asthma Nguyen

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Author:
alvo2234
ID:
235480
Filename:
asthma Nguyen
Updated:
2013-09-18 02:38:02
Tags:
asthma
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Description:
asthma
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  1. FEV1
    • forced expiratory volume in 1 second
    • volume exhaled forcefully in the first second
  2. FVC
    • forced vital capacity
    • max volume exhaled
  3. special populations
    • young children
    • elderly
    • pregnancy
  4. medications preferred for pregnant pts
    • budesonide preferred ICS
    • albuterol for quick relief
  5. mometasone brand name and dosing
    • asmanex
    • 220 QD
  6. beclamethasone brand and dosing
    • QVAR
    • low: 80 - 240 BID
  7. Budesonide brand and dosing
    • Pulmicort, Entocort
    • low: 180 - 1200 BID
  8. Fluticasone brand and dosing
    • Flovent
    • low: 88 - 264 BID
  9. ciclesonide brand name and dosing
    • Alvesco
    • low: 80 - 160 mg/day
  10. Flovent DPI dosing
    low dose: 100 - 300
  11. budesonide nebulizer dosing for 0 - 11 years
    • low dose: 0.25 - 0.5 (0 - 4 yrs)
    •                0.5 mg (5 - 11 yrs)
  12. black box warning for LABAs
    asthma related death
  13. AE for LABAs
    • palpitation
    • tremor
    • HA
  14. AEs of SABAs
    • nervousness
    • restlessness
    • tremor
  15. polymorphism with B2 receptor
    • Mutations:
    •       Ar 16 to glycine
    •       Glu 27 to glutamic acid
    • Decrease binding and down regulation
    • Homozygous Arg 16
  16. how long until sx improvement with cromolyn
    ~ 2 weeks
  17. AEs of mast cell stabilizer
    • unpleasant taste
    • no evidence of mutagenesis or teratogenesis
  18. MOA of methyxanthine
    • PDE inhibitor
    • stimulates catechol release
  19. things that decrease theophylline concentration
    • 1-9 yrs
    • Rifampin
    • interferon
    • Phenytoin
    • Phenobarbital
    • Carbamazapine
    • Zileuton
    • Smoking
    • High protein
  20. age that increase concentration of theophylline
    < 6 months and the elderly
  21. comorbid conditions that increases theophylline lvs
    • systemic febrile viral illness
    • hypoxia
    • cor pulmonae
    • decompensated CHF
    • cirrhosis
  22. medications which decrease theophylline concentration
    • cimetidine
    • erythromycin
    • clarithromycin
    • ciprofloxacin
    • ticlopidine
  23. foods that decrease theophylline concentrations
    • high carbs
    • fatty foods
  24. AE of methylxanthine
    • NVD
    • HA
    • nervousness
    • difficulty sleeping
    • severe: tachyarrhythmias and seizures
  25. Leukotriene modifiers AE
    • mood/behavior changes
    • LFT elevation
    • HA
  26. when and how is xolair given
    SQ injection every 2-4 weeks
  27. AE of xolair
    • malignancy
    • injection site reaction
    • respiratory tract infection
    • HA
  28. what is the black box warning for xolair
    anaphylaxis
  29. Peters SP study result
    tiotropium add on was superior than doubling ICS

    tiotropium add on was non inferior to LABA
  30. Kerstjens study result
    tiotropium add on was superior to placebo

    no differences between doses
  31. Bateman study result
    tiotropium add on and salmeterol add on were superior to placebo

    tiotropium add on was non inferior to salmeterol
  32. kerstjens
    PrimoTinA- asthma 1 and asthma 2
    tiotropium add on showed greater change in FEV1 and prolonged time to exacerbation compared to placebo
  33. when should follow ups occur
    • 2-6 wk intervals: initiating therapy/step up
    • 1-6 mths interal: after control is achieved
    • 3 mth intervals: step down tx anticipated
  34. causes for nocturnal asthma
    • increase inflm mediators
    • increase parasym nervous system
    • lower levers of epi and cortisol
    • GERD
  35. what is NOT recommended for managing exacerbations
    • OTC products
    • drinking large amts of liquids
    • breathing warm moist air
  36. what should always be used with a nebulizer
    spacer

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