Management of Asthma in Adults

Question 1

What type of muscle surrounds airways?

Answer 1

Smooth muscle

Question 2

List some of the non-pharmacological managements of asthma.

Answer 2

Exercise
Smoking cessation
Weight management
Flu/pneumococcal vaccines

Question 3

List some of the aims of asthma treatment

Answer 3

no daytime symptoms
no night time wakening
no need for rescue medication
no asthma attacks
no limitations on activity including exercise & normal lung function (in practical terms FEV1 and/or PEF>80% predicted or best)
minimal side effects from medication.

Question 4

What is the first step if you have a patient w suspected asthma?

Answer 4

Give them a low does of ICS (inhaled corticosteroids)

Question 5

Describe the delivery of inhalers.

Answer 5

Delivers directly to target organ- lungs and airways

Question 6

ARe inhalers for small or large doses of drugs?

Answer 6

Small

Question 7

List some advantages of inhalers.

Answer 7

Onset of effect is faster
Minimal systemic exposure
Systemic adverse effects are less severe and less frequent

Question 8

What type of inhalers are commonly used? (inhaler not medication)

Answer 8

Metered dose inhalers

Question 9

For those who struggle to coordinate pressing the inhalers while breathing in, what is recommended?

Answer 9

Using their metered dose inhalers with a spacer.

Question 10

What are dry powder inhalers?

Answer 10

Open it up and gives you a measured quantity of a dry powder to suck/inhale

Question 11

Name the reliever medications.

Answer 11

Salbutamol (either MDI or DPI)
Terbutaline (DPI)

Question 12

Are short acting beta agonists relievers or preventive?

Answer 12

Relievers

Question 13

What are the main side effects of salbutamol?

Answer 13

Tremor and increased HR

Question 14

List three oral therapies.

Answer 14

Leukotriene Receptor Antagonist
Theophylline
Prednisolone

Question 15

What are some of the options that specialists in asthma may use?

Answer 15

Omalizumab (Anti- IgE)
Mepolizumab (Anti-Interleukin-5)
Bronchial thermoplasty

Question 16

Name the steps that would be followed after a mild/moderate acute asthma attack.

Answer 16

Increase inhaler use
Oral Steroid
Treat trigger
Early follow up
Back up plan

Question 17

Under what categories of asthma attack should the patient be in hospital?

Answer 17

Moderate, severe, life threatening, near fatal

Question 18

What might be used to limit patient interaction if in hospital after an asthma attack?

Answer 18

Nebulisers
IV

Question 19

What are the similarities between asthma and COPD?

Answer 19

Both have areas inflammation and some irritability of the smooth muscle, causing increased contraction and narrowing of the airways.

Similar therapies
Non pharmacological interventions are the same.

Question 20

What are some of the differences between asthma and COPD?

Answer 20

COPD- unrealistic to keep them symptom free, usually have a smoking history, older,
Asthma- patients tend to be younger, able to minimise or treat symptoms.