Asthma Flashcards Preview

Year 1 - Respiratory (DP) > Asthma > Flashcards

Flashcards in Asthma Deck (20):
0

How do we treat a moderate asthma attack?

10 puffs of salbutamol (4 initial puffs, 2 every 2 minutes)
OR
5mg neb. salbutamol
OR
10mg neb. terbutaline
THEN
40mg oral prednisolone

1

What is the treatment of a severe acute asthma attack?

Initially as for a moderate attack
With salbutamol, 0.5mg neb. ipratropium
IF POOR RESPONSE
5mg/kg IV aminophylline

2

What is the treatment and step-up treatment for COPD?

SABA or SAMA initially
If FEV1 > 50% - LABA or LAMA
If FEV1 < 50% - LABA + ICS or LAMA + ICS (try LABA + LAMA if ICS declined)
If above fails, LABA + LAMA + ICS
If give a LAMA at any point discontinue SAMA use

3

What are three examples of LABAs?

Salmeterol
Formoterol
Indacterol (an ultra LABA)

4

What are some examples of SAMAs?

Ipratropium
Oxitropium

5

What are some examples of LAMAs?

Tiotropium
Aclindinium

6

What are some side effects of salbutamol?

Fine tremor
Tachycardia

7

When is salmeterol useful?

Nocturnal asthma

8

When are CysLT1 antagonists used?

In antigen-induced and exercise-induced asthma

9

What are two examples of CysLT1 antagonists?

Montelukast
Zafirlukast

10

How do xanthines work?

Inhibit enzymes inactivating cAMP and cGMP (and hence allowing relaxation)

11

Why are glucocorticoids used in asthma?

For prophylaxis

12

How do glucocorticoids work?

Deacetylation of histones - prevents transcription of inflammatory genes (Th2 cytokines)
Prevent IgE formation
Prevent eosinophil influx

13

What are the side effects of inhaled steroids?

Dysphonia
Orophrayngeal candidiasis

14

How does Omalizumab work?

Prevents IgE attachment to FcEpsilon receptors
Decreased mast cell response in allergic asthma

15

What symptoms are present in asthma?

Diurinal variation
Non-productive cough
Wheeze
Triggers
Atopy
FHx

16

How is asthma diagnosed?

Hx and exam
PEFR
Decreased FEV1%
Reversed on inhaled SABA
Provocation testing

17

When is chromoglycate effective?

Prevention of asthma in atopic children

18

When would H1-receptor antagonists be used?

If there is a known allergic trigger

19

What is Samter's triad?

Asthma
Nasal polyps
Salicylate sensitivity