Lungs Flashcards
what is asthma
chronic inflammation of disease of the airways due to airways being hyper-active to triggers. Excess mucus is produced
Name some non-pharmacological management for asthma
- avoid allergen/ trigger
- stop smoking
- decrease weight if obese
- avoid exercise in cold air
- avoid NSAIDS and B-blockers
what drugs should asthmatics avoid
NSAIDs and Beta-blockers
How do reliever inhalers (SABA) work?
- name an example of a reliever inhaler
Reliever inhalers produce quick symptom relief
- e.g salbutamol/ terbutaline
How do preventer inhalers work?
- name an example of a preventer inhaler
They work by acting on the underlying inflammation
e.g corticosteroids (e.g beclomethasone)
how do controller inhalers (LABA) work?
- name an example of a controller inhaler
they slow onset and are long acting
e.g: salmeterol / formoterol
what is the first line treatment for asthma
a short-acting beta-2 agonist (SABA)
e.g salbutamol/terbutaline
when do you add a patient onto a corticosteroid
- when they’re using their SABA >3 times a week and feeling symptomatic >3 times per week
what is a common side effect of inhaled corticosteroids
- can cause oral candidiasis
- hoarseness or abnormal voice (dysphonia)
- adrenal suppression
what should patients on an inhaled corticosteroid do to prevent oral candidiasis
They should rinse their mouth after use
how should you use oral corticosteroids
use the lowest dose that will control symptoms for the shortest time possible
describe how to escalate medication for asthma
- all patients on SABA.
if SABA not effective:
SABA + low dose ICS
if SABA + ICS not effective:
SABA + ICS + LABA
if SABA + ICS + LABA not effective:
- if addition of LABA show no improvement, stop it and increase dose of ICS. if LABA shows an improvement, keep it and still increase dose of ICS
consider adding trials of leukotriene antagonist, SR theophylline or LAMA
which drug class for asthma treatment can use a rash or sleep disturbances as a side effect
Leukotriene antagonists
e.g oral Montelukast and Zafirlukast
what does a peak expiratory flow (PEF) rate of <50% mean
acute severe asthma
what peak expiratory flow (PEF) rate should patients aim more
> 70
what FEV1/FEV should patients aim for
0.7
what does a peak expiratory flow (PEF) rate of <33% mean
the patient has acute severe asthma and it is life-threatening
what stage of asthma does a patient need hospitalisation
acute severe asthma
what is COPD
obstruction of the airways due to bronchitis (chronic inflammation of the airways) and emphysema (damage to the air sacs). It is associated with an inflammatory response to the lungs
what is a major risk factor for COPD
smoking
what is a chronic productive cough a symptom of
COPD
what is breathlessness and wheezing at night a common symptom of
Asthma
what is the difference in breathlessness in asthma vs COPD
- In asthma breathlessness is variable in asthma whereas in COPD it is persistent and progressive
- In asthma breathlessness is common at night whereas breathlessness at night in COPD is uncommon
how is COPD diagnosed
- symptoms of COPD
- use spirometry to take patients forced expiratory volume in 1 second (FEV1) befor and after using a bronchodilator. If there is a large response to the bronchodilators then it is asthma not COPD.
