Yes book (Asthma)

Question 1

What is asthma?

Answer 1

Chronic inflammatory disease of the airways that causes hyperresponsiveness, mucosal edema, and mucus production

Inflammation leads to cough, chest tightness, wheezing, and dyspnea (Fig. 24-6)

Asthma is largely reversible; spontaneously or with treatment

Allergy is the strongest predisposing factor

Question 2

What are triggers for asthma?

Answer 2

Pollen, pets, mold and dust mites.
Upper respiratory infections.
Tobacco smoke.
Inhaling cold, dry air.
Gastroesophageal reflux disease (GERD)
Stress.

Question 3

How is asthma classified?

Answer 3

Classified according to severity:

• Mild intermittent
• Mild persistent
• Moderate persistent
• Severe persistent

Question 4

What are the clinical manifestations of asthma

Answer 4

Cough, dyspnea, wheezing

Exacerbations

Cough, productive or not

Generalized wheezing

Chest tightness and dyspnea

Diaphoresis

Tachycardia

Hypoxemia and central cyanosis

Question 5

What are the complications of asthma?

Answer 5

Status asthmaticus

Question 6

What is the underlying pathology of asthma

Answer 6

Inflammation

Question 7

What are the two general classes of medications for asthma?

Answer 7

Quick relief medications for immediate treatment of asthma symptoms and exacerbations
Long acting medications to control persistent asthma

Question 8

What is the first choice of route administration in asthma and why?

Answer 8

Used of metered dose inhaler (MDI) or dry powder inhaler (DPI) to limit systemic side effect.

Question 9

Why are inhaled corticosteroids given?

Answer 9

Alleviate asthma symptoms
Improve airway function
Improve peak flow by decreasing variability
Usually used in its inhaled form to decrease side effects.
Patients are taught to rinse their mouth after using this inhaler to prevent thrush, a complication of inhaled corticosteroids
Initially the inhaled form is used. If response is not adequate systemic corticosteroids can be used.

Question 10

Why are systemic corticosteroids given?

Answer 10

Gain rapid control over an asthma attack.
Manage severe persistent asthma
Prevent reoccurence.

Question 11

What are the side effects of corticosteroids given for asthma?

Answer 11

Hyperglycemia 
Fluid retention 
Dyspepsia 
GI bleeding 
Impaired healing 
Muscle wasting 
Osteoporosis 
Susceptibility to infection 
Hypotension

Question 12

What are the corticosteroids given for asthma?

Answer 12

Methylprednisolone
Prednisolone
Prednisone

Question 13

How are long acting beta 2 agonists used in asthma?

Answer 13

Used with inhaled corticosteroids
Helps control asthma symptoms especially nocturnal symptoms.
Effective in preventing exercise induced asthma (EIA)
Not used for immediate symptom relief or exacerbations

Question 14

What are the LABAs used for asthma?

Answer 14

Salmeterol

Formoterol

Question 15

Why are leukotriene modifiers given to patients with asthma?

Answer 15

Works by inhibiting leukotrienes that are bronchoconstrictors.
Alternative to inhaled corticosteroid for mild persistent asthma and an adjuvant for severe asthma control.

Question 16

What are the names of the leukotriene modifiers given to patients with asthma?

Answer 16

Monteleukolast

Zafirlukast

Question 17

Why are methylxanthines given to patients with asthma

Answer 17

Requires blood monitoring for therapeutic level. Maintain steady state serum concentrations between 5 and 15 mcg/dL.
Used in addition to an inhaled corticosteroid.

Question 18

What are the name(s) of methylxanthines?

Answer 18

Theophylline sustained release tablets and capsules