Management of Asthma Flashcards
What is asthma described as?
Respiratory disorder where there is narrowing of the airways
As well as a host factor, what else is required for asthma to be present?
An external irritant
What is the smooth muscle narrowing due to?
Histamine release
What percentage of hospital admissions for asthma are avoidable?
75%
How is asthma mainly diagnosed?
Clinically
What is the function of the inhaler?
To try and blunt the response of external irritants
What does pMDI stand for?
Pressured metered dose inhalers
What percentage of the drug in an inhaler actually gets to the lung?
10-20%
What is the drug kept as in a dry powder inhalers?
A sugar coated particle
What is the treatment for step 1 in asthma treatment?
Short acting Beta-2 agonists
In step 2 of asthma treatment, what would you give to help the patient?
Regular treatment of steroid inhalers
What are the 3 main advantages of ICS?
Low dose
Delivered to the site of action
Minimal side effects
In step 3, what is added to treatment for asthma?
An inhaled long-acting B2 agonist
What is the main advantage of formoterol compared to other long acting B2 agonists?
It has a quicker onset of action
In what step are LTRAs first introduced for asthma treatment?
Step 4 - alongside inhaled steroids
What are the main problems with theophylline?
It has a narrow therapeutic index
Unpredictable metabolism
What is omalizumab?
A monoclonal antibody against IgE
What does SANE stand for?
Short acting beta agonist/week
Absence from school/nursery
Nocturnal symptoms/ week
Excertional symptoms/week
Which three age ranges are there for the stepwise approach to treatment?
Adults
5-12 year olds
Under 5’s
Even if severe asthma, what should be the first course of treatment?
ICS
What is the best way to give corticosteroids
Through inhalers
During step 1 of asthma treatment for children, when should ICS only be taken?
When needed to relieve symptoms
When should step 2 of asthma treatment be given?
When inhaled B2 agonists are being used 3 times a week or more
OR
When symptomatic 3 times a week or more
What is the main suggestion for step 3 treatment for child asthma?
A long-acting B-agonist
What is the main side effect of ICS?
1/2 - 1 cm reduction in height
When is the increase of positive effects of ICS most prevalent?
When you go from low to medium dose of ICS
What can help prevent the chance of getting oral candidiasis as a side effect of ICS?
Brushing teeth after taking inhaler
Long acting beta agonists have to be used alongside what?
ICS
What are the main issues that contribute to asthma treatment not working?
Wrong diagnosis
Psychological issues
Compliance issues
What is the % lung deposition of ICS for the actual drug without a spacer?
How can you double the effectiveness of an inhaler?
Shaking it inbetween uses
What percentage of lung deposition do dry powder devices achieve?
20%
