Management of Asthma- Adults Flashcards
What cells are responsible for the effects of asthma?
Th2 Cytokines - (IL-5, LT)
Eosinophils
Mast cells
What is the major contributor for the ari resistance of a tube?
The radius
![](https://s3.amazonaws.com/brainscape-prod/system/cm/365/032/509/a_image_thumb.png?1486044610)
What is the difference between occupational asthma and work-exacerbated asthma?
Occupational has no prior history of asthma
What is non-pharma management of chronic asthma?
Asthma Action Plan
Weight loss if ˄BMI
Vaccines – flu & pneum
Allergen avoidance
(inc. occup. Asthma)
Physiotherapy
Smoking Cessation
Bronchial Thermoplasty
What are the drugs used to treat acute asthma attack and chronic asthma?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/365/032/512/a_image_thumb.png?1486044964)
What are the drugs to avoid during the treatment of asthma?
**β-blockers**
NSAIDS / Aspirin
Sedatives/strong opiates (unless in critical care)
What are the non-pharma methods of treatment of acute asthma attack?
ITU/HDU
Ventilation
ECCO2R
Chest drain if
pneumothorax
What are the benefits of inhalers?
- Small dose of drugs
- Delivery directly to the target organ (airways and lung)
•
•Onset of effect is faster
•
•Minimal systemic exposure
•
•Systemic adverse effects are less severe and less frequent
What are the problems associated with metered dose inhalers?
- Needs co-ordination
- Elderly, young children, unwell can’t use effectively
What are the benefits of spacers?
- Low oro-pharyngeal deposition of aerosol
- Reduced speed of the aerosol
- decreases bad taste associated with oral deposition
- reduced the risk of oral candidiasis and dysphonia with steroids
- Reduced “cold-Freon effect” in some
What are the benefits associated with dry powder inhalers?
- Less coordination required
- Similar issues with deposition
Requires high inspiratory flow
What is defined as the complete control of asthma?
- no daytime symptoms
- no night-time awakening due to asthma
- no need for rescue medication
- no asthma attacks
- no limitations on activity including exercise & normal lung function (in practical terms FEV1 and/or PEF>80% predicted or best)
- minimal side effects from medication.
–BTS/SIGN 2016
What does SABA stand for?
Short acting beta 2 agonists
Where do you find salbutamol?
MDI
DPI
Where do you find terbutaline?
DPI
What are the adverse side effects of beta 2 stimulants?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/365/032/525/a_image_thumb.png?1486045505)
What are regular preventers?
Low dose Inhaled Corticosteroids (ICS) - Preventers
•Beclomethasone
•
•Budesonide
•
•Fluticasone
•
•Ciclesonide
•
•Mometasone
When do you start ICS?
- Using inhaled β2 agonist (“Reliever”) x3/week or more
- Waking one night a week or more due to asthma
- Requiring oral steroid for an exacerbation in the past 2 years
- Symptomatic x3/week or more
What are the advantages of inhaled ICS?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/365/032/528/a_image_thumb.png?1486045597)