Term
| frequency of sx's in intermittent asthma |
|
Definition
|
|
Term
| frequency of sx's in mild, persistent asthma |
|
Definition
|
|
Term
| frequency of sx's in moderate, persistent asthma |
|
Definition
|
|
Term
| frequency of sx's in severe, persistent asthma |
|
Definition
|
|
Term
| # nighttime awakenings in intermittent asthma |
|
Definition
0-4: 0
5-11, 12+: ≤ 2x/month |
|
|
Term
| # nighttime awakenings in mild, persistent asthma |
|
Definition
0-4: 1-2 x/month
5-11, 12+: 3-4 x/month |
|
|
Term
| # of nighttime awakenings in moderate, persistent asthma |
|
Definition
0-4: 3-4 x/mon
5-11, 12+: > 1x/wk, but not nightly |
|
|
Term
| # of nighttime awakenings in severe, persistent asthma |
|
Definition
0-4: >1 x/wk
5-11, 12+: often, 7x/wk |
|
|
Term
Lung function measurements:
Normal FEV1/FVC for 8+
(4 age groups, %) |
|
Definition
8-19: 85%
20-39: 80%
40-59: 75%
60-80: 70% |
|
|
Term
Lung function for...
5-11, intermittent asthma
FEV1%, FEV1/FVC |
|
Definition
FEV1 > 80% predicted
FEV1/FVC > 85%
|
|
|
Term
Lung function for...
5-11, mild persistent asthma
FEV1%, FEV1/FVC |
|
Definition
FEV1 > 80% pred
FEV1/FVC > 80% |
|
|
Term
Lung function for...
5-11, moderate persistent asthma
FEV1%, FEV1/FVC |
|
Definition
FEV1 60-80% predicted
FEV1/FVC = 75-80%
|
|
|
Term
Lung function for...
5-11, severe persistent asthma
FEV1%, FEV1/FVC |
|
Definition
FEV1 < 60%
FEV1/FVC < 75% |
|
|
Term
Lung function for...
12+, intermittent asthma
FEV1%, FEV1/FVC |
|
Definition
FEV1 > 80% predicted
FEV1/FVC normal |
|
|
Term
Lung function for...
12+, mild persistent asthma
FEV1%, FEV1/FVC |
|
Definition
FEV1 ≥ 80% predicted
FEV1/FVC normal |
|
|
Term
Lung function for...
12+, moderate persistent asthma
FEV1%, FEV1/FVC
|
|
Definition
FEV1 > 60% but < 80%
FEV1/FVC dec by 5% |
|
|
Term
Lung function for...
12+, severe persistent asthma
FEV1%, FEV1/FVC
|
|
Definition
FEV1 < 60%
FEV1/FVC dec by 5+% |
|
|
Term
| brand name for Levalbuterol |
|
Definition
|
|
Term
| brand name for Pirbuterol |
|
Definition
|
|
Term
|
Definition
|
|
Term
| 4 side effects of beta2 agonists |
|
Definition
| tremor, tachycardia, palpitations, HYPOkalemia |
|
|
Term
|
Definition
|
|
Term
|
Definition
| activation of AC, increase in cAMP, smooth muscle relaxation (bronchodilation) |
|
|
Term
| anticholinergics for EIB? |
|
Definition
|
|
Term
| Adverse effect of anticholinergics |
|
Definition
|
|
Term
| SAA + SABA, where and doses |
|
Definition
| ED setting only, x3 doses in ER (don't continue if pt gets admitted) |
|
|
Term
| brand name of ipratropium bromide |
|
Definition
|
|
Term
|
Definition
| bronchodilation via inhibition of muscarinic cholinergic receptors reduction of glandular mucus secretion |
|
|
Term
| Systemic steroid dosing for acute exacerbation |
|
Definition
Adults: 40-60 mg once daily (or div BID) x 5-10 days
Children: 1-2 mg/kg/day (max 60mg) x 3-10 days |
|
|
Term
| 7 side effects seen w/ systemic corticosteroids |
|
Definition
| abnormalities in glucose metabolism, increased appetite, fluid retention, weight gain, mood alteration, HTN, peptic ulceration |
|
|
Term
brand name for beclomethasone dipropionate
|
|
Definition
|
|
Term
| brand name for budesonide |
|
Definition
|
|
Term
| brand name for ciclesonide |
|
Definition
|
|
Term
| brand name for flunisolide |
|
Definition
|
|
Term
| brand name for fluticasone |
|
Definition
|
|
Term
| brand name for mometasone furoate |
|
Definition
|
|
Term
|
Definition
reduce synthesis/release of proinflammatory cytokines
reduce inflammatory cell activation, recruitment, and infiltration
reduce vascular permeability (dec airway edema) |
|
|
Term
| Adverse effects of inhaled CS |
|
Definition
cough, dysphonia
oral thrush (candidiasis)
systemic effects (high-dose)-- adrenal/growth suppression, osteoporosis, skin thinning/easy bruising, weight gain/fluid retention |
|
|
Term
| brand name for Cromolyn sodium |
|
Definition
|
|
Term
mast cell stabilizers for EIB?
