Therapy, Controller Meds Asthma

Front 1

what's given for mild persistent asthma

Back 1

ICS

Front 2

what's given for moderate-severe asthma

Back 2

ICS

and

LABA

Front 3

what prevents EIB

Back 3

albuterol

Front 4

what can worsen asthma

Back 4

NSAID

and

B blockers

Front 5

name the clinical pattern:

extended periods free of symptoms

Back 5

intermittent

Front 6

during this period a pt goes on for weeks or months w/o symptoms

Back 6

intermittent

Front 7

t/f

there are a variety of preventative meds for intermittent

Back 7

f

there are NO preventative meds unless the pt has EIB

Front 8

poorly controlled persistent asthma

a persons has symptoms more than or equal to --- days a wk

Back 8

2

Front 9

in poorly controlled persist. asthma the pt uses ---- ---- more than 2 x week

Back 9

beta 2 agonist

Front 10

t/f

during poorly controlled persist. asthma the pt participates in norm activity

Back 10

f

there's interference w/ norm activity

Front 11

the pt w/ poor controlled persist asthma may have --- visits or ----

Back 11

ED

hospitalization

Front 12

the pt w/ poor control persis. asthma wakes up at least more than --- times month w/ symptoms

Back 12

1

Front 13

FEV1 of pt w/ poor control persistent asthma

Back 13

less than 80%

Front 14

no ICS the risk of hospitalization and death increases/decreases

Back 14

increases

Front 15

which is works first, fluticasone or albuterol

Back 15

fluticasone

Front 16

is there a big difference between ICS by itself and ICS w/ LABA in mild persis asthma?

Back 16

no not much of a difference.

sometimes there's no need for the combo

Front 17

when will the combo of ICS and LABA be a good choice

Back 17

during mod severe persistent asthma

Front 18

examples combo drugs of ICS and LABA

Back 18

advair

symbicort

Front 19

why are LABA by itself contraindicated in asthma

Back 19

cuz no antiinflammatory effects

Front 20

which steroids has the smallest 1st pass effect

Back 20

beclomethasone dipropionate (beconase)

budesonide (rhinocort)

flunisolide (Nasarel)

Front 21

why does fluticasone have a steeper dose response

Back 21

it has a higher potency at the glucocorticoid receptor, so a higher affinity in the lungs

Front 22

explain why nsaids increase the risk of asthma

Back 22

they block the cyclooxygenase.

this will prevent prostaglandins from being created.

prostaglandins block leukotrienes.

an increase in leukotrienes increase chances of asthma.

Front 23

t/f

leukotrienes are the sole culprits of asthma

Back 23

f

if they were the sole culprit then montelukast and fluticasone would prevent asthma completely

something else is also causing asthma

Front 24

who gets thrush and dyphonia w/ the uses of ics

Back 24

adults

kids usu don't get it. also, no evidence of growth problems

Front 25

topical and systemic steroids are ---- dependent

Back 25

dose

Front 26

how do you prevent oral deposition of steroids

Back 26

change to spacer device or dry powder

this will reprevent thrush and dysphonia in adults

Front 27

hoarseness aka

Back 27

dysphonia

Front 28

t/f

cromolyn is good for eib

Back 28

f

it's effects are very similar to the placebo

Front 29

what's best for EIB

Back 29

albuterol

Front 30

during the peak of exercise why is lung function improved

Back 30

due to the release of catecholamines

Front 31

after exercise what causes EIB

Back 31

release of mediators

Front 32

t/f

there's spontaneous improvement of eib after exercise

Back 32

t

after about 40 minutes

Front 33

if ---- is given before exercise then there's no drop in lung function

Back 33

albuterol

Front 34

montekast is better than albuterol in all aspects

Back 34

f

it does not have as much efficacy as B agonist for anything

Front 35

for many kids if montelukast and --- given in AM then there's no need to give albuterol before Phys Ed

Back 35

ICS

Front 36

why don't we use 5LO inhibitors

Back 36

high liver toxicity

Front 37

t/f

for many kids if montelukast and ICS given in AM then there's no need to give albuterol before Phys Ed

Back 37

t

Front 38

----- ----- antagonizes B agonists and increases asthma symptoms

Back 38

Beta blockers

Front 39

t/f

if pt takes ICS and LABA then there's no need to take albuterol prior to exercise

Back 39

t

if it works for that patient

Front 40

- patients with episodic illness interspersed with extended symptom-free periods. These are most commonly triggered by viral respiratory infections or exposure to a specific allergen (e.g., cat dander in a cat-sensitive patient). Also, some patients have isolated EIB. They only experience symptoms with vigorous exercise.

Back 40

intermittent

Front 41

patients with virtually daily symptoms or symptoms several times/week without extended symptom-free periods in the absence of continuous medication.

Back 41

persistent aka chronic

Front 42

patients with virtually daily symptoms during an inhalant allergy season; for example, from outdoor molds that grow on decaying vegetation from early spring through late fall with peaks particularly in the spring and fall. These patients do not have persistent symptoms during other seasons when the allergen to which they are sensitive is not present. For example, a patient with grass pollen-induced asthma may have persistent symptoms during the spring when grass pollen is in the air but have intermittent symptoms during summer, fall, and winter.

Back 42

seasonal allergic