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Asthma > Treatment Of Asthma > Flashcards

Treatment Of Asthma Flashcards

1
Q

Asthma management cycle

A

Review- control. Lung function, patient satisfaction
Assess- confirm diagnosis, r/f , comorbidities, tech/adherence
Adjust- rx

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2
Q

Best way to treat ti decease exacerbation

A

Feno

Eosinophil

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3
Q

How do u choose device

A

Technique if he can use
Adherence - will he use
Cost

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4
Q

When do u use track 2

A

If pt is stable/ gud adherence/no exacerbation In past one year on this therapy

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5
Q

What is mart

A

Maintenance and reliever therapy

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6
Q

What is controller

A

Containing ics

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7
Q

Things to do before stepping up

A 
Technique 
Adherence
Exposure
Confirm diagnosis
Comorb
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8
Q

What is the usual dose of sos foracort

A

200/6 mcg

Max- 72 mcg of formeterol

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9
Q

Name anti ige and indications

A

Omalizumab

>6yrs- mod and severe allergic asthma

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10
Q

Anti il-5 /5r

A

Mepolizumabs/c 6yrs
Resli- 18yrs
Benralizumab- 12yrs

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11
Q

Anti il4 receptor

A

Dupilumab >6yrs requiring maintenance ocs

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12
Q

Anti tslp

A

Thymic stromal lipoprotein
Tezepelumamab
12 yrs and severe asthma

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13
Q

Add on therapies

A

Sputum guided - more than 3 eosinophilia
Bronchial thermoplasty
Low dose Ics - <75mg/day prednisone equivalent

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14
Q

How to u step up
What is day to day step up
Short term step up
Sustained step up

A

Who are on sos laba+ics- increase number of doses needed to dec exacerbation
1-2 wks- increase in maintenance ics dise as per action plan
2-3 months- who are not better with low dose ics

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15
Q

How do u step down

Factors for risk of exacerbation after step down

A

By one step
To minimum effective dose after 2-3 month
History of exacerbation, emergency visit, low baseline fev1

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16
Q

Allergen immunotherapy types and indications

Advantages

A 
Mc allergens- dust mites/ pollen
S/c and s/l
In pts with allergic sensitization 
If fev1>70 
Persistent symptoms
Ld-md ics
Adv: decrease dose if steroids , symptoms better
17
Q

Vaccination

A

Influenza ✅

Pneumococcal- no evidence

18
Q

Non pharmacological

A 
Smoking
Diet
Avoid pollution/occupational
Exercise 
Weight
Food chemicals
19
Q

Comorbs

A

Obesity- wt loss. Inc ics- osa
Gerd- ppi
Ar- polyposis- omalizumAb
Eia- bc worsens after cessation

20
Q

Pregnancy

A 
Ics laba to continue 
Monte
Theophylline
No risk to baby 
Omalizumab✅
21
Q

How do u treat exacerbation

A

02
Saba
Iv cs

22
Q

Difficult to treat asthma

A

Uncontrolled despite step 5

23
Q

Severe asthma

A

Uncontrolled despite adherents optimized high dose ics-laba therapy and treatment of contributing factors or worsens on step down

24
Q

How do u manage difficult to treat asthma

A

Add on depending on phenotypes

Low dose ocs- last

25
Q

Definition of Uncontrolled asthma

A

Poor symptom control
Frequent exacerbation 2 requiring ocs
Or serous exacerbation 1 or more requiring hospitalization

Asthma (3 decks)

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