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Asthma Classification and Treatment
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Asthma Classification and Treatment

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Questions and Answers

Which medication is categorized as a leukotriene receptor antagonist?

  • Omalizumab
  • Albuterol
  • Montelukast (correct)
  • Cromolyn sodium

    • Omalizumab requires administration every 1-2 weeks.

    False

    What is the normal peak expiratory flow rate (PEFR) percentage for a healthy individual based on predicted values?

    greater than 70%

    For a patient experiencing severe asthma, a peak expiratory flow below ___ indicates a severe exacerbation.

    <p>25%</p> Signup and view all the answers

    Match the following asthma medications to their intended use:

    <p>Cromolyn sodium = Inhibits histamine release Montelukast = Inhibits bronchoconstriction and mucus production Omalizumab = Targets IgE antibodies SABA = Quick relief during exacerbations</p> Signup and view all the answers

    What action should be taken if a patient does not improve after SABA and has a peak flow between 50% to 70%?

    <p>Consider high-dose oral corticosteroids</p> Signup and view all the answers

    In a situation of hyperventilation, the partial pressure of CO2 is expected to be high.

    <p>False</p> Signup and view all the answers

    What is a key indicator of a life-threatening asthma exacerbation?

    <p>Elevated respiratory and heart rate</p> Signup and view all the answers

    While using asthma medications, it is contraindicated to use certain treatments without concurrent _____.

    <p>ICS</p> Signup and view all the answers

    Which is an associated risk of using certain asthma medications?

    <p>Tachyarrhythmias</p> Signup and view all the answers

    What defines Severe Persistent Asthma?

    <p>Symptoms occur daily with nighttime symptoms occurring nightly.</p> Signup and view all the answers

    Mild Persistent Asthma is classified by having more than two daytime symptoms per week but less than daily.

    <p>True</p> Signup and view all the answers

    What medication is typically used for treatment of Intermittent Asthma?

    <p>Short-acting beta-2 agonist (SABA)</p> Signup and view all the answers

    Inhaled corticosteroids help to reduce inflammation by inhibiting ______ release.

    <p>cytokine</p> Signup and view all the answers

    Which of the following is a common adverse effect associated with SABA?

    <p>Tachyarrhythmias</p> Signup and view all the answers

    Match the type of asthma with its characteristic:

    <p>Intermittent Asthma = Less than two daytime symptoms per week Mild Persistent Asthma = 3-4 nighttime symptoms per month Moderate Persistent Asthma = Daily daytime symptoms Severe Persistent Asthma = FEV1 &lt; 60%</p> Signup and view all the answers

    What is the FEV1 measurement range for Moderate Persistent Asthma?

    <p>60-80%</p> Signup and view all the answers

    LABA can be used alone for acute episodes in asthma treatment.

    <p>False</p> Signup and view all the answers

    Adverse effects of inhaled corticosteroids may lead to the development of ______.

    <p>oral candidiasis</p> Signup and view all the answers

    Which medication is commonly used for nighttime symptoms in asthma treatment?

    <p>Long-acting beta-2 agonists (LABA)</p> Signup and view all the answers

    What is the primary treatment for Mild Persistent Asthma?

    <p>SABA PRN plus low-dose inhaled corticosteroids (ICS)</p> Signup and view all the answers

    Inhaled corticosteroids primarily provide bronchodilation.

    <p>False</p> Signup and view all the answers

    What FEV1 percentage indicates Severe Persistent Asthma?

    <p>Less than 60%</p> Signup and view all the answers

    The main adverse effect associated with SABA use is __________.

    <p>tachyarrhythmias</p> Signup and view all the answers

    Match each type of asthma with its description:

    <p>Intermittent Asthma = Less than two daytime symptoms per week Mild Persistent Asthma = More than two daytime symptoms per week but less than daily Moderate Persistent Asthma = Daily daytime symptoms Severe Persistent Asthma = Symptoms occur daily throughout the day</p> Signup and view all the answers

    What is an additional treatment option for Severe Persistent Asthma if the initial treatment is not responsive?

    <p>Increase to high-dose ICS + LABA</p> Signup and view all the answers

    Long-acting beta-2 agonists (LABA) can be used alone for acute asthma episodes.

