Pulmonary conditions & tobacco cessation: Asthma Flashcards
Classic symptoms of asthma
breathlessness
wheezing
chest tightness
coughing
Common asthma triggers
Pollution
cigarettes
coldair/changes in weather
pets
dust/pollen
perfume
Drugs: aspirin, NSAIDs, beta-blockers
FEV1
how much air can be forcefully exhaled in 1 second
FVC
max volume of air exhaled after taking deep breath
FEV1/FVC
percent of total air that can be forcefully exhaled in 1 second
GINA Step 1
Daytime symptoms: < 2 X/month
Nighttime symptoms: none
GINA Step 2
Daytime symptoms > 2X/month, < 4-5 days/week
Night: none
GINA Step 3
Daytime symptoms: most days
Night: > 1/week
GINA Step 4/5
Daytime symptoms:daily
Night > 1/week
General asthma treatment approach
Start with which ever step based on symptoms
follow up 2-6 wks
counsel on appropriate technique
control risk factors
assess if need to step up therapy/down or maintain
once controlled can decrease visits 1-6 months
SABA…
short acting beta 2 agonist
ICS…
inhaled corticosteroid + relieved (formoterol preferred)
LABA….
Long acting beta 2 agonist
When are systemic steroids used in Asthma?
during exacerbations or severe asthma that is difficult to control
MART is…
maintenance and reliever therapy
Step 1 therapy
Rescue inhalers only:
As needed low-dose ICS-formoterol
or
SABA + low dose ICS
Step 2 therapy
Rescue: As needed low-dose ICS-formoterol
or
Rescue: SABA & Maintenance: Low dose ICS
Step 3 therapy
Rescue: Low dose ICS-formoterol & Maintenance same
or
Rescue: SABA + Maintenance: low dose ICS-LABA
Step 4 therapy
Rescue: Low dose ICS-formoterol & Maintenance: Medium dose ICS-formoterol
or
Rescue: SABA & Maintenance: Medium dose ICS-LABA
STEP 5 therapy
Rescue: Low dose ICS-formoterol & Maintenance: High dose ICS-formoterol
or
Rescue: SABA & Maintenance: High-dose ICS-LABA
Asthma variability of control
well = keep current therapy
Partly = Step up 1 step
Uncontrolled = Step up 1-2 steps, maybe short course oral steroid
SABA (albuterol) side effects
nervousness
tremor
tachycardia
palpitations
cough
hyperglycemia
decrease K