Asthma Management in Adults Flashcards

1
Q

what are 4 main asthma symptoms

A

coughing
wheezing
chest tightness
SOB

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2
Q

How would you diagnose asthma in an adult

A

symptoms
signs they may show
investigations

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3
Q

what investigations could be done to help diagnose asthma

A

peak flow
spirometry
blood tests for IgE, inhaledd allergens
CXR in some patients

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4
Q

what are the goals of asthma treatment

A
no daytime symptoms
no night time awakening
no asthma attacks
no limitation on activity
normal lung function
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5
Q

what is step 1 in asthma treatment for adults

A

start on inhaled short acting B2 agonist

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6
Q

what is stage 2 of asthma treatment for adults

A

add inhaled steroid of 200-800mcg a day

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7
Q

what is step 3 (initial add on therapy) of asthma treatment in adults

A

add inhaled long acting B2 agonist

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8
Q

in step 3 of asthma treatment if a patient responds well to the added LABA what is the next course of treatment

A

to continue with the LABA

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9
Q

in step 3 of asthma treatment what would be the next action if the patient benefited from the LABA but asthma control was still inadequate

A

continune LABA and increase inhaled steroid dose to 800mcg a day

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10
Q

in step 3 of asthma treatment what would happen next if the patient had to response to the :LABA

A

stop the LABA

increase inhaled steroid to 800mcg per day

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11
Q

hat is step 4 of asthma treatment in adults

A

consider trials of medication

e.g increase inhaled steroid use to 2000, addition of 4 th druglike leukkotriene receptor agonist

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12
Q

what is step 5 asthma treatment of adults

A

use daily steroid TABLET
maintain high dose of inhaled steroid
may refer patient to a speacilist

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13
Q

what are 2 short acting B2 agonists

A

salbutamol

terbutaline

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14
Q

when B2 stimulants are taken orally what are some common side effects

A
tremor
cramp
headache
flushing
palpitations
angina
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15
Q

when would a patient start using ICS for asthma

A

if using inhaled B2 agonist x3> a week
waking 1 night a week
sub-normal exercise tolerance

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16
Q

what are the advantages of ICS being inhaled as a route of administration

A

low dose required
delivered to the site of action
minimal side effects

17
Q

For long term steroid use, what route of administration is associated with far more side effects

A

oral administration

18
Q

what are 4 examples of LABA

A

flutiform
fostair
seretide
symbicort

19
Q

what are 2 LTRA (lekotriene receptor antagonists)

A

Montelukast

zafirlukast

20
Q

what are the problems with using Theophylline

A

has many side effects
narrow therapeutic window
can interact with many drugs

21
Q

what is the function of LTRA

A

in response to antigens mast cells release leukotrienes that stimulate bronchoconstriction,inflammation and mucous production

22
Q

what is the protocol for acute asthma

A

Oral predisolone for 7 days

SABA (relievers) upto 2 hourly