spirometry is not recommended age < ______ and during acute exacerbations
< 5 yo
Tx of acute asthma exacerbation via SNV
Albuterol +/- Ipratropium SVN q 20-30 min PRN up to 3 doses
recommended dosage of albuterol SVN < 12 yo
0.15-0.3 mg/kg
How long does albuterol last?
4 hours
Tx of acute asthma exacerbation via MDI
Albuterol MDI 90 mcg/puff 2-6 puffs q 20 minutes
Tx of acute asthma exacerbation via oral GCs…
1-2 mg/kg/day, QD or BID x 3-5 days
when to f/u for acute asthma exacerbation?
2-3 days
Mild persistent asthma/STEP 2
SABA + low dose ICS OR Montelukast
2 major indications for montelukast
asthma
allergic rhinitis
dosing for montelukast 1-6 yo
4mg QD
dosing for montelukast 6-15 yo
5mg QD
dosing for montelukast > 15 yo
10 mg QD
When can you step down asthma therapy?
after 3 mo of sxs control
Omalizumab cannot be prescribed to pts < _____ yo
6 yo
Tiotropium is a _______ used for tx of ______
long acting anticholinergic
tx of COPD
which is a short acting bronchodilator/anticholiergic?
ipratropium
2 major SEs of tiotropium
dry mouth
cough
purpose of using anticholinergics like tio/ipratropium?
sx relief
purpose of combo bronchodilator + anti-inflammatory agents…
control
ICS have what 2 major SEs
thrush
hoarseness
3 tx options for acute exacerbation of COPD
intensification of bronchodilator
short course GCs
Abx (macrolide or FLQ)
Acute exacerbation of COPD: bronchodilator…
albuterol 2 puffs q 6 hours x 48 hours
Acute exacerbation of COPD: GCs
prednisone 40 mg PO QD x 5 days
Acute exacerbation of COPD: Abx
Azithromycin 500 mg PO QD x 3 days
OR
Levaquin 500-750 mg PD QD x 5-7 days
