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Asthma
Question | Answer |
---|---|
mild intermittent | sx<2 times/week; nighttime sx<2 times/month; FEV1>80% |
mild persistent | sx > 2 times/week but < 1 time/day; nighttime sx>2times/month; FEV >80%; treatment with low dose inhaled CS |
moderate persistent | daily symptoms; nighttime symptoms > 1/week; FEV 60-80%; treat with low dosed or medium dosed inhaled CS |
severe persistent | daily symptoms and nighttime symptoms; FEV<60; high dosed inhaled CS and long acting beta agonist |
omalizumab | xolair; anti-IgE treatment for severe; injection every 2 -4 weeks |
quick relief asthma medications | albuterol, pirbuterol, ipratropium, ipratropium+ albuterol, methylprednisolone, prednisone, prednisolone |
peak expiratory flow (PEF) | green 80-100%; yellow 50-79%; red <50% |
long term control | inhaled CS, leukotriene modifiers, mast cell stabilizers, long acting beta agonists, methylxanthines |
beclomethasone | QVAR |
budesonide | pulmicort respules |
flunisolide | aerobid |
fluticasone | flovent |
fluticasone/salmeterol | advair diskus |
mometasone | asmanex |
triamcinolone | azmacort |
montelukast | singulair |
zafirlukast | accolate |
zileuton | zyflo |
cromolyn sodium | intal |
nedocromil | tilade |
formaterol | foradil |
salmeterol | severent diskus |
inhaled CS ADR | cough, dysphonia, oral thrush |
long acting beta agonist ADRs | tachycardia, tremor, hypokalemia, QT prolongation |
methylxanthines ADR | tachycardia, N/V, SVT, headaches, seizures, hematemesis, hyperglycemia, hypokalemia, insomnia, gastric upset, aggravation of ulcer or reflux, increase hyperactivity in some children |
theophylline kinetics | levels 5-15; half life: 8 hours; half life in smokers and children <1 year is 4 hours; half life in decompensated HF and cirrhosis is 24 hours |
increases theophylline concentration | diet, hypoxia, cor pulmonale, decompensated HF, cirrhosis, age <6 months, elderly, cimetidine, macrolides, quinolones, ticlodipine |
decreases theophylline concentration | age (1-9 years), phenobarbital, phenytoin, CBZ, rifampin, smoking |