    <p>False</p> Signup and view all the answers

    List one common adverse effect of inhaled corticosteroids.

    <p>Oral candidiasis or thrush</p> Signup and view all the answers

    Mild Persistent Asthma is characterized by nighttime symptoms occurring __________ times per month.

    <p>three to four</p> Signup and view all the answers

    Which medication is typically used as needed for intermittent asthma symptoms?

    <p>Short-acting beta-2 agonist (SABA)</p> Signup and view all the answers

    What is a potential side effect associated with leukotriene receptor antagonists?

    <p>Mood changes</p> Signup and view all the answers

    Cromolyn sodium is useful for exercise-induced asthma.

    <p>True</p> Signup and view all the answers

    What is the expected peak flow percentage for a normal individual?

    <p>greater than 70%</p> Signup and view all the answers

    In the case of hyperventilation, the pCO2 level is expected to be _____ due to excessive exhalation.

    <p>low</p> Signup and view all the answers

    Match the following asthma medications with their characteristics:

    <p>Montelukast = Inhibits bronchoconstriction Cromolyn sodium = Inhibits histamine release Omalizumab = Anti-IgE antibody treatment SABA = Used for quick relief in exacerbations</p> Signup and view all the answers

    Which of the following is a suitable treatment option during a life-threatening asthma exacerbation?

    <p>Administer a Short-Acting Beta Agonist (SABA)</p> Signup and view all the answers

    Continuous monitoring and supportive care are unnecessary for a patient with an acute asthma exacerbation.

    <p>False</p> Signup and view all the answers

    What is one indicator of severe asthma exacerbation based on peak flow percentage?

    <p>peak flow between 25% to 50%</p> Signup and view all the answers

    If the patient's peak flow is between 50% to 70% after SABA, further assessment including an _______ analysis should be considered.

    <p>Arterial Blood Gas (ABG)</p> Signup and view all the answers

    What is the required frequency for administering Omalizumab?

    <p>Every 2-4 weeks</p> Signup and view all the answers

    What FEV1 percentage indicates Intermittent Asthma?

    <p>Greater than 80%</p> Signup and view all the answers

    Inhaled corticosteroids can lead to oral candidiasis if proper mouth rinsing is not performed.

    <p>True</p> Signup and view all the answers

    What is the primary treatment for Moderate Persistent Asthma?

    <p>SABA PRN plus medium-dose ICS, or low-dose ICS with LABA.</p> Signup and view all the answers

    For Mild Persistent Asthma, nighttime symptoms occur __________ times per month.

    <p>three to four</p> Signup and view all the answers

    Match the asthma types with their FEV1 measurements:

    <p>Intermittent Asthma = &gt; 80% Moderate Persistent Asthma = 60-80% Severe Persistent Asthma = &lt; 60% Mild Persistent Asthma = ≥ 80%</p> Signup and view all the answers

    What adverse effect is commonly associated with the use of SABA medications?

    <p>Tachyarrhythmias</p> Signup and view all the answers

    LABA should be used alone for acute asthma episodes.

    <p>False</p> Signup and view all the answers

    List one common medication used as a short-acting beta-2 agonist (SABA).

    <p>Albuterol</p> Signup and view all the answers

    For Severe Persistent Asthma, symptoms occur __________ throughout the day.

    <p>daily</p> Signup and view all the answers

    Which medication is primarily used to manage inflammation in asthma?

    <p>Inhaled corticosteroids</p> Signup and view all the answers

    Which medication is known to inhibit bronchoconstriction and mucus production?

    <p>Montelukast</p> Signup and view all the answers

    Cromolyn sodium is primarily used to treat exercise-induced asthma.

    <p>True</p> Signup and view all the answers

    What is the role of SABA in asthma management?

    <p>Quick relief from acute symptoms</p> Signup and view all the answers

    In cases of severe asthma exacerbations, patients may require ______ medications for management.

    <p>high-dose oral corticosteroid or intravenous</p> Signup and view all the answers

    Match the following asthma medications with their corresponding characteristics:

    <p>Cromolyn sodium = Useful for exercise-induced asthma Montelukast = Leukotriene receptor antagonist Omalizumab = Anti-IgE antibody treatment SABA = Quick relief medication</p> Signup and view all the answers

    What is a potential adverse effect related to leukotriene receptor antagonists?

