Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/38

Click to flip

38 Cards in this Set

  • Front
  • Back
TEST QUESTION

Asthma is a chronic inflammatory disorder involving what inflammatory factors
Mast cells, eosinophils, neutrophils
Cytokines, leukotrienes, histamine
TEST QUESTION

Asthma is a Chronic inflammatory disorder that causes reversible airflow obstruction caused by what?
Bronchial hyperresponsiveness to stimuli
Symptoms of Asthma
Dyspnea
Wheeze
Chest tightness
Cough
Allergic rhinitis
Asthma triggers
Exercise
Allergan exposure
Cold air
Inhaled irritants
Tobacco smoke
TEST QUESTION

Triad Asthma

Syndrome of:
Asthma
Nasal polyps
Aspirin sensitivity
TEST QUESTION

Asthma Diagnosis
Spirometry

*Reversibility of reduced FEV1
12% improvement of FEV1
Explain the spirometry test for asthma involving beta2 agonist
Obtain FEV1 by spirometry, 3 efforts
Administer inhaled short acting beta2 agonist
Albuterol (Ventolin) Metered Dose Inhaler (MDI) 2 puffs, 2 minutes apart
Albuterol 2.5mg via aerosol nebulizer
Repeat spirometry, 3 efforts
Explain the spirometry test for asthma involving steroid
Spirometry, 3 efforts
Systemic steroids for 2 weeks
Prednisone 20mg P.O. daily
Repeat spirometry
Describe Bronchoprovacation Testing


(rarely used)
Inhalation of Methacholine or Histamine in attempt to trigger bronchospasm
High risk
Reserved for suspected asthma with normal spirometry
Classification (staging) of Asthma
Mild Intermittent
Mild Persistent
Moderate Persistent
Severe Persistent (previously Status Asthmaticus)
TEST QUESTION

Definition of poorly controlled asthma
2 or more exacerbations per week
Treatment of Asthma:

Treatment of bronchial hypersensitivity
Short acting Beta 2 agonist
*1 Inhaler should last 1 year

(* test question)
Treatment of Asthma:

Treatment of chronic inflammation
Inhaled steroid
Long acting Beta2 Agonist
Leukotriene blocker
Theophylline
Oral steroid
Other agents
Simple, safe, inexpensive way to prevent asthma
Identify and avoid triggers

Can be difficult
Getting rid of the family pet
Moving
STOP SMOKING

Desensitization
Allergy shots
Can be life-saving
Bronchospasm treatment
Short acting Beta2 Agonists

Mainstay of treating exacerbation
Selectivity preferred over Epinephrine (Primatene Mist): less side effects
Inhaled route preferred
-Less systemic side effects
-MDI or nebulizer delivery

Subcutaneous route available
Short acting Beta 2 Agonists
1) Albuterol (Proventil, Ventolin)
2) Levalbuterol (Xopenex)
L-isomer of Albuterol (less side effects- tachy cardia, jitteriness, shakes)
3) Metaproterenol (Alupent)
4) Pirbuterol (Maxair)
5) Terbutaline (Brethine)
Albuterol:
Meter Dose Inhaler Rx:
2 puffs every 4 hours prn
How many puffs in one inhaler
200 inhalations per MDI
200/52 weeks = 4 puff/week = 1-2 exacerbations
Nebulizer solution Rx:
2.5mg hourly prn for exacerbation
Albuterol syrup Rx:
Age 2-6: 0.1mg/kg P.O. TID
Age 6+: 2mg P.O. QID
Terbutaline (Brethine) Rx:
Subcutaneous administration
0.25mg in lateral deltoid area
May repeat after 15 minutes
TEST QUESTION

Inhaled Corticosteroids (6)
Beclomethasone (Qvar)
Budesonide (Pulmicort)
Flunisolide (Aerobid)
Fluticasone (Flovent)
Mometasone (Asmanex)
Triamcinolone (Azmzcort)
Corticosteroids taken long term can suppress ______-______-_____ axis (true)
Hypothalamus-Pituitary-Adrenal
Corticosteroids Can lead to ________ in children (true)
short stature
Corticosteroids short kids that grow up to be of _______ stature in adults
normal
“Poor man’s Steroid”
More accepted in pediatric patients
(2 examples)
Mast Cell Stabilizers

Cromolyn (Intal)
4 times daily
MDI or nebulizer
Nedocromil (Tilade)
MDI 4 times daily
Long-acting Beta2 Agonists (2)
Formoterol (Foradil)
Salmeterol (Serevent)
1 inhalation twice daily
Leukotriene agents (2 types)
5-Lipoxygenase inhibitor
Leukotriene Receptor Antagonist
5-Lipoxygenase inhibitor (1)
Zileuton (Zyflo)
Dosed 4 times daily
Leukotriene Receptor Antagonist
(2)
1) Montelukast (Singulair)
Dosed P.O. once daily in the P.M.
1-5 years: 4mg
6-14 years: 5mg
15+: 10mg
2) Zafirlukast (Accolate)
Twice daily on empty stomach
Systemic Corticosteroids Ideally used for 5 days, ______ maximum
2 weeks
Intravenous Systemic Corticosteroid (1)
Methylprednisolone (SoluMedrol) 2mg per kg loading dose, then 1mg per kg IV q 6 hours
Systemic Oral steroids (2)
Prednisone tablets: 20mg daily
Prednisolone syrup: Metabolite of Prednisone
Xanthine (1 example)
Theophylline (TheoDur)
Problems with Theophylline
Monitor serum levels
Drug-drug interactions problematic
IgE blocker (1 example)
Omalizumab (Xolair)
Antihistamines Benefit in astmatics?
inconclusive

"Throwing everything at the patient"
What's Advair (Fluticasone/Salmeterol)?
Steroid/Long acting Beta2 Agonist

Dose of Advair:
Doses 100/50, 250/50, 500/50
1 inhalation twice daily