Management of Asthma

Question 1

What is asthma described as?

Answer 1

Respiratory disorder where there is narrowing of the airways

Question 2

As well as a host factor, what else is required for asthma to be present?

Answer 2

An external irritant

Question 3

What is the smooth muscle narrowing due to?

Answer 3

Histamine release

Question 4

What percentage of hospital admissions for asthma are avoidable?

Answer 4

75%

Question 5

How is asthma mainly diagnosed?

Answer 5

Clinically

Question 6

What is the function of the inhaler?

Answer 6

To try and blunt the response of external irritants

Question 7

What does pMDI stand for?

Answer 7

Pressured metered dose inhalers

Question 8

What percentage of the drug in an inhaler actually gets to the lung?

Answer 8

10-20%

Question 9

What is the drug kept as in a dry powder inhalers?

Answer 9

A sugar coated particle

Question 10

What is the treatment for step 1 in asthma treatment?

Answer 10

Short acting Beta-2 agonists

Question 11

In step 2 of asthma treatment, what would you give to help the patient?

Answer 11

Regular treatment of steroid inhalers

Question 12

What are the 3 main advantages of ICS?

Answer 12

Low dose
Delivered to the site of action
Minimal side effects

Question 13

In step 3, what is added to treatment for asthma?

Answer 13

An inhaled long-acting B2 agonist

Question 14

What is the main advantage of formoterol compared to other long acting B2 agonists?

Answer 14

It has a quicker onset of action

Question 15

In what step are LTRAs first introduced for asthma treatment?

Answer 15

Step 4 - alongside inhaled steroids

Question 16

What are the main problems with theophylline?

Answer 16

It has a narrow therapeutic index

Unpredictable metabolism

Question 17

What is omalizumab?

Answer 17

A monoclonal antibody against IgE

Question 18

What does SANE stand for?

Answer 18

Short acting beta agonist/week
Absence from school/nursery
Nocturnal symptoms/ week
Excertional symptoms/week

Question 19

Which three age ranges are there for the stepwise approach to treatment?

Answer 19

Adults
5-12 year olds
Under 5’s

Question 20

Even if severe asthma, what should be the first course of treatment?

Answer 20

ICS

Question 21

What is the best way to give corticosteroids

Answer 21

Through inhalers

Question 22

During step 1 of asthma treatment for children, when should ICS only be taken?

Answer 22

When needed to relieve symptoms

Question 23

When should step 2 of asthma treatment be given?

Answer 23

When inhaled B2 agonists are being used 3 times a week or more
OR
When symptomatic 3 times a week or more

Question 24

What is the main suggestion for step 3 treatment for child asthma?

Answer 24

A long-acting B-agonist

Question 25

What is the main side effect of ICS?

Answer 25

1/2 - 1 cm reduction in height

Question 26

When is the increase of positive effects of ICS most prevalent?

Answer 26

When you go from low to medium dose of ICS

Question 27

What can help prevent the chance of getting oral candidiasis as a side effect of ICS?

Answer 27

Brushing teeth after taking inhaler

Question 28

Long acting beta agonists have to be used alongside what?

Answer 28

ICS

Question 29

What are the main issues that contribute to asthma treatment not working?

Answer 29

Wrong diagnosis
Psychological issues
Compliance issues

Question 30

What is the % lung deposition of ICS for the actual drug without a spacer?

Question 31

How can you double the effectiveness of an inhaler?

Answer 31

Shaking it inbetween uses

Question 32

What percentage of lung deposition do dry powder devices achieve?

Answer 32

20%