    <p>Mood changes</p> Signup and view all the answers

    Continuous monitoring is necessary for stabilizing a patient during an acute asthma exacerbation.

    <p>True</p> Signup and view all the answers

    What percentage of predicted peak flow indicates a severe asthma exacerbation?

    <p>Below 25%</p> Signup and view all the answers

    In hyperventilation, the partial pressure of CO2 (pCO2) is expected to be _____ due to excessive exhalation.

    <p>low</p> Signup and view all the answers

    When should high-dose corticosteroids or intravenous medications be considered?

    <p>If there is no improvement after SABA</p> Signup and view all the answers

    What is the primary treatment for Moderate Persistent Asthma?

    <p>SABA PRN plus medium-dose inhaled corticosteroids</p> Signup and view all the answers

    Severe Persistent Asthma is characterized by FEV1 measurements less than 60%.

    <p>True</p> Signup and view all the answers

    How often do nighttime symptoms occur for Mild Persistent Asthma?

    <p>three to four times per month</p> Signup and view all the answers

    SABA medications primarily provide __________ by activating beta-2 adrenergic receptors.

    <p>bronchodilation</p> Signup and view all the answers

    Match the type of asthma with its FEV1 measurement range:

    <p>Intermittent Asthma = FEV1 greater than 80% Mild Persistent Asthma = FEV1 ≥ 80% Moderate Persistent Asthma = FEV1 between 60-80% Severe Persistent Asthma = FEV1 &lt; 60%</p> Signup and view all the answers

    Which medication is commonly used for treating nighttime symptoms in asthma?

    <p>Salmeterol</p> Signup and view all the answers

    Inhaled corticosteroids help to reduce inflammation primarily by activating cytokine release.

    <p>False</p> Signup and view all the answers

    What adverse effect is commonly associated with inhaled corticosteroids?

    <p>oral candidiasis</p> Signup and view all the answers

    For individuals with Asthma, a peak expiratory flow below __% indicates a severe exacerbation.

    <p>50</p> Signup and view all the answers

    What treatment is typically added for Severe Persistent Asthma if the initial treatments are not responsive?

    <p>High-dose ICS + LABA</p> Signup and view all the answers

    Which medication is indicated for exercise or cold-induced asthma?

    <p>Cromolyn sodium</p> Signup and view all the answers

    Leukotriene receptor antagonists are primarily used to increase bronchoconstriction.

    <p>False</p> Signup and view all the answers

    What is a significant associated risk of using certain asthma medications?

    <p>Tachyarrhythmias</p> Signup and view all the answers

    For a life-threatening asthma exacerbation, the rapid assessment of response to __________ is crucial.

    <p>SABA</p> Signup and view all the answers

    Match the following asthma treatments to their characteristics:

    <p>Cromolyn sodium = Mast cell stabilizer for exercise-induced asthma Montelukast = Leukotriene receptor antagonist Omalizumab = Anti-IgE antibody treatment SABA = Short-acting beta agonist for acute relief</p> Signup and view all the answers

    What percentage of predicted peak flow indicates severe asthma if it is below this value?

    <p>25%</p> Signup and view all the answers

    Continuous monitoring and supportive care are necessary for stabilization in acute asthma exacerbations.

    <p>True</p> Signup and view all the answers

    What should be done if a patient with a peak flow between 50% to 70% does not improve after SABA?

    <p>Consider further assessment including ABG analysis.</p> Signup and view all the answers

    For a peak expiratory flow rate (PEFR), normal peak flow should be greater than _________ of the predicted value.

    <p>70%</p> Signup and view all the answers

    Which adverse effect is associated with leukotriene receptor antagonists?

    <p>Mood changes</p> Signup and view all the answers

    What characterizes a severe asthma exacerbation based on peak flow measurement?

    <p>Peak flow below 25%</p> Signup and view all the answers

    Leukotriene receptor antagonists have no association with mood changes.

    <p>False</p> Signup and view all the answers

    Which medication is used for exercise-induced asthma management?

    <p>Cromolyn sodium</p> Signup and view all the answers

    A normal peak expiratory flow rate (PEFR) should be greater than ______ of the predicted value.

