Asthma DSA Flashcards
(23 cards)
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
asthma populations
8% adults
boys more than girls
before age 25 common
mild asthma
edema and hyperemia of mucosa plus mucosal infiltration with mast cells, eosionphils, and lymphocytes
moderate asthma
chemokines eotaxin, RANTES, macrophage inflammatory protein 1 alpha, IL 8 lead to inflammation and smooth m consriction
severe asthma
hypertrophy and hyperplasia of airway glands and smooth m lead to severe airway thickening
airway obstruction causes
1 constriction of airway smooth m
2 thickened airway epithelium
3 liquids in airway
ACh
stimulate M3 muscarinics - causing smooth m constriction
histamine
released from mast cells
leukotrienes and lipoxins
derived by lipoxygenation of arachidonic acid released from target cell membrane phospholipids during cell activation
nitric oxide
produced by airway epithelium and by inflammatory cells found in asthmatic lung
-high levels found during asthma attack**
mild intermittent asthma
symptoms for < 2 days / week or < 2 nights / week
mild persistent asthma
symptoms > 2 days / week but < 1 daily, or > 2 nights / month
moderate persistent asthma
symptoms daily or > 1/night
severe persistent asthma
symptoms continual during day or frequent at night
tachypnea, tachycardia, pulsus paradoxus, accessory muscle use, hyperinflamtion, prolonged FEV1, expiratory wheezing
asthma
asthma ABG
often hypocapnea
if normalizes- may indicate resp failure
asthma CBC
eosinophilia, elevated IgE
asthma EKG
sinus tachycardia, RBBB, P pulmonale, ST-T changes
intermittent asthma Tx
short acting beta2 agonist
mild persistent asthma Tx
short acting beta2 agonist
inhaled corticosteroid
alternate - mast cell stabilizer, leukotriene-receptor antagonist, theophylline
moderate persistent asthma Tx
short acting beta2 agonist
low-medium dose corticosteroid
long acting beta2 agonist
alternate - inhaled corticosteroids and leukotriene antagonist or theophylline
severe persistent asthma Tx
short acting beta2 agonist PRN
high dose inhaled corticosteroid and long acting beta2 agonist
if severe - prednisone
omalizumab
monoclonal antibody for IgE
moderate to severe persistent asthma with reactivity to allergen and who inhaled corticosteroid Tx does not work
