Asthma

Question 1

What causes asthma attack?

Answer 1

chronically hyperactive and inflamed airways leading to airflow obstructin

Question 2

symptoms of asthma

Answer 2

wheezing, coughing, dyspnea, chest tightness, chest pain

Question 3

Components of managment

Answer 3

1. routine monitoring of symptoms/lung function
2. create partnership
3. control environmental factors, comorbid conditions
4. pharm therapy

Question 4

Goals of treatment

Answer 4

1. decrease frequency of symptoms
2. minimal need of SABA
3. fewer night-time awakening
4. optimization of lung function
5. maintenance of normal daily activities

Question 5

Categories of severity

Answer 5

1. Intermittent
2. Mild, persistent
3. Moderate, persistent
4. Severe, persistent

Question 6

Intermittent Asthma

Answer 6

1. daytime asthma symptoms occurring 2 or less days per week

2. 2 or less nocturnal awakenings per month

Question 7

Mild, persistent Asthma

Answer 7

1. symptoms more then 2x weekly (but less than daily)

2. ~3-4 nocturnal awakenings per month (but fewer than every week)

Question 8

Moderate persistent

Answer 8

1. daily symptoms

2. nocturnal awakenings at least once a week

Question 9

Severe persistent

Answer 9

1. symptoms throughout day

2. nocturnal awakenings nightly

Question 10

Treatment of Intermittent

Answer 10

Quick acting inhaled beta-2 selective adrenergic agonist PRN

Question 11

Treatment of mild persistent

Answer 11

Daily long-term controller medication: low dose inhaled glucocorticoid + SABA

Question 12

Alternative for step 2 (low dose inhaled GC)

Answer 12

leukotriene receptor antagonists

Question 13

Treatment of moderate persistent

Answer 13

1. Low dose inhaled GC + inhaled LABA
   OR
2. medium dose inhaled GC

Question 14

Treatment of persistent asthma

Answer 14

1. medium or high dose of inhaled GC and LABA

2. Can add leukotriene modifier (triple-controller therapy)

Question 15

What can you give if evidence of sensitivity to perennial allergen and inadequately controlled on high-dose inhaled GCs and LABAs

Answer 15

omalizumab

Question 16

What can you give for eosinophilic severe asthma poorly controlled w/ conventional therapy

Answer 16

monoclonal antibodies (mepolizumab and reslizumab)