51 - Asthma in Adults Flashcards Preview

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Flashcards in 51 - Asthma in Adults Deck (32):
1

What does control mean?

<3 attacks/ week
<3 reliever doses/week

2

non-pharms

-identify and avoid precipitating factors
-smoking cessation

3

Bronchodilators:
Examples of SABAs

-salbutamol
-terbutaline

4

Bronchodilators:
What are SABAs used for?

acute exacerbations and for prevention of exercise-induced asthma

used PRN

5

Bronchodilators:
If they use their SABA more than 2 times/week, initiate treatment with ?

anti-inflammatory agent

6

Bronchodilators:
Give examples of LABAs

-salmeterol (slow onset of action)
-formoterol (fast onset of action)

7

Bronchodilators:
What are LABAs for?

for regular BID treatment of asthma

8

Bronchodilators:
Who should LABAs be given to?

ONLY for those already taking ICS

*adding LABAs to ICS may permit decreasing the dose of the ICE and also has been clearly shown to reduce the incidence of exacerbations to a great extent in comparison with an increased dose of ICS without a LABA

9

Bronchodilators:
In adults, consider adding LABA when low-dose ____ fail to provide adequate control of asthma

ICS

10

Bronchodilators:
LABAs also help to prevent _____-induced bronchospasm

exercise

11

Bronchodilators:
Why should adults not have monotherapy with LABA in asthma?

has been associated with increased risk of death in asthmatics

12

Bronchodilators:
Why are oral beta agonists not used?

offer less bronchodilation, more systemic s/e and slower onset of action than inhaled preparations

13

Anticholinergics:
______ is a short-acting anticholinergic used as add-on therapy to beta agonists for management of acute asthma

ipratropium

14

Anticholinergics:
When are anticholinergics useful?

if patients get tremor or tachycardia from beta agonists

15

Anticholinergics:
Bronchodilator effects last longer than ____ _____

beta agonists

16

Anticholinergics:
____ is a long acting once daily bronchodilator to improve lung function and decrease exacerbations

tiotropium

17

Methylxanthine:
Why is oral theophylline uncommonly used?

bc of systemic toxicity and only mild bronchodilator activity

18

Methylxanthine:
Need to monitor what with theophylline?

blood levels

19

ICS:
____ is a prodrug that is biologically inert until activated by esterases in the lung so may have fewer topical s/e such as thrush

ciclesonide

20

When are systemic corticosteroids used?

for acute exacerbations (x 7-14 days)

21

s/e of systemic corticosteroids?

fluid retention, glucose intolerance, increased BP, increased appetite, mood alterations, weight gain

22

Place in therapy for montelukast?

-not as effective as low-dose ICS so second line monotherapy after ICS for asthma
-they may be considered as add-on to ICS even though ICS/LABA is more effective

23

What is an IgE-neutralizing antibody for mod-severe asthma uncontrolled by ICS and add-on Tx (and positive to allergen test)?

Omalizumab

24

What is an IL-5 inhibitor for eosinophilic asthma?

Mepolizumab, Resilizumab, Benralizumab

25

How often is Mepolizumab administered?

SC injection every month

26

How often is Resilizumab administered?

IV q4 weeks

27

How often is Benralizumab administered

every 8 weeks

28

Step up therapy at ____ weeks

6-12

29

Can step down at ___ month intervals

3

30

Describe step down therapy

can include reducing ICS by 25-50% reducing another agent or removing a bronchodilator

31

For pregnancy:
Everything is safe except ______ as it worsens GERD and nausea

theophylline

32

For breastfeeding, what can they use?

everything

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