    <p>70%</p> Signup and view all the answers

    Match the following medications with their associated risks:

    <p>SABA = Tachyarrhythmias Leukotriene receptor antagonists = Mood changes Omalizumab = Costly and requires ongoing administration Cromolyn sodium = Histamine release inhibition</p> Signup and view all the answers

    When should high-dose oral corticosteroids be considered in asthma exacerbation management?

    <p>If there is no improvement after SABA</p> Signup and view all the answers

    Continuous monitoring and supportive care are optional for a patient with an acute asthma exacerbation.

    <p>False</p> Signup and view all the answers

    What is a potential side effect of using SABA medications?

    <p>Tachyarrhythmias</p> Signup and view all the answers

    In hyperventilation, low pCO2 is expected due to excessive ______ exhalation.

    <p>CO2</p> Signup and view all the answers

    What is the required administration frequency for Omalizumab?

    <p>Every 2-4 weeks</p> Signup and view all the answers

    What is the treatment for Mild Persistent Asthma?

    <p>Short-acting beta-2 agonist plus low-dose inhaled corticosteroids</p> Signup and view all the answers

    Severe Persistent Asthma is characterized by symptoms that occur only once a week.

    <p>False</p> Signup and view all the answers

    What does FEV1 stand for?

    <p>Forced Expiratory Volume in 1 second</p> Signup and view all the answers

    The primary bronchodilator used as needed for asthma symptoms is known as a __________.

    <p>SABA</p> Signup and view all the answers

    Match each type of asthma with its corresponding FEV1 measurement:

    <p>Intermittent Asthma = FEV1 &gt; 80% Mild Persistent Asthma = FEV1 ≥ 80% Moderate Persistent Asthma = FEV1 60-80% Severe Persistent Asthma = FEV1 &lt; 60%</p> Signup and view all the answers

    Which of the following is a common adverse effect of inhaled corticosteroids?

    <p>Oral candidiasis</p> Signup and view all the answers

    LABA should be used alone for managing acute asthma episodes.

    <p>False</p> Signup and view all the answers

    What is the expected FEV1 percentage for Intermittent Asthma?

    <p>Greater than 80%</p> Signup and view all the answers

    In Moderate Persistent Asthma, nighttime symptoms occur at least __________ per week.

    <p>once</p> Signup and view all the answers

    Which medication is typically used for long-term control in combination with ICS?

    <p>Long-acting beta-2 agonists</p> Signup and view all the answers

    Study Notes

    Asthma Classification and Treatment

    • Asthma is classified according to the frequency of daytime and nighttime symptoms, and FEV1 measurement.

    • Intermittent Asthma:

      • Less than two daytime symptoms per week.
      • Less than three nighttime symptoms per month.
      • FEV1 greater than 80%.
      • Treatment: Short-acting beta-2 agonist (SABA), typically used as needed (PRN).

    • Mild Persistent Asthma:

      • More than two daytime symptoms per week but less than daily.
      • Nighttime symptoms occur three to four times per month.
      • FEV1 ≥ 80%.
      • Treatment: SABA PRN plus low-dose inhaled corticosteroids (ICS), such as fluticasone or budesonide.

    • Moderate Persistent Asthma:

      • Daily daytime symptoms.
      • Nighttime symptoms occurring at least once per week.
      • FEV1 between 60-80%.
      • Treatment: SABA PRN plus medium-dose ICS, or low-dose ICS with long-acting beta-2 agonists (LABA).

    • Severe Persistent Asthma:

      • Symptoms occur daily throughout the day.
      • Nighttime symptoms occur nightly.
      • FEV1 < 60%.
      • Treatment options:
        • SABA PRN, medium-dose ICS, and LABA.
        • If not responsive, increase to high-dose ICS + LABA.
        • Oral corticosteroids may be added for severe cases.

    Medication Mechanism of Action

    • SABA (e.g., Albuterol):

      • Provides bronchodilation by activating beta-2 adrenergic receptors in bronchial smooth muscles.
      • Common administration forms: metered-dose inhaler (MDI), dry powder inhaler (DPI), nebulizer.
      • Adverse effects: tachyarrhythmias, tremors, dizziness, contraindicated in patients with heart issues or narrow-angle glaucoma.

