Flashcards in Asthma DSA Deck (23):
1
definition of asthma
3 components
1 recurrent airway obstruction - resolves with treatment
2 airway hyper-responsiveness, exaggerated bronchoconstriction in response to stimuli with little or no effect on non-asthmatic patients
3 airway inflammation
2
asthma populations
8% adults
boys more than girls
before age 25 common
3
mild asthma
edema and hyperemia of mucosa plus mucosal infiltration with mast cells, eosionphils, and lymphocytes
4
moderate asthma
chemokines eotaxin, RANTES, macrophage inflammatory protein 1 alpha, IL 8 lead to inflammation and smooth m consriction
5
severe asthma
hypertrophy and hyperplasia of airway glands and smooth m lead to severe airway thickening
6
airway obstruction causes
1 constriction of airway smooth m
2 thickened airway epithelium
3 liquids in airway
7
ACh
stimulate M3 muscarinics - causing smooth m constriction
8
histamine
released from mast cells
9
leukotrienes and lipoxins
derived by lipoxygenation of arachidonic acid released from target cell membrane phospholipids during cell activation
10
nitric oxide
produced by airway epithelium and by inflammatory cells found in asthmatic lung
-high levels found during asthma attack**
11
mild intermittent asthma
symptoms for < 2 days / week or < 2 nights / week
12
mild persistent asthma
symptoms > 2 days / week but < 1 daily, or > 2 nights / month
13
moderate persistent asthma
symptoms daily or > 1/night
14
severe persistent asthma
symptoms continual during day or frequent at night
15
tachypnea, tachycardia, pulsus paradoxus, accessory muscle use, hyperinflamtion, prolonged FEV1, expiratory wheezing
asthma
16
asthma ABG
often hypocapnea
if normalizes- may indicate resp failure
17
asthma CBC
eosinophilia, elevated IgE
18
asthma EKG
sinus tachycardia, RBBB, P pulmonale, ST-T changes
19
intermittent asthma Tx
short acting beta2 agonist
20
mild persistent asthma Tx
short acting beta2 agonist
inhaled corticosteroid
alternate - mast cell stabilizer, leukotriene-receptor antagonist, theophylline
21
moderate persistent asthma Tx
short acting beta2 agonist
low-medium dose corticosteroid
long acting beta2 agonist
alternate - inhaled corticosteroids and leukotriene antagonist or theophylline
22
severe persistent asthma Tx
short acting beta2 agonist PRN
high dose inhaled corticosteroid and long acting beta2 agonist
if severe - prednisone
23