January 15, 2016 - Asthma Management Flashcards Preview

COURSE 3 > January 15, 2016 - Asthma Management > Flashcards

Flashcards in January 15, 2016 - Asthma Management Deck (10):
1

Current Drugs for Asthma

Short-acting ß2-andrenoceptor agonists (SABA)

Inhaled corticosteroids (ICS)

Long-acting ß​2-andrenoceptor agonists (LABA)

Leukotriene receptor antagonists (LTRA)

Anti-IgE monoclonal antibodies

Oral corticosteroids (try to avoid)

2

Relievers

"Rescue medications"

Activates ß​2-andrenoceptors on airway's smooth muscle to quickly relieve symptoms in 1-2 minutes, but are short acting (2-6 hours).

Examples are SABAs such as Salbutamol (Ventolin®).

These are not for regular prophylactic use.

3

ß​2-Andrenoceptor Agonists

Work by relaxing bronchial smooth muscle irrespective of the spasmogen.

These act as "functional antagonists" regardless of what caused the provocation, and these are very effective.

4

Side Effects of ß​-Agonists

SABAs are well-tolerated, but some minor side effects include tremors, tachycardia, and tachyphylaxis.

LABAs are the same as above.

5

Controllers

Used regularly for phophylaxis.

Include inhaled corticosteroids (ICS), ICS/LABA combinations, and leukotriene receptor antagonists (LTRA).

The anti-inflammatory effect has a slow onset of 1-3 hours, but has a long duration of action of 12-24 hours.

 

* Controllers are indicated if there is any sign of poor control. *

 

6

When Controllers are Indicated

If there is any signs of poor control.

7

Controlled Asthma Criteria

Daytime symptoms of <4 days a week

Nighttime symptoms <1 night a week

Physical activity is normal

Excaberations are mild and infrequent

Absence from work or school - none

Need for SABA <4 doses a week

FEV1 is >90% of personal best

PEF diurnal variation is <10-15%

8

Side Effects of Inhaled Corticosteroids (ICS)

Because of the oropharyngeal deposition, the patient may experience hoarseness, sore throat, or thrush.

Systemic effects for inhaled corticosteroids are not nearly as strong as with systemic corticosteroids, but high-doses of ICS in children may lower growth velocity and have a final height that is ~1cm shorter.

9

Leukotriene Receptor Antagonists

Leukotrienes are potent bronchoconstrictors.

Leukotrienes cause inflammation and mucous secretions, therefore by adding antagonists this can help in patients with asthma. 

These are typically used as an add-on therapy.

10

Anti-IgE Therapy

Indications for use in patients who have moderate to severe asthma despite guideline care.

Have serum IgE between 30 and 700.

Decks in COURSE 3 Class (102):