Asthma in Pregnancy

Medications

100

These are considered your long-term control medications for asthma.

What are inhaled C/S's, Cromolyn, Long-acting B-agonists and Theophylline?

200

These are considered your rescue therapy medications.

What are inhaled short-acting B-agonists?

300

These can be used for long-term or rescue therapy.

What are oral C/S's?

400

This uterotonic is contraindicated in poorly controlled asthmatic patients.

What is Hemabate?

500

BONUS points

What is you win 500 free points?

Severity Classification, Tx

100

This is how you would define an intermittent asthmatic (re: sxs freq, nighttime awakening, FEV1) and treat it.

What is < or = 2 days per week, < or = twice per month and FEV1 >80%? What is Albuterol PRN?

200

This is how you would define a mild persistent asthmatic (re: sxs freq, nighttime awakening) and treat it.

What is >2 d/wk but <7d/wk, >2x per month and FEV1 >80%? What is low-dose inhaled C/S (Budesonide preferred however can use any) vs Cromolyn vs Theophylline?

300

This is how you would define a moderate persistent asthmatic (re: sxs freq, nighttime awakening) and treat it.

What is daily sxs, >1x/wk and FEV1 60-80%? What is low-dose inhaled C/S + Salmeterol or med dose inhaled C/S or med dose inhaled C/S + Salmeterol?

400

This is how you would define a severe persistent asthmatic (re: sxs freq, nighttime awakening) and treat it.

What is multiple times per day, >/= 4 times per week and and FEV1 <60%? What is high dose inhaled C/S + Salmeterol + PRN PO C/S?

500

This should be the expected outcome of asthmatics during pregnancy (improvement, worsening or no change).

What is any of the above (33% of each)?

Evaluation

100

There is a known significant relationship of decreased FEV1 with these obstetrical complications.

What are low birth weight and prematurity?

200

This is how you diagnose asthma in pregnancy.

What is just as in non-pregnant pt? Sxs (wheezing, chest cough, SOB, chest tightness), temporal relationships (fluctuating intensity, worse at night) and triggers (allergens, exercise, infxns) ideally confirmed by demonstrating airway obstruction on spirometry that is at least partially reversible (>12% increase in FEV1 after bronchodilator).

300

This is how you differentiate dyspnea of pregnancy from asthma.

What is a lack of cough, wheezing, chest tightness or airway obstruction?

400

This is the test that is preferred to assess pulmonary function in a pregnant patient with asthma.

What is spirometry? 2nd line choice would be peak expiratory flow measurement with a peak flow meter.

500

These are some additional questions you might ask a pregnant pt with asthma to assess their status.

What are h/o prior hospitalizations, ICU admissions and oral C/S administrations? Also how did asthma affect your prior pregnancies?*

Management

100

This is the recommended controller therapy for mild, intermittent asthma during pregnancy.

What is no controller medication?

200

This is the appropriate add-on controller therapy for asthma during pregnancy.

What is long-acting B2-agonist Salmeterol? Preferred d/t low side effect profile and Theophylline's narrow therapeutic index.

300

These are some non-pharmacologic approaches to help with managing asthma during pregnancy.

What are identify and avoid triggers, treating GERD if exacerbating the asthma (elevated bed...) and educate?

400

These are your goals for an acute asthma exacerbation in pregnancy, determining the patient to be safe for discharge.

What are FEV1 >70% for >60 minutes from last tx and reassuring fetal status?*

500

This is the recommended management after an acute exacerbation.

What is continue w/short-acting B2-agonist PRN, PO C/S qd or BID x3-10 days and inhaled C/S thru follow-up in 5 days?*