Management of Asthma- Adults Flashcards
What cells are responsible for the effects of asthma?
Th2 Cytokines - (IL-5, LT)
Eosinophils
Mast cells
What is the difference between occupational asthma and work-exacerbated asthma?
Occupational has no prior history of asthma
What is non-pharma management of chronic asthma?
Asthma Action Plan
Weight loss if ˄BMI
Vaccines – flu & pneum
Allergen avoidance
(inc. occup. Asthma)
Physiotherapy
Smoking Cessation
Bronchial Thermoplasty
What are the drugs used to treat acute asthma attack and chronic asthma?
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What are the drugs to avoid during the treatment of asthma?
β-blockers
NSAIDS / Aspirin
Sedatives/strong opiates (unless in critical care)
What are the non-pharma methods of treatment of acute asthma attack?
ITU/HDU
Ventilation
ECCO2R
Chest drain if
pneumothorax
What are the benefits of inhalers?
- Small dose of drugs
- Delivery directly to the target organ (airways and lung)
- Onset of effect is faster
- Minimal systemic exposure
- Systemic adverse effects are less severe and less frequent
What are the problems associated with metered dose inhalers?
- Needs co-ordination
- Elderly, young children, unwell can’t use effectively
What are the benefits of spacers?
- Low oro-pharyngeal deposition of aerosol
- Reduced speed of the aerosol
- decreases bad taste associated with oral deposition
- reduced the risk of oral candidiasis and dysphonia with steroids
- Reduced “cold-Freon effect” in some
What are the benefits associated with dry powder inhalers?
- Less coordination required
- Similar issues with deposition
Requires high inspiratory flow
What does SABA stand for?
Short acting beta 2 agonists
Where do you find salbutamol?
MDI
DPI
Where do you find terbutaline?
DPI
What are the adverse side effects of beta 2 stimulants?
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What are regular preventers?
Low dose Inhaled Corticosteroids (ICS) - Preventers
- Beclomethasone
- Budesonide
- Fluticasone
- Ciclesonide
- Mometasone