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#1 Asthma/COPD 2007
Ferris Therapeutics
| Asthma/COPD | Answer |
|---|---|
| Asthma med with possibility of dlayed onset anaphylaxis | Omalizumab (Xolair) |
| Asthma medicine preferred in pregnancy? | Budesonide (Pulmicort) |
| Flow of air into and out of the lungs is determined by... | 1) Elastic recoil 2) Airway resistance |
| What 3 categories of medicines might work well for exercise induced bronchospasms? | A) Short acting Beta agonists 5-15 minutes prior to exercise. B) Long acting Beta agonists 30 minutes prior to exercise. C) Mast cell stabilizers |
| 3 medicines that can influence asthma severity | 1) Aspirin 2) Sulfites 3) Non-selective beta blockers |
| What is the best measurement for restrictive disease? | TLC Also, FEV1/FVC is >75 |
| Two main SE from the overuse of short-acting Beta2 agonists? | 1) hypokalemia 2) hyperglycemia |
| How can you MEASURE if a bronchodilator is working? | After dose from MDI, FEV1 increases by >12% |
| Exercise-induced bronchospasm is defined as... | A decline in FEV1 of more than 15-20%. |
| One main PFT difference between asthma and chronic bronchitis? | Asthma's response to brochiodialators is much, MUCH greater. |
| What is the most important precipitant of severe asthma exacerbations? | Environmental exposures. |
| What is the predominant risk factor for children to have continued asthma? | Atropy (hypersensitivity). |
| Meds for Step 4 asthma? | 1) High dose inhaled corticosteroids, AND 2) Long-acting Beta2 agonist, AND 3) Leukotriene modifer, AND corticosteroid tablets or syrup long-term |
| Advair discus contains | Steroid/long acting B2 agonist Fluticasone/salmeterol |
| Stage a 38 year old male with Asthma. Albuterol 1x/day Nightime cough 1x/week Peek flow of 70% | Step 3 Low to medium corticosteroids. Long acting inhalde Beta2 OR add Leukotrine OR add Theophilline |
| Combivent contains...? | Ipratropium/Albuterol anticholinergic/short-acting B2 agonist |
| Nam 2 mast cell stabilizers | Cromolyn sodium Nedocromil |
| Name 2 leukotrine modifiers | 1) Montelukast (Singulair) 2) Zafirlukast (Accolate) |
| Name 3 short-acting B2 agonist | 1) Albuterol 2) Pirbuterol 3) Levalbuterol |
| Name 5 inhaled corticosteroids | 1) Beclomethasone (Beclovent) 2) Triamcinolone (Azmacort) 3) Budesonide (Pulmicort) 4) Flunisolide (Aerobid), 5) Fluticasone Propionate (Flovent) |
| What medicines are used in Step 3 of long-term control of asthma? | Preferred: low to medium dose inhaled corticosteroids and long acting beta2 agonists. Alternative: increase inhaled corticosteroids to medium dose or low to medium inhaled and addition of leukotrine modifers or theophylline. |
| What are the classes of medicines used for Step 1 asthma? | None (just a rescue Albuterol--as for all steps) |
| What are the classes of medicines required for Step 2 asthma? | Preferred: Low dose inhaled corticosteroid Alternative: Cromolyn, Leukotrine modifers, Nedocromil, or sustained release theophylline. |
| What are 3 drugs in the pharmacoligic management of COPD exacerbations? | 1) Bronchodilators (Intensification of short-acting B2 agonists 2) Oral Corticosteroids (7-14 days) 3) Antibiotic therapy if with 2 of 3 a)increased dyspnea, b)increased sputum volume, c)increased sputum purulence |
| Most common organisms in COPD exacerbations? | H. influenzae H. parainflenzae M. catarrhalis S. pneumoniae |
| How long do you treat with oral corticosteroids in COPD exacerbations? | 7-14 days |
| Obstructive disease is ... | a decreased capacity to get air through the airways and out the lung. |
| What meds might work for exercise-induced bronchospasms? | Short-acting Beta2 agonist: 5-15 mins prior to exercise Long-acting Beta2 agonist: 30 min prior to exercise |
| What is the physiological action of Beta2 agonists? | Relax airway smooth muscle. |
| Quick relief for all stages of asthma is given___________. | PRN |
| What is the medicine contained in Ventolin HFA and Proventil HFA? | Albuterol |
| What is the medicine contained in Maxair? | Pirbuterol. |
| What are the levels of oxygen desired with oxygen therapy in COPD exacerbations? | Titrate to PaO2 > 60mmHg or oxygen saturation > 90% |
| How long are oral corticosteroids used in COPD exacerbations? | 7-14 days (for moderate to severe exacerbations). |
| What are the criteria to use antimicrobial therapy in COPD exacerbations? | When patient presents with 2 of 3: increased dyspnea increased sputum volume increased sputum purulence |
| What are two types of propellents for inhalers? | HFA's --hydrofluroalkanes (safer) CFC's --chloroflorocarbons (hazardous) |
| Best measure to distinguish asthma and COPD? | Asthma has a great response to bronchodilators DLco does not change in asthma |
| What "Step" in asthma is: 38 year old male Albuterol 1x/day Nightime cough 1x/week Peekflow of 70% | Step 3 |
| What "Step" in asthma: Uses albuterol > 2x/week Nighttime use > 2x per month Affects activity | Step 2 |
| What "Step" in asthma: Filled Albuterol < 2 weeks Missed work Peek flow of < 50% | Step 4 |
| What is the definition of "restrictive disease"? | Inability to get air INTO the lungs and maintain normal lung volumes. |
| When should expectorants and mucolytic agents be used in COPD? | They are not recommended. Instead maintain adequate hydration. |
| Three common SE of inhaled corticosteroids. | 1) hoarseness 2) Throat irritation 3) oral thrush --reduce by rinsing mouth after use |
| What are 5 SE's of short acting Beta2 agonists? | 1) Tachycardia 2) HA 3) Palpitations 4) Tremor 5) hypokalemia |
| What is the treatment of choice for severe acute asthma? | Short-acting beta-2 agonists. |
| What are 3 types of anti-inflammatory agents? | 1) Inhaled corticosteroids 2) Mast cell stabilizers 3) Leukotrine modifiers |
| What are three types of bronchodilators? | 1) Long acting Beta2 agonists 2) Combination therapies 3) Methylxanthines |
| What are 3 adverse effects of oral corticosteroids in COPD? | 1) hyperglycemia 2) insomnia 3) increased appetite |
| Name 6 DPI's (Dry Powder Inhalers). | Pulmicort Asmanex Foradil Advair Flovent Ventolin |
Created by:
Oldschool1
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