Lecture 7: Asthma Flashcards
Asthma is characterized by a limitation of airflow on which clinical tests?
- PFT
or
- Positive bronch-provocation challenge (i.e., methacholine challenge)
What are the walls of the airway like in an asthmatic and what occurs to the airway during an asthmatic attack?
- Walls = inflammed and thickened
- During attack = tightened smooth ms.
What is the strongest predisposing factor to asthma?
Atopy
What is difference in terms of airflow limitation reversibility in asthma vs. COPD?
- Asthma = reversible
- COPD = partially reversible; may be irreversible w/ significant disease
What time of the day do sx’s of asthma typically worsen?
Occur/worsen at night (often awaken pt)
What is this flow-volume curve indicative of?
Vocal cord dysfunctions
What is this flow-volume curve indicative of?
Asthma
What do the curves of A-C represent?
A) Normal
B) Obstructive (i.e., asthma or COPD)
C) Restrictive
What are 2 classes of drugs which are great for long-term control of asthma?
- Inhaled corticosteroids
- Leukotriene modifiers (i.e., montelukast, zafirlukast, zileuton)
Which RR and HR is a sign of imminent respiratory arrest?
- RR = >30/minute
- HR = bradycardia
What are the criteria for days per week w/ sx’s, nighttime awakenings, use of SABA for sx control, and interference with normal activity for asthma to be classfied as intermittent?
- Sx’s = ≤2 days/week
- Nighttime awakenings = ≤2x/month
- Use of SABA for sx’s = ≤2 days/week
- NO interference w/ normal activity
Moving from the intermittent category of asthma to the persistent category is an indication for the use of what?
Long-term preventative medicine such as ICS
How many exacerbations of a pt’s asthma requiring oral systemic corticosteroids per year places them in the intermittent vs. persistent classification?
- 0-1/year = intermittent
- ≥2/year = persistent
Pts who had ≥2 exacerbations requiring oral systemic glucocorticoids in the past year may be considered the same as patients who have what classification of asthma; even in the absence of what?
Persistent asthma.. even in the absence of impairment levels consistent with persistent asthma
What is the initial at home tx for an asthma attack?
Inhaled SABA (i.e., albuterol)
If pt has sx’s >2 days per week, which classification of asthma do they have?
Persistent
What 4 things should you educate a patient on after starting them on medication for asthma?
- Treatment goals
- Inhaler technique
- Elimination of triggers
- Asthma action plan
What are the 3 treatments use in combo for pt having exacerbation of their asthma (aka asthma attack)?
- SABA (i.e., albuterol)
- Oxygen
- Oral corticosteroids
