Asthma Classifications
daytime symptoms: >2 days/week but not daily
nighttime awakenings: 3-4x/month
use of SABA: >2days/week; but not >1x/day
Interference with activity: minor limitation
Mild Persistent
#1 nonpharmacological treatment/education
smoking cessation
Initial treatment of CAP with no antibiotics in past 3 months (3)
Macrolide (azithromycin) x4 days OR doxycycline x7 days OR amoxicillin x7 days
What classification of meds are:
atenolol, metoprolol, propranolol
beta blockers
What is the classification of medications for:
indacaterol, formoterol fumarate, salmeterol xinafoate
Long-Acting Bronchodilators (LABA)
daytime symptoms: throughout the day
nighttime awakenings: often 7x/week
use of SABA: several times per day
Interference with activity: extremely limited
severe persistent
What severity of COPD if GOLD Standard is FEV1 >50% but <80%
Moderate
Treatment of CAP in a patient with comorbidities or has had antibiotic therapy in past 3 months (4)
Amoxicillin/clavulanate OR cephalosporin (cephalexin)
ANDmacrolide (azithromycin) OR doxycycline
What classification of medications is:
amlodipine, nicardipine, diltiazem and verapamil
Calcium channel blockers
What is the initial therapy of intermittent asthma?
daytime symptoms: <2 days/week
nighttime awakenings: <2x/month
use of SABA: <2days/week
Interference with activity: none
intermittent
LABA+LAMA
Most common atypical cause
M. pneumoniae
What classification of meds is:
enalapril, lisinopril, captopril
ACE inhibitors
What classification of medications are:
mometasone furoate, fluticasone propionate, budesonide, beclomethasone
Inhaled corticosteroids
SNEAKY COPD! HOW DID YOU GET HERE?!?
What severity of COPD if GOLD Standard is FEV1 <30% predicted
Very Severe
What severity of COPD if GOLD Standard is FEV1 >80% predicted
Mild
What is the physical exam findings of pneumonia?
dullness to percussion, egophony (E-to-A changes), bronchial breath sounds
What classification of meds are:
losartan and valsartan
ARB
What oral medication can you treat asthma that is effective in preventing exercise-induced bronchoconstriction?
(Wait this question isn't about inhalers?!)
leukotriene modifier (montelukast)
daytime symptoms: daily
nighttime awakenings: >1x/week but not nightly
use of SABA: daily
Interference with activity: some limitation
Moderate persistent
Initial pharmacological treatment in a patient with 0-1 moderate exacerbations (not leading to hospital admission) with CAT score <10 and >10. (2)
CAT <10: a bronchodilator (LABA)
CAT >10: LABA+LAMA
Most common bacterial cause of CAP
S. pneumoniae
MULTI ANSWER FRIENDS!!
1)What classification of meds are: fenofibrate?
2) What classification of meds are: simvastatin, pravastatin, atorvastatin and rosuvastatin?
3) What classification of meds are: cholestyramine, colesevelam hydrochloride?
1) fibrates
2) HMG-CoA reductase inhibitors (statins)
3) bile acid sequestrants (resins)
Your patient is needing the next STEP UP for asthma treatment based on his symptoms. They are currently on low-dose ICS and LABA. What is the next step up managment?
medium dose ICS and LABA