Therapeutics: Asthma 1

Card Set Information

Author:
kyleannkelsey
ID:
270381
Filename:
Therapeutics: Asthma 1
Updated:
2014-04-12 21:23:20
Tags:
Therapeutics Asthma
Folders:
Therapeutics: Asthma
Description:
Therapeutics: Asthma
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user kyleannkelsey on FreezingBlue Flashcards. What would you like to do?


  1. What is Asthma
    Reversible obstructive chronic inflammatory disorder of the airways, characterized by airway responsiveness, recurrent wheezing, chest tightness and coughing often in the morning and night
  2. What happens if you leave asthma untreated?
    Each recurrent attack is worse = more likely to become life threatening
  3. What is the Central abnormality of asthma?
    Airway inflammation caused triggering the AA cascade leading to bronchospasm, epithelial damage and hyper-responsiveness
  4. What is the AA cascade?
    • Phosholipdids →AA→COX pathway OR Lipoxygenase pathway
    • COX = less involved in asthma
    • 5-lipoxygenase = involved in asthma
    • LTC4, LTD4, LTE4 = bronchospasm
    • LTB4 = inflammation
  5. What part of the AA cascade is inhibited by Corticosteroids?
    PL conversion to AA (stops whole AA cascade)
  6. What part of the AA cascade is inhibited by 5-lipoxygenase inhibitors (zileuton)?
    Lipoxygenase pathway
  7. What part of the AA cascade is inhibited by Leuko Mod.(Monte/Zafirlukast)?
    LTC4, LTD4, LTE4 (NOT LTB4)
  8. What Asthma Tx is recommended for a patient with allergies?
    Leukotriene Modifiers (Monte/Zafirlukast)
  9. When does the Early Asthmatic response occur?
    1-2 hrs
  10. What causes the Early Asthmatic response?
    • Mast cell mediators =
    • Histamine
    • Leukotrienes
    • PLT AF
    • WBC chemotactic factors (recruit other inflammatory mediators)
  11. What I sthePrimary disorder of the Early Asthmatic response?
    ACUTE BRONCHOSPASM
  12. What Tx is indicated for the Early Asthmatic response?
    Use rescue inhaler to avoid decompensation
  13. What is the time frame for the Late Asthmatic response?
    2 hrs +
  14. What is the Cause for the Late Asthmatic response?
    • Increase in inflammatory mediators:
    • Eosinophils and PMNs
    • mediated by IgE and mast cell degranulation
  15. What is the Primary disorder of Late Asthmatic response?
    INFLAMMATION that sensitizes tissue
  16. What is the Tx for the Late Asthmatic response?
    • Rescue inhaler is less effective
    • Prevent during early phase don’t treat during late phase
  17. What are the inflammatory mediators the early phase of asthma attacks?
    Histamine, Prostaglandins, Leuk C/D/E, Ach
  18. What are the inflammatory mediators involved in the late phase of asthma attacks?
    • Cellular inflammation: Leuk B4, Eosoniphil AF, PMN AF
    • Later in Late phase:
    • Musocal Edema/ Mucous secretion = Histamine, Prostaglandins, Leuk C/D/E
  19. What inflammatory mediators are involved in early phase Bronchospasm?
    Histamine, Prostaglandins, Leuk C/D/E, Ach
  20. What inflammatory mediators are involved in late phase Cellular inflammation?
    Leuk B4, Eosoniphil AF, PMN AF
  21. What inflammatory mediators are involved in late phase Musocal Edema?
    Histamine, Prostaglandins, Leuk C/D/E
  22. What inflammatory mediators are involved in late phase Mucous secretion?
    Histamine, Prostaglandins, Leuk C/D/E
  23. What can trigger an asthma attack?
    Metacholine, Cold air, exercise, hyperventilation, Cigs, gas, mites, pollen, dander, virus/bacteria
  24. What are the Types of asthma?
    • Standard
    • Exercise induced
    • Cough variant
    • Seasonal
  25. What group is more likely to develop EIB?
    Asthmatics
  26. What causes EIB?
    loss of heat/water + hyperventilation of cool dry air
  27. How do you treat EIB?
    Use rescue inhaler prior to exercise
  28. What group usually gets Cough variant asthma?
    Young kids
  29. What are the characteristics of Cough variant asthma?
    • Trouble sleeping, ceases in AM = difficult to diagnose
    • Usually grow out of it
    • rarely becomes Std asthma
  30. What is the Tx for Cough variant asthma?
    • Long term treatment is not indicated
    • Use SABA
  31. What triggers Seasonal asthma?
    Pollens/molds
  32. How should you treat seasonal asthma?
    Only treat seasonally
  33. When would you use Components of severity charts?
    Used for newly diagnosed or Mild/intermittent not on Long term therapy
  34. What is the treatment and step indicated for patient with a component of severity rating of Intermittent:
    Step 1 = SABA PRN
  35. What is the treatment and step indicated for patient with a component of severity rating of Mild persistent?
    Step 2 = Low dose ICS (alt: Cromolyn, LTRA, Theo or Nedocromil)
  36. What is the treatment and step indicated for patient with a component of severity rating of Moderate persistent?
    Step 3 = Low ICS + LABA or med ICS (alt: LD ICS +LTRA, Theo or Zileuton)
  37. What is the treatment and step indicated for patient with a component of severity rating of Severe persistent?
    • Step 4 = Med ICS + LABA (alt: LD ICS +LTRA, Theo or Zileuton)
    • Step 5 = High ICS + LABA (CONSIDER Omalizumab if have allergies)
  38. What are the s/s for a patient with a components of severity rating of intermittent?
    Symptoms < 2D/wk, Night wakening < 2x/mo, SABA use < 2D/wk, no interference ADL, FEV1 >80% during attacks, FEV1/FVC and FEV1 between attacks = Normal , 0 exacerb.
  39. What are the s/s for a patient with a components of severity rating of Mild persistant?
    Symptoms > 2D/wk, Night wakening 3-4x/mo, SABA use > 2D/wk, Minor interference ADL, FEV1 >80% during attacks, FEV1/FVC = Normal, 0-1 exacerbations/year
  40. What are the s/s for a patient with a components of severity rating of Moderate persistant?
    Symptoms QD, Night wakening > 1x/wk, SABA use QD, Some interference ADL, FEV1 60-80% during attacks, FEV1/FVC = Reduced by 5%, > 2 exacerbations/year
  41. What are the s/s for a patient with a components of severity rating of Severe persistant?
    Symptoms multiple x day, Night wakening > 7D/wk, SABA use multiple x day, Extreme interference ADL, FEV1 <60% during attacks, FEV1/FVC = Reduced by 5%, > 2 exacerbations/year
  42. What are the goals of asthma Therapy?
    • Provide best therapeutic outcome with least amount of drug and adverse effects
    • Prevent chronic symptoms & exacerbations
    • Normal lung function & activities
    • Meet expectations/create partnership (education, develop joint goals, promote communication)

What would you like to do?

Home > Flashcards > Print Preview