    • Inhaled Corticosteroids:

      • Reduce inflammation by inhibiting cytokine release and the chemotaxis of white blood cells.
      • Common drugs: fluticasone, budesonide, mometasone.
      • Adverse effects: possibility of oral candidiasis (thrush), hence mouth rinsing is advised.

    • LABA (e.g., Salmeterol, Formoterol):

      • Long-acting agents used in combination with ICS.
      • Should never be used alone for acute episodes due to risk of worsening symptoms.
      • Associated risks: tachyarrhythmias, trembling, contraindicated without concurrent ICS.

    Alternative Treatment Options

    • Mast Cell Stabilizers:

      • Example: Cromolyn sodium, useful for exercise or cold-induced asthma, inhibits histamine release.

    • Leukotriene Receptor Antagonists:

      • Example: Montelukast (Singulair), inhibits bronchoconstriction and mucus production.
      • Associated with potential mood changes and suicidal ideation.

    • Omalizumab:

      • Anti-IgE antibody treatment, useful in severe allergic asthma; very costly and requires administration every 2-4 weeks.

    Management of Acute Exacerbation

    • For life-threatening or near-fatal exacerbations, immediate intervention is crucial:
      • Administer SABA and ensure rapid assessment of response.
      • Consider high-dose oral corticosteroids or intravenous medications if no improvement.
      • Continuous monitoring and supportive care are necessary to stabilize the patient.### Asthma Exacerbation Management
    • Peak Expiratory Flow Rate (PEFR) is utilized in acute asthma management when Pulmonary Function Tests (PFTs) are impractical.
    • Normal peak flow should be greater than 70% of the predicted value based on age, gender, and height.

    Patient Assessment

    • Situation 1: Patient improves after taking a Short-Acting Beta Agonist (SABA); peak flow is likely above 70%. Discharge may be appropriate.

    • Situation 2: If the patient has a peak flow between 50% to 70% and has not improved after SABA, consider further assessment, including an Arterial Blood Gas (ABG) analysis.

    • ABG Results:

      • pH, partial pressure of CO2 (pCO2), partial pressure of O2 (pO2), and bicarbonate levels are measured.
      • In hyperventilation, expect low pCO2 due to excessive CO2 exhalation.

    Severe Exacerbation Indicators

    • Situation 3: Elevated respiratory and heart rate (20-25 breaths/min and >100 bpm); peak flow between 25% to 50% indicates severe asthma. Abnormal ABG expected, usually showing low pCO2.

    • Situation 4: Peak expiratory flow below 25% and O2 saturation (<92%) signals potential respiratory failure. Lack of wheezing indicates severe obstruction; normal pCO2 suggests respiratory fatigue.

    • Situation 5: Elevated pCO2 in conjunction with peak flow <25% indicates severe obstruction and impending respiratory acidosis. Immediate intervention required.

    Treatment Protocol

    • Administer non-rebreather mask with supplemental oxygen targeting O2 saturation >92%.
    • Provide Short-Acting Beta Agonist (e.g., albuterol) combined with Ipratropium Bromide, which prevents bronchoconstriction by blocking acetylcholine.
    • If ineffective, initiate corticosteroids (IV or oral) for inflammation.
    • Explore IV Magnesium Sulfate for severe cases; it enhances smooth muscle dilation by blocking calcium channels.
    • If other measures fail, consider positive pressure ventilation or intubation for airway protection.

    Discharge Protocol

    • Upon stabilization, discharge typically includes an oral corticosteroid taper using a Medrol Dose Pack for ongoing symptom management.

    Asthma Classification and Treatment

    • Asthma is categorized based on the frequency of symptoms and FEV1 levels.

    • Intermittent Asthma:

      • Daytime symptoms <2 times/week; nocturnal symptoms <3 times/month.
      • FEV1 ≥ 80%.
      • Treatment: Short-acting beta-2 agonist (SABA) as needed.

    • Mild Persistent Asthma:

      • Daytime symptoms >2 times/week but <1 time/day; nighttime symptoms 3-4 times/month.
      • FEV1 ≥ 80%.
      • Treatment: SABA as needed + low-dose inhaled corticosteroids (ICS).

    • Moderate Persistent Asthma:

      • Daily daytime symptoms; nighttime symptoms at least once/week.
      • FEV1 between 60-80%.
      • Treatment: SABA as needed + medium-dose ICS, or low-dose ICS + long-acting beta-2 agonists (LABA).

