Exam 1 - Asthma (chronic) Flashcards
What is the MOA for short-acting beta-2 agonists (SABAs)?
stimulate beta-2 receptors in lungs causing bronchial smooth muscle relaxation
What are AEs of SABAs? (6)
tremor, lightheadedness, cough, tachycardia, hypokalemia, hyperglycemia
What are the SABAs? (2)
albuterol and levalbuterol
What are the inhaled corticosteroids (ICSs)?
budesonide, ciclesonide, fluticasone, beclomethasone, mometasone
With what things do ICSs aid? (5)
reduce chronic airway inflammation, reduce risk of exacerbations, improve lung function, reduce symptoms, and improve QoL
What are AEs of ICSs? (4)
growth concerns, hyperglycemia, increased risk of fractures, oral candidiasis (thrush)
Which dosage form should be shaken? Which should not?
metered-dose inhaler (MDI); dry powder inhaler (DPI)
When should DPIs be avoided?
milk protein allergies
What is important regarding ciclesonide (Alvesco)?
not recommended in children <12
What is important regarding fluticasone (Flovent, Arnuity, ArmonAir)?
higher risk of sore throat/hoarseness
What is important regarding beclomethasone (Qvar RediHaler)?
not recommended in children <5
What is important regarding mometasone (Asmanex)? (2)
not recommended in children <4, administer in evening
What is important regarding budesonide (Pulmicort)?
not recommended in children <6
What are the long-acting beta agonists (LABAs)? (3)
salmeterol, formoterol, vilanterol
What is a boxed warning for LABAs?
increased risk of asthma-related death when treated with LABA alone
What is important regarding fluticasone propionate/salmeterol (Advair/Wixela)?
not recommended in children <4
What is important regarding fluticasone propionate/salmeterol (AirDuo Respiclick)?
not recommended in children <12
What is the long-acting muscarinic antagonist (LAMA)?
tiotropium
What is the MOA for methylxanthines?
block phosphodiesterase and increase cAMP levels
What are AEs of theophylline? (5)
tremor, diarrhea, HA, tachycardia, CYP3A4 substrate
What are the biologic therapies for asthma? (6)
omalizumab (Xolair), mepolizumab (Nucala), reslizumab (Cinqair), benralizumab (Fasenra), dupilumab (Dupixent), tezepelumab (Tezpire)
What are environmental risk factors for asthma? (7)
SE status, secondhand exposure, allergen exposure, urbanization, RSV infection, family size, decreased exposure to common infectious agents during childhood
What are symptoms of asthma?
dyspnea, chest tightness, coughing, wheezing/whistling, in association with exercise/laugh/cold air
What are signs of asthma?
expiratory wheezing on auscultation, dry/hacking cough, atopy, reduced O2 saturation
What is a normal airflow for adults?
> 0.75 - 0.8
What steps do mild, moderate, and severe asthma correlate to?
mild = steps 1 or 2, moderate = steps 3 or 4, severe = step 5
What comorbidities are risk factors for asthma exacerbations? (7)
obesity, chronic rhinosinusitis, GERD, confirmed food allergy, anxiety, depression, pregnancy
What are risk factors for developing fixed-airflow limitation? (6)
preterm/low birth weight, lakc of ICS treatment, exposure to tobacco or other smokes, low FEV1, chronic mucus hypersecretion, sputum or blood eosinophilia
