inflammatory drugs, if not controlled then step 3

Question 9

how is step 3 of asthma, severe symptoms treated and what is the predicted PEFR

Answer 9

predicted PEFR = 50-80%

treatment = inhaled corticosteroid + LABA, if not controlled add LTRA/theophyline, if still not controlled then step 4

Question 10

how is step 4 of asthma, severe symptoms uncontrolled treated, and what is the predicted PEFR

Answer 10

predicted PEFR = 50-80%

treatment = high dose inhaled corticosteroid plus regular LABA

Question 11

how step 5 of asthma, severe symptoms deteriorating treated, and what is the predicted PEFR

Answer 11

predicted PEFR = <50%

treatment = high dose inhaled cortcosteroid, plus regular LABA, plus oral corticosteroid (prednisolone)

Question 12

how is step 6 of asthma, severe symptoms deteriorating despite prednisolone treated, and what is predicted PEFR

Answer 12

predicted PEFR = <30%

treatment = hospital admission