Asthma

Question 1

Asthma - Pathophysiology

Answer 1

• IgE activation > IR in airways > excessive mucus production > bronchoconstriction
• Trapping air > hyperinflation of lungs
  The obstruction occurs because the mast cells release histamines and leukotrienes which causes inflammation or airway hyper-responsiveness

Question 2

Asthma - Hospital Treatment

Answer 2

• Steroids
  > bronchodilators (inhalers)
  > SABA: acute exacerbations
  > LABA: prevent exacerbations, maintenance
• Possible intubation

Question 3

Asthma Attack Triggers

Answer 3

• Allergens
• Irritants
• Exercise
• Cold air
• Colds/infections
• Food additives
• Animals
• Medications
• Strong emotions

Question 4

Asthma Lab Tests - Pulmonary Function Test

Answer 4

Spirometry testing assesses the presence and degree of disease & can determine the response to treatment

Question 5

Asthma Lab Tests - Peak Expiratory Flow Rate Measurement

Answer 5

Measures maximum flow of air tht can be forcefully exhaled in 1 second; child uses a peak expiratory comparison at other times, such as during and after an asthma attack

Question 6

Asthma Lab Tests - Skin Testing

Answer 6

Done to identify specific allergens

Question 7

Asthma Lab Tests - Exercise Challenges

Answer 7

Exercise is used to identify the occurence of exercise-induced bronchospasm

Question 8

Asthma Lab Tests - Chest Radiograph

Answer 8

May show hyperexpansion of airways

Question 9

Asthma Medications - SABA

Answer 9

• Short-acting beta2-agonist
• Rescue inhaler
• EX: albuterol
• if going through 2+ inhalers = poorly controlled

Question 10

Asthma Medications - ICS

Answer 10

• Inhaled corticosteroid
• EX
  > Solumedrol
  > flovent

Question 11

Asthma Medications - LABA

Answer 11

• Long-acting Beta2-agonist
• EX
  > formoterol (Foradil)
  > salmeterol
• Leukotriene modifier can be used instead of LABA
  > Montelukast/Singulair

Question 12

Asthma Medications - Oral

Answer 12

• Oral systemic cortocsteroid
  > Dexamethasone (also IM)
  > Prednisone
  rescue

Question 13

Asthma Quick Relief - Rescue Medications

Answer 13

• Short Acting B2 agonists
  > for bronchodilation
  > albuterol, levalbuterol, terbutaline
• Anticholinergics
  > block the parasympathetic nervous system, for relief of acute bronchospasm
  > atropine, ipratropium
• Systemic Corticosteroids
  > for anti-inflammatory action to treat reversible airflow obstruction

Question 14

Asthma Long-Term Control - Prevent Attacks

Answer 14

• Inhaled Corticosteroids
  > for anti-inflammatory action
• Long-Acting B2 agonists
  > for long-acting bronchodilation
• Leukotriene modifiers
  > to prevent bronchospasm & inflammatory cell infiltration
• Monoclonal antibody
  > blocks binding of IgE to mast cells to inhibit inflammation
• Antiallergy meds
• Nonsteroidal anti-inflammatory drugs

Question 15

Does status asthmaticus require hospitalization

Answer 15

Yes, the original treatment method is not working

Question 16

Goals of Asthma Management

Answer 16

• Prevent exacerbation
  > avoid allergens
• Provide acute asthma care
• Relieve bronchospasm
• Monitor function w/ peak flowmeter
• Master self-management of inhalers, devices, and activity regulation