part 7

Question 1

What are the classifications of asthma?

Answer 1

• intermittent
• mild persistent
• moderate persistent
• severe persistent

Question 2

• symptoms less than 2 days/week
• nighttime awakening less than 2X’s/month
• meds such as albuterol less than 2 days a week
• no interference with normal activity
• normal FEV between exacerbations
• exacerbations requiring corticosteroids 0-1/year

Answer 2

intermittent asthma

Question 3

• symptoms greater than 2 days/week but not daily
• nighttime awakening 2-4x/month
• meds such as albuterol greater than 2 days a week, but not daily
• interference with normal activity minor limitation
• FEV greater than 80%
• exacerbations requiring corticosteroids greater than 2xs per year

Answer 3

mild persistent asthma

Question 4

• symptoms daily
• nighttime awakening 3-4x/month, 1x/per week but not nightly
• meds such as albuterol daily
• interference with normal activity some limitation
• FEV 60-80%
• exacerbations requiring corticosteroids greater than 2xs per year, more frequent and intense events indicate greater severity

Answer 4

moderate persistent asthma

Question 5

• symptoms daily
• nighttime awakening nightly
• meds such as albuterol daily
• interference with normal activity extreme limitation
• FEV less than 60%
• exacerbations requiring corticosteroids greater than 2xs per year, more frequent and intense events indicate greater severity

Answer 5

severe persistent asthma

Question 6

What are the asthma rescue medications?

Answer 6

• short acting Beta2 agonists: albuterol (Proventil) give before inhaled steroid
• corticosteroid: Methylprednisolone (solu-medrol, prednisone)
• anticholinergic: Ipratropium (atrovent)

Question 7

What are the asthma controller medications?

Answer 7

• long acting Beta2 agonists: Salmeterol (serevant) used in combo with inhaled corticosteroids
• corticosteroids: beclomethasone (Qvar)
• mast cell inhibitors: cromolyn sodium (intal)
• leukotriene modifiers: montelukast (singulair)
• Methylxanthines: Theophyline

Question 8

What does the FDA require there be a warning for with corticosteroids?

Answer 8

reduced rate of growth

Question 9

What do beta agonists do?

Answer 9

relax smooth muscle in airway to increase air exchange to obtain clear breath sounds

Question 10

What do corticosteroids do?

Answer 10

Diminish airway inflammation and obstruction. Enhance bronchodilation effect of beta agonists.

Question 11

What are some asthma home control measures?

Answer 11

• avoid triggers
• annual influenza vaccine
• treat rhinitis, sinusitis, GERD
• proper use of medications
• home monitoring
• action plan
• care at school

Question 12

-respiratory distress continues despite vigorous therapeutic measures
-emergency treatment is epinephrine 0.01 ml/kg subcutaneously (max dose 0.3ml)
-concurrent infection in some cases
-therapeutic intervention:
humidified oxygen
inhaled aerosolized short acting beta agonists
systemic corticosteroid
IV infusion fluids may include magnesium sulfate

Answer 12

status asthmaticus