Term
|
Definition
| SABA - Salbutamol or Terbutaline used PRN |
|
|
Term
| If patient is using SABA > 4 times per week including for exercise purposes, what should be done? |
|
Definition
| Initiate Inhaled corticosteroid - beclomethasone, budesonide, ciclesonide, or fluticasone |
|
|
Term
| If the patient is taking SABA & Inhaled corticosteroid and asthma is still poorly controlled, what should be done? |
|
Definition
Add LABA - Salmeterol or Formoterol
- Particularly useful in preventing nocturnal symptoms, and exercise induced symptoms |
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|
Term
| Role of Ipratropium in Asthma |
|
Definition
| Not routinely used, but it is a useful alternate in patients susceptible to tremor or tachycardia from Beta Agonists |
|
|
Term
| Role of Tiotropium in asthma |
|
Definition
| Alternate to Ipratropium, which is a substitute for BA's. Tiotropium is dosed once daily, and advantage over ipratropium (3-4 times daily) |
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|
Term
| Counseling point for inhaled corticosteroids. |
|
Definition
| Rinse mouth after use to decrease incidence of pharyngeal candidiasis. |
|
|
Term
| Which long acting LABA can be used as rescue therapy because of its fast onset? |
|
Definition
| Formoterol, NOT salmeterol |
|
|
Term
LTRAs - Leukotriene Receptor antagonists
What are they?
Place in therapy? |
|
Definition
Montelukast or Zafirlukast
Can be used in addition to inhaled corticosteroids instead of increasing corticosteroid dose. OR can be tried in mild asthmatic patients who refuse inhaled corticosteroids. |
|
|
Term
| Which anti-asthma drugs are not safe for pregnancy or breastfeeding? |
|
Definition
| Pretty much all are safe. Keep an eye on theophylline levels, ensuring that they are LLN. Avoid LTRAs in breastfeeding |
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|
Term
IgE-Neutralizing antibody
What is it?
Role in therapy? |
|
Definition
Omalizumab
For patients with moderate to severe asthma who have had a positive skin test or in vitro reactivity to a perennial aeroallergen, whos symptoms are inadequately controlled with inhaled corticosteroids. |
|
|
Term
| Emergency treatment in asthma |
|
Definition
| O2 + Salbutamol + Ipratropium + parenteral corticosteroid |
|
|
Term
Oral Corticosteroids
Place in therapy
Side effects |
|
Definition
Oral Corticosteroids -
Place in therapy - preventing & treating acute exacerbations
Side effects - glucose intolerance, increased apetite, weight gain, mood alterations, fluid retention, & HTN. Long term: Diabetes, glaucoma, osteoporosis, Cataracts, myopathy |
|
|
Term
| What meds should be avoided in Asthmatics? |
|
Definition
| ASA & NSAIDs, Prefer selective BBs over non-selective |
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