Asthma

Question 1

what ways can asthma be diagnosed

Answer 1

Spirometry: Key diagnostic lung function test measuring airflow volume and speed.

Blood tests (eosinophils): Raised levels support asthma diagnosis; normal levels don’t exclude it.

Peak flow: Supports diagnosis and monitoring; ≥20% drop from personal best suggests an attack

Question 2

how do you use a peak flow test (8)

Answer 2

Attach mouthpiece – clean, disposable.

Reset meter – pointer to zero.

Position – stand or sit upright; hold horizontally, don’t block vents.

Deep breath in – lungs fully filled.

Seal lips – tight seal around mouthpiece.

Blow hard & fast – single explosive breath.

Read value – note where pointer stops.

Repeat ×3 – reset each time; record best reading.

A drop of 20% or more from your
best reading can signal an asthma attack.

Question 3

what are common symptoms of asthma

Answer 3

Coughing. Wheezing , reduce exercise tolerances trouble sleeping, chest tightness

Question 4

what can trigger asthma

Answer 4

Pollen, dust, ciggerette smoke,

Question 5

what’s a metered Dose inhaler (MDI)

Answer 5

Pressurised aerosol delivery via propellant

Slow, steady inhalation + canister press

Good hand–breath coordination required

Question 6

what’s a dry powder Inhaler DPI

Answer 6

Powder delivery, no propellant

Fast, forceful inhalation required

Less coordination needed than MDI

Question 7

how does MDI impact the environment

Answer 7

~70% of UK inhalers are MDIs

MDIs use HFC propellants → potent greenhouse gases

DPIs are more sustainable

No HFCs; much lower global warming potential

Question 8

what can we do to ensure ‘greener prescribing’ ?

Answer 8

Prescribe DPIs as the first-line option when clinically appropriate.

If a MDI is necessary, choose lower-impact brands.

Question 9

Why is Ventolin rarely prescribed in the UK, and why is Salamol preferred?

Answer 9

Both contain salbutamol, but Ventolin MDI has a high carbon footprint

Salamol MDI uses a lower-impact propellant → <50% of Ventolin’s emissions

UK practice prefers DPIs first-line, or lower-impact MDIs when needed

Question 10

What is AIR therapy in asthma management?

Answer 10

Anti-Inflammatory Reliever (AIR)

ICS + fast-acting LABA (formoterol) in one inhaler

Used only when symptoms occur

Treats inflammation + bronchoconstriction together

Recommended for mild asthma (UK 2024 guidelines)

Question 11

What is MART therapy and how does it differ from AIR?

Answer 11

Maintenance And Reliever Therapy (MART)

Same ICS + LABA inhaler used daily AND as needed

For moderate–severe asthma

More symptoms → more doses → more anti-inflammatory treatment

Requires ICS + formoterol inhaler

Question 12

What major change was made in the 2024 UK asthma guidelines?

Answer 12

SABA-only treatment (e.g. salbutamol alone) is no longer recommended

Applies to newly diagnosed asthma patients

First unified guideline by NICE, BTS, and SIGN

Question 13

Why are SABAs no longer recommended as standalone treatment?

Answer 13

Asthma is an inflammatory disease

SABAs relieve symptoms only

They do not treat airway inflammation

Over-reliance increases risk of poor control and attacks

Question 14

What is the preferred first-line treatment in the 2024 UK guidelines?

Answer 14

Anti-Inflammatory Reliever (AIR) therapy

Low-dose ICS + LABA (formoterol)

Taken as needed

Treats symptoms AND inflammation together

Question 15

What are the benefits of AIR therapy compared to SABA-only treatment?

Answer 15

Better asthma control

Fewer exacerbations and hospital admissions

Reduced asthma-related mortality

Ensures inflammation is treated every time relief is used

Question 16

Which inhalers are suitable for AIR and MART therapy?

Answer 16

ICS + formoterol inhalers only

Formoterol is fast-acting AND long-acting

Other LABAs (e.g. salmeterol) are not suitable

Question 17

what’s important maintenance rules to follow for an inhaler

Answer 17

replaced every 6-12 months

monthly basis removed port and soak both pieces in warm soapy water

DON’T RUB DRY JUST AIR DRY

Question 18

important things to remember when dispensing an inhaler

Answer 18

label for box and the thing its closest in (inhaler)

‘Shake before use’