age < 5, elderly
Who should we avoid using DPIs in ? (2)
ICS+form, airsupra, SABAs, SAMA, systemic corticosteroids, inhaled epinephrine
What are the quick relief medications (6)?
albuterol + budesonide
Airsupra =
SABAs
Chronic use is NOT recommended with __________.
d
Which is LABA w/ fast onset?
a) systemic corticosteroids
b) SABAs
c) SAMAs
d) ICS + formoterol
e) inhaled epinephrine
d
Which is used intermittently/prn ?
a) systemic corticosteroids
b) SABAs
c) SAMAs
d) ICS + formoterol
e) inhaled epinephrine
b
According to the NHLBI, ______ is the DOC for acute symptoms.
a) systemic corticosteroids
b) SABAs
c) SAMAs
d) ICS + formoterol
e) inhaled epinephrine
# of days of use, symptom frequency
What are the key monitoring points for SABAs? (2)
c
Which is an additive that can ONLY be used in ER setting?
a) systemic corticosteroids
b) SABAs
c) SAMAs
d) ICS + formoterol
e) inhaled epinephrine
ipratropium + albuterol nebulizer
Combivent =
a
Which is used in non-responsive asthma?
a) systemic corticosteroids
b) SABAs
c) LAMAs
d) ICS + formoterol
e) inhaled epinephrine
speed recovery, prevent recurrence, increase response to SABA, decrease hospital admissions
What are systemic corticosteroids used for clinically? (4)
4-12 hours
How long does it take to see a clinical response from systemic
corticosteroids?
f; oral is preferred
IV route is preferred in systemic corticosteroid use. T/F?
until PEF 80% of predicted/personal best
How long do we continue systemic steroid use?
e
Which is available OTC?
a) systemic corticosteroids
b) SABAs
c) LAMAs
d) ICS + formoterol
e) inhaled epinephrine
e
Which is NOT included in asthma guidelines?
a) systemic corticosteroids
b) SABAs
c) LAMAs
d) ICS + formoterol
e) inhaled epinephrine
mild; intermittent
Inhaled epinephrine is FDA approved for _______ symptoms in _________ asthma only.
potent; effective
Inhaled corticosteroids (ICS) are the most _____ & ______ medications
available for asthma.
2x daily
How often do patients with moderate asthma need to take their ICS?
low-medium
What kind of ICS dose is used for patients with moderate asthma?
smokers, neutrophilic inflammation, AA children
Corticosteroid responsiveness may be decreased in what patients (3)
rinse mouth w/water; can use space/VHC w non-breath activated MDI, administer less frequently
How can we prevent AE's w ICS?
formoterol
What is our MART (Maintenance and Reliever Therapy)?
urinary retention; glaucoma
Patients with what conditions should NOT receive LAMA therapy? (2)
f; LAMA + ICS has no effect on exacerbations
In adults with uncontrolled persistent asthma, LAMA + ICS is just as effective
as LABA + ICS. T/F?
2-6 weeks
When is the initial follow up?
1-6
Once controlled, visits can be in ________ month intervals.
3 months
How long does a patient need to be controlled in order to step down their therapy?
assess asthma severity prior to starting treatment; assess asthma control after therapy for monitoring/adjusting
What are the goals of clinical management? (2)
symptoms, use of SABAs, limitations to normal activities, pulmonary function, exacerbations
How is severity & control measured? (5)
c
Intrinsic intensity of the disease process.
a) responsiveness
b) control
c) severity
c
Easiest to measure when patient is NOT receiving long-term control therapy.
a) responsiveness
b) control
c) severity
a
The ease with which asthma control is achieved by therapy.
a) responsiveness
b) control
c) severity
b
The degree to which manifestations are minimized by therapeutic
intervention & goals of therapy are met.
a) responsiveness
b) control
c) severity
b
Assess ____ to adjust therapy.
a) responsiveness
b) control
c) severity
c
Assess ____ to initiate therapy.
a) responsiveness
b) control
c) severity
assess severity & control, education, control environmental/comorbidities, medication
What are the 4 components of asthma care?