Medications
These 2 medication classes are used as needed for intermittent symptoms
SABA or combo ICS-SABA
How would you classify someone who only has daytime symptoms once a month and does not require an inhaler?
mild asthma
What is the youngest age that you can do a PFT?
5 years
What symptoms may you see during an exacerbation (must name at least 3)?
tachypnea, tachycardia, accessory muscle use, inability to speak in full sentences, inability to lie supine, diaphoresis, hypoxia, etc.
Common asthma triggers
allergens, cigarette smoke, viral, stress, hormones, exercise, etc.
What class of medication is typically used alone for maintenance therapy?
ICS
What severity would you classify someone who has daytime symptoms twice a week, no nighttime symptoms, has had one exacerbation in the past year?
Mild asthma
How else can you measure changes in pulmonary function easily in an office setting?
peak flow meter
What are the typical therapies for exacerbations?
oxygen if needed, systemic steroids (IV or PO), albuterol nebulizers, ICS.
What is an asthma action plan?
A written documented plan for the patient to follow at home detailing the instructions of how and when to use their inhalers and how to recognize a decline in asthma symptoms.
What class of medication can be used both as maintenance therapy and for as needed symptoms?
Combo ICS-fomoterol
What severity would you classify someone who has daily daytime symptoms, nighttime symptoms once a week, and requiring controller therapy + additional agents?
severe asthma
How do you determine between COPD and asthma on a PFT?
bronchodilator challenge - improves FEV or FVC
What is an additional agent that can be given to someone with a severe exacerbation?
Magnesium sulfate
How would you counsel someone to use their inhaler?
Take the cap off, shake the inhaler for 5 seconds, breathe out a normal breath, then place lips on mouthpiece and breathe in slowly and deeply and press down on the cannister, once lungs are full hold breath for 5-10 seconds then breathe out.
What medication class is typically used as an add on therapy for maintenance therapy?
LABA
What severity would you classify someone with daytime symptoms 4 times a week, two nighttime awakenings per month, no exacerbations, and well controlled on an ICS + SABA?
moderate asthma
Asthma is defined on PFT as an FEV/FVC ratio less than?
70%
How would you objectively determine the severity of an exacerbation?
PEF: If <50% = severe
What vaccine is recommended as an additional dose for patient's with asthma?
pneumococcal
What class of medication is used alone as maintenance therapy primarily in children but can also be used as add on therapy in adults?
LTRA
What severity would you classify someone who has daytime symptoms twice a week, nighttime symptoms 4 times a week, only 1 exacerbation a year, and a FEV1 <60%?
severe asthma
A decrease in peak expiratory flow by how much (with symptoms) is indicative of asthma?
20%
recommended = ICS
NOT recommended = SABA
What meteorologic phenomenon is often associated with sudden epidemics of severe asthma exacerbations in a community?
thunderstorms