Asthma Flashcards
(31 cards)
Symptoms of Asthma
SOB
Wheezing
Cough
Chest tightness
Risk factors for asthma
smoking
tendency to allergy (dermatitis, allergic rxn)
family history
obesity
lower SES
males in children
females > 40
stress
anxiety
early puberty
What is the main way to diagnose asthma?
spirometer with FEV1 > 80%
What are the short-term triggers for asthma?
COLD air
exercise
emotional stress
What are the long-term triggers for asthma?
allergens
dust, mites
cockroaches
mold, pollen
pet’s danders
Which conditions should be controlled as they may affect asthma exacerbations?
GERD
rhinitis
sinusitis
Non-pharms
warm humidifier
air purifier (no evidence)
avoid emotional stress
exercise
What is FEV1?
It is the forced expiratory volume one second - amount of air a patient can EXHALE in one second.
What is FVC?
Forced vital capacity = total amount of air that the lungs can hold
What is a normal FEV1?
> 80% in adults
What is an indicator of LOW respiratory function?
Severe FEV1 = < 50%
If in doubt, you can do a methacholine test to confirm diagnosis of asthma. What are the steps to this test?
- measure FEV1
- inhale methacholine
- in 15-20 mins, repeat spirometry and measure FEV1. If FEV1 is reduced by > 20% , asthma was triggered by the allergen (methacholine) which caused airway narrowing.
When is peak flow meter used?
can be used to monitor asthma. its used at home, easy for day-today home follow up (i.e. for an asthma action plan)
What is the purpose of using a Chest Xray in asthmatics?
eliminates possibility of TB or lung cancer
What is the ABG test? (Arterial Blood Gas)
determines the need for oxygen therapy; measures lung size, oxygenation, and gas diffusion across alveolar membrane.
normal = SpO2 > 95%
If below < 90%, requires intervention.
Can weight loss help with asthma control?
yes
General sequence of asthma therapy (GINA GUIDELINES)?
- Low dose ICS/LABA prn or SABA prn
- Medium dose ICS/LABA, alternative: LTRA
- PO corticosteroid
- IV corticosteroid
Examples of ICS + LABA
budesonide + formoterol (symbicort)
mometasone + formoterol (Zenhale)
can work both as reliever and controller
What frequency of asthma attacks indicates CONTROLLED asthma?
- Daytime asthma symptoms: ≤2 times per week.
- Night-time waking due to asthma: None.
- Reliever medication use: ≤2 times per week.
- Activity limitation due to asthma: None.
Side effects of SABA
tremors
nervousness
tachycardia
palpitations
weakness
facial flushing/skin
insomnia
N/V
Examples of SABA vs. LABA
SABA: salbutamol, terbutaline
LABA: Formoterol (full b2 agonist), Salmeterol (partial agonist)
Onset of SABA vs. LABA?
SABA: 5 min
LABA: 14 mins but lasts longer (upto 24 hrs). Formoterol has a faster onset compared to salmeterol by 3-5 min
Examples of ICS/LABA combo?
symbicort: budesonide/formoterol
Breo Ellipta: fluticasone/vilanterol
Advair diskus or MDI: luticasone/salmeterol
Zenhale: mometasone/formoterol
side effects of ICS?
oral pharyngeal candidasis
dysphonia
cough
