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Asthma 411
Asthma
| Question | Answer |
|---|---|
| Smooth muscle relaxation resulting in bronchodilation, doesn't affect inflammation | B2 agonists |
| Early phase response | bronchospasm |
| Late phase response | Inflammatory |
| Tachycardia, muscle tremor, hypokalemia, HA, hyperglycemia | B2 agonists ADRs |
| Long acting B2 agonists | Formoterol and Salmeterol |
| Short acting B2 agonists | Albuterol, Bitolterol, Levalbuterol, Metaproternol, Pirbuterol |
| Anti-inflammatory, can block late phase response, minimize remodeling | Corticosteroids |
| Cough, dysphonia, thrush (inhaled only) | Corticosteroids ADRs |
| Hyperglycemia, increased appetite, fluid retention, HTN, weight gain, mood changes, peptic ulcer | Short term ADRs of oral corticosteroids |
| Adrenal suppression, Cushing's Syndrome, growth suppression, skin thinning, HTN, diabetes, cataracts, impaired immune function | Long term ADRs of oral corticosteroids |
| Used in persistent asthma to modify chronic inflammation and remodeling | Leukotriene Modifiers |
| Monteleukast, Zafirlukast, Zileuton | Leukotriene Modifiers |
| Inhibit both early and late phase response to allergens as well as inhibit exercise induced bronchospasm | Mast cell stabilizers |
| Cromolyn, Nedocromil | Mast cell stabilizers |
| Smooth muscle relaxation causing bronchodilation | Theophylline MOA |
| Tachycardia, insomnia, hyperactivity, gastric upset, aggravation of gastric ulcer or GERD symptoms. | Theophylline ADRs |
| Sometimes used for augmenting B2 agonists in acute exacerbations | Ipatropium/Anticholinerginic |
| Ipratroprium MDI or Neb | Anticholinerginics |
| 2-4 puffs of short acting B2 agonist as needed for symptoms | For all pts |
| No daily meds needed. Short course of systemic (oral) corticosteroids may be indicated after an acute attack. | Step 1-Mild Intermittent |
| Rescue meds + low dose inhaled corticosteroids. | Step 2-Mild Persistent |
| Low-medium dose inhaled corticosteroids and long acting B2 agonist (Formoterol, Salmeterol) | Step 3-Moderate Persistent |
| High dose inhaled corticosteroids and long acting B2 agonist and if needed oral corticosteroids | Step 4-Severe Persistent |
| Bronchodilation Only | B2 agonists, Theophylline |
| Anti-inflammatory, minimize remodeling | Corticosteroids, Leukotreine Modifiers |
Created by:
lbreimeir
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