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Flashcards in Pharm 4 Resp pt3 Deck (25)
1

2 main causes of asthma

2nd hand smoke
Allergic march (keeping the kid in a bubble)

2

Diff btwn Asthma-Inflammation and Bronchospasm. (Comparing the muscle and airway lining, each surrounding the airway)

Asthma: the airway lining swells, the muscle lining is normal. Airway lining swelling makes it like breathing through a straw.
Bronchoconstriction: the muscle tightens and constricts the airway.

3

Why do people outgrow asthma?

kids have o: if that closes up, they get asthma
adults have O: if that closes up, their airway is still wide open enough to breathe normally.

4

COPD is actually a term that groups two closely related diseases:

Chronic Bronchitis & Emphysema

5

How to differentiate between asthma and COPD?

spirometry.
If you have a reversible obstructive flow, that’s asthma.
If it’s not reversible, that’s COPD.

6

What's WBC are affected in asthma?

CD4 T-Lymphocytes, Eosinophils

7

What WBC are affected in COPD?

CD8 T-Lymphocytes, Macrophages, Neutrophils

8

5 Inhaled Medical Delivery Devices

Metered Dose Inhaler (MDI)
Dry Powder Inhaler (DPI)
Spacer/holding Chamber
Spacer/holding Chamber with face mask
Nebulizer

9

Peak flow is unique to the patient.
Peak flow <__% needs help

<80% needs help

10

Asthma severity classification:
Days with sx, Nights with sx, FEV1.
Step 1

Mild Intermittent
80%

11

Asthma severity classification:
Days with sx, Nights with sx, FEV1.
Step 2

Mild Persistent
Days: >2/week but 2/month
FEV1: >80%

12

Asthma severity classification:
Days with sx, Nights with sx, FEV1.
Step 3

Moderate Persistent
Days: Daily
Nights: >1/week
FEV1: 60-80%

13

Asthma severity classification:
Days with sx, Nights with sx, FEV1.
Step 4

Severe Persistent
Days: Continual
Nights: Frequent
FEV1: <60%

14

The patients “step” of asthma severity is determined by:

their most severe features
(days, nights, fev1, pef variability)

15

3 as-needed, quick-relief, rescue meds (types) for Asthma

Short-acting beta2-agonists
Anticholinergics
Systemic corticosteroids

16

5 types of daily, long-term control meds for asthma:

Corticosteroids (inhaled and systemic)
Cromolyn/nedocromil
Long-acting beta2-agonists (LABA)
Leukotriene inhibitors
Methylxanthines

17

___ are clearly the most effective long-term-therapy for persistent asthma

Inhaled Corticosteroids
There is a small or no risk for adverse events when prescribed at recommended doses

18

3 tips for using ICS for asthma

spacer and rinse mouth after use
lowest possible dose
in combination with long-acting beta2-agonists

19

Kids who gets constant asthma attacks get chronic basement membrane changes, aka, scarred alveoli. The drug to prevent with this is:

ICS

20

Effects of ICS on children's growth:

the average child for the 1st year on HIGH-dose ICS will have a ½” growth delay, which they then reverse with a growth spurt after the first year.
low-medium doses usually show no effect on growth

21

3 examples of ICS for asthma.
They all have different doses.

Beclomethasone, Budesonide, Fluticasone

22

Not a substitute for anti-inflammatory therapy (not a substitute for ICS)
Not for acute exacerbation and not a rescue medication
Not appropriate for monotherapy
Beneficial when added to ICS

Long-Acting Beta2-Agonist

23

Single most effective medication for relief of acute bronchospasm

Short-Acting Beta2-Agonists

24

What suggests inadquate control of SABA for asthma?

>2 canisters annually

25

2 SABA to know:

Albuterol, Levalbuterol