Asthma Flashcards
(17 cards)
What is the initial management for moderate acute asthma in adults?
Use SABA through large volume spacer – up to 10 puffs. Adult: 4 puffs initially followed by 2 puffs every 2 minutes according to response. Child: give a puff every 30-60 seconds.
SABA stands for Short-Acting Beta-Agonists
What oral medication should be given to adults for moderate acute asthma?
Oral prednisolone: 40-50mg for 5 days.
Prednisolone is a corticosteroid used to reduce inflammation.
What criteria warrant hospitalization for acute asthma management?
Age under 18, pregnant, previous severe asthma attack, inadequate treatment response, living alone, psychological problems, physical or learning disabilities, presentation after mid-day.
These criteria help identify high-risk patients.
What is the treatment for severe or life-threatening acute asthma?
High-dose salbutamol via oxygen-driven nebulizer: 5mg for people over 5 years, 2.5mg for children 2-5 years. Add nebuliser ipratropium if not controlled.
Salbutamol is a common bronchodilator.
What lifestyle changes are recommended for chronic asthma management?
Weight loss in overweight patients, smoking cessation, breathing exercise programmes, identifying and avoiding triggers, keep warm and dry in cold weather.
Lifestyle changes can significantly impact asthma control.
What is the key point for asthma treatment in patients aged 12 and older?
No more SABA without an ICS.
low dose inhaled corticosteroid/formoterol combination when needed
ICS stands for Inhaled Corticosteroids.
What is AIR therapy in the context of asthma treatment?
Low dose inhaled corticosteroid/formoterol combination when needed, called AIR therapy (e.g budesonide / formoterol).
AIR therapy is used for both maintenance and relief.
What does MART stand for in asthma treatment?
Maintenance and reliever therapy.
MART allows for flexible dosing in managing asthma.
Under what conditions should AIR therapy be switched from using as when needed to MART?
If pt needs reliever 3+ days per week or having 1+ nights per week of night time awaking
Elevated levels may indicate uncontrolled asthma or allergic components.
What is the first step in asthma treatment for children aged 5-11?
SABA + paediatric low-dose inhaled corticosteroid (ICS).
ICS is administered twice a day.
What is the first step of treatment for children under 5 with asthma?
SABA + paediatric low-dose inhaled corticosteroid (ICS) for 8-12 weeks trial.
Treatment should be adjusted based on symptom resolution.
What does complete control of asthma entail?
No daytime symptoms, no night-time awakening due to asthma, no asthma attacks, no need for rescue medication, no limitations on activity e.g exercise
, normal lung function (FEV1 and/or PEF >80% predicted or best), minimal side-effects from treatments.
Achieving complete control is the goal of asthma management.
What is the recommended approach for reducing asthma treatment?
Reductions considered every 3 months – 25-50% reduction each time.
Regular reviews are essential when decreasing treatment.
What should be done if a child’s symptoms do not resolve during the trial period?
Check inhaler technique, adherence, alternative diagnosis, environmental factors. If none explain failure, refer to specialist.
Proper technique and adherence are critical for effective asthma management.
What can be given if a pt cannot have oral prednisolone?
IM methylprednisolone or IV hydrocortisone if cant have oral prednisolone
What should be done if a low dose MART therapy is not improving asthma symptoms?
increase to moderate dose MART
A pt is on moderate dose MART therapy with symptoms still not improving. What must be checked before LTRA or LAMA is added?
Fractional exhaled nitric oxide (FeNO) level and blood eosinophil count.
If either is raised -> refer to specialist
if not raised LTRA or LAMA can be added