|
|
Definition
|
|
Term
| MCS only indicated for what subtype of asthma |
|
Definition
|
|
Term
| not preferred tx's for asthma per EPR-3 |
|
Definition
|
|
Term
| the antiinflammatory mechanism of MCS |
|
Definition
inhibit activation/release of inflammatory mediators from eosinophils
block early/late reaction to allergen
inhibit acute response to exercise/cold air/sulfur dioxide |
|
|
Term
| onset/DOA of salmeterol versus formoterol |
|
Definition
S: 20 minutes, 12 h
F: 5 minutes, 12 h |
|
|
Term
| Serevent dosing, age limitations |
|
Definition
4+ y/o
1 inhalation BID (DPI) |
|
|
Term
Foradil Aerolizer
dosing, age limitations |
|
Definition
one 12 mcg capsule via inh q 12 h
5 y/o |
|
|
Term
2 brand names for theophylline
|
|
Definition
|
|
Term
|
Definition
| smooth muscle relaxation/bronchodilation via inhibition of phosphodiesterase; may affect eosinophilic infiltration into bronchial mucosa |
|
|
Term
Adverse effects of theophylline
3 w/ therap doses
6 w/ toxic doses |
|
Definition
therap doses:
insomnia
GI upset/potentiation of GER
hyperactivity in children
toxic doses:
tachycardia, tachyarrhythmias
N/V, headache
CNS stimulation, seizures
hypokalemia |
|
|
Term
| mandatory serum concentration monitoring w/ what drug? (give therap range) |
|
Definition
|
|
Term
| brand name for zafirlukast |
|
Definition
|
|
Term
|
Definition
|
|
Term
| brand name for montelukast |
|
Definition
|
|
Term
Of the 3 LTM's, which one has the unique MOA?
|
|
Definition
zileuton (Zyflo)-- 5-LOX inhibition
zafirlukast (Accolate), montelukast (Singulair)-- CLT receptor antagonists |
|
|
Term
Cysteinyl Leukotrienes (LTC4, LTD4, LTE4)
have what 5 effects |
|
Definition
bronchoconstriction
mucus secretion
edema
hyperresponsiveness
eosinophilia |
|
|
Term
zafirlukast:
age
usual dose
warnings
metabolism
dosing considerations |
|
Definition
5+ years
20mg BID (12+), 10mg BID (5-11)
Warnings: Churg-Strauss, LFTs
Metabolism: CYP450 3A4, 2C9
dose on empty stomach, 1h pre/2h post |
|
|
Term
zileuton:
age
usual dose
warnings
metabolism
dosing considerations |
|
Definition
12+
600mg QID (IR), 1200mg BID (CR)
increased LFTs
Metabolism: CYP450 1A2*, 3A4, 2C9
|
|
|
Term
montelukast:
age
usual dose
warnings
metabolism
dosing considerations |
|
Definition
1+ y/o
10mg QHS (adults), 5 mg chew QPM (6-14), 4 mg chew/granules QPM (1-5)
Metabolism: P450 3A4, 2C9 |
|
|
Term
Advair diskus
combo of what meds? strengths? and dose? |
|
Definition
fluticasone propionate (100, 250, or 500 mcg) +
salmeterol (50 mcg)
1 inh twice daily |
|
|
Term
Advair HFA
ingredients, strengths, and dosing |
|
Definition
fluticasone propionate (45, 115, or 230 mcg) +
salmeterol (21 mcg)
2 inh twice daily |
|
|
Term
Symbicort:
combo of what? strengths? DPI, MDI, or both? dosing?
|
|
Definition
budesonide + formoterol
80mcg bud/ 4.5 mcg for
OR
160 mcg bud/ 4.5 mcg for
MDI (HFA)
2 inh twice daily |
|
|
Term
Dulera:
combo of what? strengths? DPI, MDI, or both? dosing? |
|
Definition
mometasone + formoterol
100/5 or 200/5
MDI (HFA)
2 inh twice daily |
|
|
Term
brand name for omalizumab
what type of antibody |
|
Definition
|
|
Term
| Omalizumab is for what age? |
|
Definition
|
|
Term
| Requirements for starting omalizumab |
|
Definition
+ skin test to perennial aeroallergen
severe, persistent asthma uncontrolled on inh CS + LABA
|
|
|
Term
|
Definition
rDNA-derived humanized monoclonal Ab selectively binds to IgE,
inhibits binding of IgE to high-affinity receptors on surface of mast cells and basophils-- dec in release of allergic response mediators.
May also reduce # of ha-IgE receptors present on basophils |
|
|
Term
dosing of Omalizumab,
max dose |
|
Definition
normal range: 150-375mg SC q2-4 weeks
dose/freq determined by:
Serum total IgE level (IU/mL) measured before start of tx
& body weight (kg)
max dose: 150mg/injection
|
|
|
Term
| Of all the asthma meds, which ones have Black Box warnings? |
|
Definition
LABAs (only add-on tx, not a subsitute for inh CS, not used to treat acute sx's, not initiated in pts with worsening/deteriorating asthma)
Omalizumab (anaphylaxis) |
|
|
Term
| Potential adverse reactions w/ Omalizumab (3) |
|
Definition
malignancy (0.5%)
anaphylaxis (<0.1%)
injection site reaction (5-20%) |
|
|
Term
Recommended during pregnancy,
drug/category |
|
Definition
inh CS
budesonide (category B) |
|
|
Term
| initiate asthma tx in 0-4y/o pts when one of what 3 things occurs? |
|
Definition
parental hx of asthma
phys dx of atopic dermatitis
evidence of sensitization to aeroallergen |
|
|
Term
| initiate asthma tx in 0-4y/o pts when 2 of what 3 things occurs? |
|
Definition
evidence of sensitization to foods
≥4% peripheral blood eosinophilia
wheezing apart from colds |
|
|
