Lecture 5 Flashcards
Define asthma
Is a reversible chronic inflammatory disease that characterised by recurrent attacks of breathlessness and wheezing
Problems with asthma treatment
Poor compliance
Name three lung function tests
FeNO, Peak flow, spirometry
Asthma symptoms
Wheezing, breathlessness, tight chest , coughing,
High probability asthma symptoms
Cough, wheeze, worse at night, exercised induced, family history, widespread wheeze, evidence of airway narrowing
Low probability of asthma symptoms
Dizzy and lightheaded, no airway narrowing, voice disturbances, symptoms with a cold only, chronic productive cough, smoking history, cardiac disease
Aim of asthma management
Control the disease
Define the asthma control test
Total score 25 - perfect control less than 20 further management needed
Explain the pathophysiology of smooth muscle dysfunction
LABA target these
Bronchial hyperreactivity
Bronchoconstriction
Hyperplasia
Explain the pathophysiolgy of airway inflammation
Mucosal oedema, inflammatory cell infiltration/activation, cellular proliferation, epithelial activation, airway remodelling, ICS target these
Define MART
Maintenance and reliever therapy is a form of combined ICS and LABA TREATMENT in which a single inhaler, controlling both ICS and a fast onset LABA is used for both delay maintenance therapy and the relief of symptoms as required,
What is pulse oximetry
Oxygen saturation measure by a pulse oximetry determines the adequacy of oxygen therapy and the need for arterial blood gas measurement the aim of oxygen therapy is to maintain 94-98%
What’s key about blood gases (ABG)?
Patients with oxygen saturation less than 92% or other features of life threatening asthma require a ABG measurement
Where are steroids given?
To all patients in an acute asthma attack
What are the pharmacological options to manage difficult to treat asthma?
Anti-igE
Anti-eosinophils therapies
Steroid sparing agents - ciclosporin, methotrexate, gold, terbutaline
