Flashcards in Asthma Deck (25)
What is a blue inhaler?
Salbutamol - beta agonist
Reversible airway obstruction that cause intermittent wheezing
= Reversible obstructive airway disease
What is a mast cell?
Inflammatory cell that release histamine in response to inflammatory response
Mechanism of mast cell releasing histamine?
1. Allergen cross link to receptor IgE
2. Intracellular response - trigger mast cell
3. catalysis intracellular process
4. secondary messenger = mast cell degranulation
5. histamine release
What does release of histamine cause?
Smooth muscle constriction = bronchoconstriction
Mucus hyper secretion - block bronchi
Mucus plug formation
Name different types of asthma?
1. Extrinsic = atopic --> pollen, house dust mite faeces
2. Intrinsic = cold, exercise, stress
3. Aspirin induced
4. Occupation - latex, animal, vapour
What is a wheeze?
When do you get wheeze with asthma?
Polyphonic whistle sound
Wheeze on expirations
What is atopy?
Predisposition to developing hypersensitivity type reaction
What is SOB?
Shortness of breath = dyspnoea
Laboured breathing - use of accessory muscles and increased breathing rate
What drives breathing? - does this ever change?
Most people CO2 drive respiration
People w/ COPD have hypoxic drive (dangerous to overload with oxygen - 1 in 200 have it and takes 4 hours to knock out)
What is normal respiratory rate?
What rate would be classical asthma
Tachypnoea >20 breath/min
Symptom of severe asthma?
Peak flow less 50% predicted, can't complete sentence, RR>25, HR>110
Symptom life threatening asthma?
Cyanosis, exhaustion, RR less 8
What is FEV1 and FVC?
FEV1= forced expiratory vol in 1 second - after full inspiration
FVC = forced vital capacity
How measure breathing?
Spirometer and peak flow meter
What expect to see in obstructive lung disease (FEV1/FVC)
Reduced FEV1 normal FVC
FEV1:FVC less 70%
How diagnose asthma?
Show FEV1:FVC less 70%
- need to show reversible
How to manage asthma w/ inhalers?
1. Reliever - manage attack by using short acting beta agonist
2. Preventer - don't relieve attack - use long acting beta agonist
What is the blue, brown and green inhaler?
Blue - salbutamol
Brown = steroid
Green = long acting
When is ipratropium bromide used?
Acute attack - can be brown colour
How does salbutamol work?
B2 agonist - stimulate B2 adrenoreceptor relaxing smooth muscle
Explain step wise approach asthma?
1. Short acting beta agonist
2. Steroid inhaler
3. Long acting beta agonist
4. Increase steroid dose/ montelukast
5. Oral steroid - short term
Assessing control asthma in dental setting?
Frequency of attack
Emergency management of acute asthma?
4. Ambulance - hypoxic, feature severe asthma