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Respiratory HQ > Management of Asthma > Flashcards

Management of Asthma Flashcards

1
Q

Give some non-pharmacological treatments for asthma

A
  • action plan
  • weight loss if there is high BMI
  • vaccines
  • physiotherapy
  • smoking cessation
  • allergen avoidance
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2
Q

What are the two classes of drugs used in the treatment of asthma

A
  • bronchodilators

- anti-inflammatory drugs

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3
Q

Name three classes of bronchodialtors

A
  • beta2 agonsists
  • anti muscarinics
  • theophylline
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4
Q

Name three classes of anti-inflammatory drugs

A
  • leukotriene receptor agonists
  • steroids
  • monoclonal antibodies
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5
Q

What drugs should be avoided by an asthma patient

A
  • beta blockers
  • NSAIDs
  • aspirin
  • sedatives
  • opiates
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6
Q

What are the benefits of using a spacer device

A
  • decreased speed of inhalation required
  • bad taste reduced
  • less oral candidiasis
  • reduced dysphonia (hoarseness)
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7
Q

What is termed as complete control of asthma symptoms

A
  • no day symptoms
  • no waking up at night
  • no rescue medication needed
  • no exacerbation (attacks)
  • no activity limitation
  • minimal side effects of medication
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8
Q

What are SABA

A

short acting bronchodilators

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9
Q

Give two examples of SABAs

A
  • salbutamol

- terbutaline

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10
Q

What are some side effects of SABAs

A
  • tremor
  • cramp
  • headache
  • palpitations
  • angina
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11
Q

What are ISCs

A

inhaled corticosteroids

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12
Q

When are ICSs indicated

A
  • when using SABA more than three times a week
  • when waking up with symptoms at least once a week
  • if steroids had to be used for an exacerbation up to two years ago
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13
Q

What are the side effects of ICSs

A
  • dysphonia

- oral candidiasis

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14
Q

What are LABAs

A

long acting bronchodilators

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15
Q

What are LABAs made up of and in what forms can they be prescribed

A
  • made up of LABA and ICS

- can come as MDI or as DPI

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16
Q

What is the next step in the management of asthma if LABAs have a poor response

A

increase the dose of ICS

17
Q

Name three classes of add-on therapy on the management of asthma

A
  • leukotriene receptor antagonists
  • theophylline
  • long acting anti muscarinics
18
Q

What is the function of LAMAs

A

antagonises muscarinic acetylcholine receptors in bronchial smooth muscle

19
Q

What are the side effects of LAMAs

A
  • dry mouth
  • headaches
  • GI upset
20
Q

Give three treatments that could be used in order to reduce dependency on oral steroids

A
  • anti IgE
  • anti interleukin-5
  • immune suppressive drugs
21
Q

How is a mild asthma exacerbation recognised

A
  • increased symptoms

- PEFR less between 50 and 75% predicted

22
Q

How is a mild asthma exacerbation treated

A
  • prednisolone
  • SABA
  • ICS
  • LABA
23
Q

How is a severe asthma exacerbation recognised

A
  • increased respiratory and heart rate

- unable to complete full sentences

24
Q

How is a severe asthma exacerbation treated

A
  • oral and IV steroids
  • SABA
  • SAMA
  • O2 as required
25
Q

How is control of asthma measured in children

A 
SANE:
SABA use per week
Absence from school/nursery
Nocturnal symptoms per week
Exertional symptoms per week
26
Q

How does asthma medications differ in children from adults

A
  • maximum ICS dose in children is 800mg
  • no oral B2 medications is suitable for children
  • LRTA is the first preventer to be used in children under five
27
Q

What is the first step in the treatment of asthma in children

A
  • low dose ICS/LRTA to confirm diagnosis, review in two months
  • SABA as required in an MDI/spacer or DPI
28
Q

What is the second step in the treatment of asthma in children

A

Add LABA or increase the dose of ICS/LRTA

29
Q

If there is no response to LABA, what are the next options

A
  • stop and further increase ICS/LRTA

- add LRTA or theophylline

30
Q

What is the next step in the management of asthma in children

A

Increase to high dose ICS or refer to senior physician to confirm the diagnosis

31
Q

What are the side effects of ICS in children

A
  • height suppression (by maximum of 1 cm)

- adrenocortical suppression (only in strong medicines in very high doses)

32
Q

How should LABA be used

A
  • with ICS

- as a fixed dose inhaler

33
Q

What is the only LTRA indicated for use in children

A

Montelukast

34
Q

Why are spacer devices more suitable for children than nebulisers

A
  • quieter
  • quicker
  • portable
  • have a valve mechanism
35
Q

How should a mild exacerbation of asthma in children be managed

A
  • SABA/spacer

- prednisolone

36
Q

How should a moderate exacerbation of asthma in children be managed

A
  • SABA/nebuliser and prednisolone

- SABA and ipratropium (LAMA)/nebuliser and prednisolone

37
Q

How should a severe exacerbation of asthma in children be managed

A
  • IV salbutamol/aminophylline/hydrocortisone

- intubate and ventilate

Respiratory HQ (26 decks)

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