Management of Asthma

Question 1

In an acute asthma attack what can be used?

Answer 1

IV MgSO4 and nebulised O2

Question 2

In chronic asthma what specific drugs can be used?

Answer 2

Leukotriene RA

Monoclonal antibodies- steroid sparing drugs.

Question 3

What drugs are used widely in asthma

Answer 3

Bronchodilators- SABA, LABA

Steroids- anti inflammatory

Question 4

Give an example of a SABA

Answer 4

Salbutamol (pMDI- need coordination, DPI- dry powder)

Question 5

Name two other types of bronchodilator

Answer 5

Anti- muscarinic- LAMA

Theophylline- many side effects

Question 6

What is the baseline treatment in all patients?

Answer 6

SABA

Question 7

What would indicate a need to escalate in an adult?

Answer 7

Using more than three times a week
Waking at night due to symptoms
Having attacks more than 3 times a week.

Question 8

Describe step 1

Answer 8

Add low dose ICS- lower side effects

Question 9

Describe step 2

Answer 9

Add LABA- symbicort/ seretide in combo with ICS

Question 10

Describe step 3

Answer 10

No response to LABA= stop and higher dose ICS
Limited control= keep LABA + med dose ICS
Consider add-on therapy= LTRA, LAMA

Question 11

Step 4

Answer 11

Fourth drug and refer to specialist

Question 12

Step 5

Answer 12

Long term oral steroids- Prednisolone

Question 13

What is AAA

Answer 13

Acute Adrenal Insufficiency - caused by sudden withdrawal of steroids- the body cannot cope.