Flashcards in 51 - Asthma in Adults Deck (32):
What does control mean?
<3 attacks/ week
<3 reliever doses/week
-identify and avoid precipitating factors
Examples of SABAs
What are SABAs used for?
acute exacerbations and for prevention of exercise-induced asthma
If they use their SABA more than 2 times/week, initiate treatment with ?
Give examples of LABAs
-salmeterol (slow onset of action)
-formoterol (fast onset of action)
What are LABAs for?
for regular BID treatment of asthma
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
In adults, consider adding LABA when low-dose ____ fail to provide adequate control of asthma
LABAs also help to prevent _____-induced bronchospasm
Why should adults not have monotherapy with LABA in asthma?
has been associated with increased risk of death in asthmatics
Why are oral beta agonists not used?
offer less bronchodilation, more systemic s/e and slower onset of action than inhaled preparations
______ is a short-acting anticholinergic used as add-on therapy to beta agonists for management of acute asthma
When are anticholinergics useful?
if patients get tremor or tachycardia from beta agonists
Bronchodilator effects last longer than ____ _____
____ is a long acting once daily bronchodilator to improve lung function and decrease exacerbations
Why is oral theophylline uncommonly used?
bc of systemic toxicity and only mild bronchodilator activity
Need to monitor what with theophylline?
____ is a prodrug that is biologically inert until activated by esterases in the lung so may have fewer topical s/e such as thrush
When are systemic corticosteroids used?
for acute exacerbations (x 7-14 days)
s/e of systemic corticosteroids?
fluid retention, glucose intolerance, increased BP, increased appetite, mood alterations, weight gain
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
What is an IgE-neutralizing antibody for mod-severe asthma uncontrolled by ICS and add-on Tx (and positive to allergen test)?
What is an IL-5 inhibitor for eosinophilic asthma?
Mepolizumab, Resilizumab, Benralizumab
How often is Mepolizumab administered?
SC injection every month
How often is Resilizumab administered?
IV q4 weeks
How often is Benralizumab administered
every 8 weeks
Step up therapy at ____ weeks
Can step down at ___ month intervals
Describe step down therapy
can include reducing ICS by 25-50% reducing another agent or removing a bronchodilator
Everything is safe except ______ as it worsens GERD and nausea