Pharm 4 Resp pt3

Question 1

2 main causes of asthma

Answer 1

2nd hand smoke
Allergic march (keeping the kid in a bubble)

Question 2

Diff btwn Asthma-Inflammation and Bronchospasm. (Comparing the muscle and airway lining, each surrounding the airway)

Answer 2

Asthma: the airway lining swells, the muscle lining is normal. Airway lining swelling makes it like breathing through a straw.
Bronchoconstriction: the muscle tightens and constricts the airway.

Question 3

Why do people outgrow asthma?

Answer 3

kids have o: if that closes up, they get asthma

adults have O: if that closes up, their airway is still wide open enough to breathe normally.

Question 4

COPD is actually a term that groups two closely related diseases:

Answer 4

Chronic Bronchitis & Emphysema

Question 5

How to differentiate between asthma and COPD?

Answer 5

spirometry.
If you have a reversible obstructive flow, that’s asthma.
If it’s not reversible, that’s COPD.

Question 6

What’s WBC are affected in asthma?

Answer 6

CD4 T-Lymphocytes, Eosinophils

Question 7

What WBC are affected in COPD?

Answer 7

CD8 T-Lymphocytes, Macrophages, Neutrophils

Question 8

5 Inhaled Medical Delivery Devices

Answer 8

Metered Dose Inhaler (MDI)
Dry Powder Inhaler (DPI)
Spacer/holding Chamber
Spacer/holding Chamber with face mask
Nebulizer

Question 9

Peak flow is unique to the patient.

Peak flow <__% needs help

Answer 9

<80% needs help

Question 10

Asthma severity classification:
Days with sx, Nights with sx, FEV1.
Step 1

Answer 10

Mild Intermittent

80%

Question 11

Asthma severity classification:
Days with sx, Nights with sx, FEV1.
Step 2

Answer 11

Mild Persistent
Days: >2/week but 2/month
FEV1: >80%

Question 12

Asthma severity classification:
Days with sx, Nights with sx, FEV1.
Step 3

Answer 12

Moderate Persistent
Days: Daily
Nights: >1/week
FEV1: 60-80%

Question 13

Asthma severity classification:
Days with sx, Nights with sx, FEV1.
Step 4

Answer 13

Severe Persistent
Days: Continual
Nights: Frequent
FEV1: <60%

Question 14

The patients “step” of asthma severity is determined by:

Answer 14

their most severe features

days, nights, fev1, pef variability

Question 15

3 as-needed, quick-relief, rescue meds (types) for Asthma

Answer 15

Short-acting beta2-agonists
Anticholinergics
Systemic corticosteroids

Question 16

5 types of daily, long-term control meds for asthma:

Answer 16

Corticosteroids (inhaled and systemic)
Cromolyn/nedocromil
Long-acting beta2-agonists (LABA)
Leukotriene inhibitors
Methylxanthines

Question 17

___ are clearly the most effective long-term-therapy for persistent asthma

Answer 17

Inhaled Corticosteroids

There is a small or no risk for adverse events when prescribed at recommended doses

Question 18

3 tips for using ICS for asthma

Answer 18

spacer and rinse mouth after use
lowest possible dose
in combination with long-acting beta2-agonists

Question 19

Kids who gets constant asthma attacks get chronic basement membrane changes, aka, scarred alveoli. The drug to prevent with this is:

Answer 19

ICS

Question 20

Effects of ICS on children’s growth:

Answer 20

the average child for the 1st year on HIGH-dose ICS will have a ½” growth delay, which they then reverse with a growth spurt after the first year.
low-medium doses usually show no effect on growth

Question 21

3 examples of ICS for asthma.

They all have different doses.

Answer 21

Beclomethasone, Budesonide, Fluticasone

Question 22

Not a substitute for anti-inflammatory therapy (not a substitute for ICS)
Not for acute exacerbation and not a rescue medication
Not appropriate for monotherapy
Beneficial when added to ICS

Answer 22

Long-Acting Beta2-Agonist

Question 23

Single most effective medication for relief of acute bronchospasm

Answer 23

Short-Acting Beta2-Agonists

Question 24

What suggests inadquate control of SABA for asthma?

Answer 24

> 2 canisters annually

Question 25

2 SABA to know:

Answer 25

Albuterol, Levalbuterol