Wait- you can't inhale these!
What is an oral beta 2 agonist that relaxes bronchial smooth muscles that is not often used due to increased risk of side effects (like tachycardia). Also, $$
Relaxes bronchial smooth muscle by action on beta2-receptors
What are:
talking in words instead of phrases
sits hunched forward, RR>30, Pulse >120, O2 sat <90, PEF< 50%
Relaxes bronchial smooth muscle by selective action on beta2-receptors
Increase SABA use
Can increase controller medicine if pt is able
In the past 4 weeks
1. Daytime symptoms more than twice a week2. Nighttime awakenings
3. Reliever medicine needed more than twice a week
4. Any activity limitation due to asthma
What is causes smooth muscle relaxation by inhibiting PDE III and some PDEIV (ie, bronchodilation) and increases the force of contraction of diaphragmatic muscles through enhancement of calcium uptake through adenosine-mediated channels. Used as add on in steps 3-4, requires monitoring, not indicated for children
Corticosteroids have been shown to have a wide range of actions on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, cytokines) involved in inflammation. These anti-inflammatory actions of corticosteroids contribute to their efficacy in asthma.
Asthma action plan instructions if PEF has fallen by >40%, or symptoms not improving after 48 hours of treatment for pts with PEF falling >20%
What is an IgG monoclonal antibody that inhibits IgE binding to the high-affinity IgE receptor on mast cells and basophils. By decreasing bound IgE, the activation and release of mediators in the allergic response (early and late phase) is limited. Used for allergy associated asthma only, add on in step 4 or 5. $$$, subq injection
Leukotriene receptor antagonist that inhibits the cysteinyl leukotriene receptor. Cysteinyl leukotrienes and leukotriene receptor occupation have been correlated with the pathophysiology of asthma, including airway edema, smooth muscle contraction, and altered cellular activity associated with the inflammatory process, which contribute to the signs and symptoms of asthma. Cysteinyl leukotrienes are also released from the nasal mucosa following allergen exposure leading to symptoms associated with allergic rhinitis
anti-IL5 (SC mepolizumab or IV reslizumab)
What is an IL-5 inhibitor, which is the major cytokine responsible for the growth and differentiation, recruitment, activation, and survival of eosinophils; by inhibiting IL-5 signaling, reduces the production and survival of eosinophils; used only in severe eosinophilic asthma in ages 12 and older
Competitively and reversibly inhibits the action of acetylcholine at type 3 muscarinic (M3) receptors in bronchial smooth muscle causing bronchodilation