Asthma and tobacco cessation

Question 1

who is predisposed to have asthma

Answer 1

those with a family history of asthma, those with atopy, smokers and those exposed to second hand smoke, high body mass index, and severe viral respiratory infections in first 3 years of life

Question 2

environmental triggers

Answer 2

cold air, dust mites, cockroaches, animal dander, molds, fungi, smoke, pollen, seafood/shellfish

Question 3

drugs or chemical triggers

Answer 3

aspirin, NSAIDs, beta blockers, food or drug preservatives, household cleaning agents, perfumes, occupational exposure to certain chemical/irritants

Question 4

conditions or event triggers

Answer 4

GERD, allergic rhinitis, panic attacks, smoking, emotional stress, exercise, viral respiratory infections

Question 5

green PEF

Answer 5

focuses on maintenance medication adherence

Question 6

yellow PEF

Answer 6

take short acting inhaled beta agonist

Question 7

red PEF

Answer 7

take beta-agonist and go to ED

Question 8

self exclusions for asthma

Answer 8

1. only used for short term in pts who symptoms are mild, intermittent, and of short duration
2. should have previous diagnosis of asthma
3. no concurrent symptoms whose symptoms may be similar to asthma
4. contraindication for bronchodilators: pregnancy, hyperthyroidism, cardiac arrhythmias, heart disease, uncontrolled hypertension
5. age requirements

Question 9

bronchodilator

Answer 9

product is asthmanefrin

Question 10

bronchodilator use

Answer 10

takes 10-15 minutes, delivers medication in a mist that can be inhaled

Question 11

bronchodilator age requirements

Answer 11

must be four y/o or older

Question 12

dosing for bronchodilator

Answer 12

1-3 inhalations every 3 hours as needed, no more than 12 inhalations in 24 hours

Question 13

side effects of bronchodilator

Answer 13

nervousness, tachycardia

Question 14

bronchodilator + expectorant products

Answer 14

bronkaid, Primatene asthma

Question 15

bronchodilator + expectorant age requirement

Answer 15

12 years of age or older

Question 16

bronchodilator + expectorant dosing

Answer 16

12.5-25mg every 4 prn, no more than 150mg in 24 hours

Question 17

bronchodilator + expectorant side effects

Answer 17

tachycardia, hypertension, tremor, nervousness/anxiety; less common arrhythmias, seizures, hypokalemia, angina, hyperglycemia

Question 18

vaccinations for asthma patients

Answer 18

flu and PPSV23

Question 19

5 A’s for treating tobacco dependence

Answer 19

Ask about tobacco use and any previous quit attempts
Advise to quit
Assess willingness to make quit attempt
Assist in quit attempt
Arrange follow-up

Question 20

exclusions for tobacco cessation

Answer 20

1. serious heart disease, including recent MI, irregular heartbeat, severe angina
2. HTN not controlled with meds
3. active peptic ulcer disease
4. pregnancy or breast feeding
5. < 18 years of age

Question 21

nicotine gum strengths

Answer 21

TTFC < 30 minutes of waking up = 4mg gum

TTFC > 30 minutes of waking up = 2 mg gum

Question 22

dosing for gum

Answer 22

1 piece ever 1-2 hours while awake for the first 6 weeks

- no more than 24 pieces per day up to 12 weeks

Question 23

eating and drinking with gum

Answer 23

do not eat or drink anything except water 15 minutes before or while using gum

Question 24

ADE for nicotine gum

Answer 24

unpleasant taste, mouth irritation, jaw fatigue, hypersalivation, hiccups, dyspepsia

Question 25

nicotine lozenge strengths

Answer 25

same as gum

Question 26

no more than _______ lozenges per day

Answer 26

20, no more than 4 in 6 hours, up to 12 weeks

Question 27

which has greater absorption, gum or lozenge?

Answer 27

lozenge has greater absorption and nicotine delivery

Question 28

nicotine patch strengths

Answer 28

7, 14, 21 mg patches

Question 29

More than ten cigarettes a day patch dosing

Answer 29

21 for 4-6 weeks, 14 for 2 weeks, then 7 for 2 weeks

Question 30

less than or equal to ten cigarettes a day patch dosing

Answer 30

14 for 6 weeks, then 7 for 2 weeks

Question 31

patches and MRIs

Answer 31

remove prior to MRI, burns

Question 32

side effects of nicotine patches

Answer 32

erythema, burning, pruritis