    • Severe Persistent Asthma:

      • Daily symptoms; nighttime symptoms nightly.
      • FEV1 < 60%.
      • Treatment: SABA as needed + medium-dose ICS + LABA, or escalate to high-dose ICS + LABA. Oral corticosteroids may be necessary for severe cases.

    Medication Mechanism of Action

    • SABA (e.g., Albuterol):

      • Bronchodilation via beta-2 adrenergic receptor activation.
      • Available as metered-dose inhaler, dry powder inhaler, or nebulizer.
      • Side effects include tachyarrhythmias and tremors; contraindicated in patients with heart issues.

    • Inhaled Corticosteroids:

      • Reduce inflammation by inhibiting cytokines and chemotaxis of white blood cells.
      • Examples include fluticasone and budesonide.
      • Risks include oral thrush; mouth rinsing is recommended after use.

    • LABA (e.g., Salmeterol, Formoterol):

      • Long-acting; used with ICS, not alone for acute episodes.
      • Associated with risks like tachyarrhythmias; use must be combined with ICS.

    Alternative Treatment Options

    • Mast Cell Stabilizers:

      • Example: Cromolyn sodium; prevents histamine release, effective for exercise or cold-induced asthma.

    • Leukotriene Receptor Antagonists:

      • Example: Montelukast (Singulair); reduces bronchoconstriction and mucus production.
      • Risks include potential mood changes and suicidal ideation.

    • Omalizumab:

      • Anti-IgE treatment for severe allergic asthma; expensive and requires administration every 2-4 weeks.

    Management of Acute Exacerbation

    • Immediate intervention is crucial for life-threatening asthma exacerbations.
    • Administer SABA and monitor response rapidly.
    • High-dose oral corticosteroids or intravenous medications may be necessary if no improvement.
    • Continuous monitoring and supportive care are essential for stabilization.

    Asthma Exacerbation Management

    • Peak Expiratory Flow Rate (PEFR) is used for acute management when Pulmonary Function Tests are impractical.
    • Normal PEFR should exceed 70% of the predicted value based on age, gender, and height.

    Patient Assessment

    • Situation 1: If the patient improves post-SABA with peak flow likely >70%, discharge is appropriate.
    • Situation 2: If peak flow is 50%-70% with no SABA improvement, further assessment and ABG analysis are warranted.
    • ABG Analysis: Measures pH, pCO2, pO2, and bicarbonate levels; low pCO2 in hyperventilation indicates excessive CO2 exhalation.

    Severe Exacerbation Indicators

    • Situation 3: Elevated respiratory rate (20-25 breaths/min) and heart rate (>100 bpm); peak flow 25%-50% suggests severe asthma with expected abnormal ABG showing low pCO2.
    • Situation 4: Peak expiratory flow <25% indicates critical condition; O2 saturation is likely low.

    Asthma Classification and Treatment

    • Asthma is categorized based on the frequency of symptoms and FEV1 levels.

    • Intermittent Asthma:

      • Daytime symptoms <2 times/week; nocturnal symptoms <3 times/month.
      • FEV1 ≥ 80%.
      • Treatment: Short-acting beta-2 agonist (SABA) as needed.

    • Mild Persistent Asthma:

      • Daytime symptoms >2 times/week but <1 time/day; nighttime symptoms 3-4 times/month.
      • FEV1 ≥ 80%.
      • Treatment: SABA as needed + low-dose inhaled corticosteroids (ICS).

    • Moderate Persistent Asthma:

      • Daily daytime symptoms; nighttime symptoms at least once/week.
      • FEV1 between 60-80%.
      • Treatment: SABA as needed + medium-dose ICS, or low-dose ICS + long-acting beta-2 agonists (LABA).

    • Severe Persistent Asthma:

      • Daily symptoms; nighttime symptoms nightly.
      • FEV1 < 60%.
      • Treatment: SABA as needed + medium-dose ICS + LABA, or escalate to high-dose ICS + LABA. Oral corticosteroids may be necessary for severe cases.

    Medication Mechanism of Action

    • SABA (e.g., Albuterol):

      • Bronchodilation via beta-2 adrenergic receptor activation.
      • Available as metered-dose inhaler, dry powder inhaler, or nebulizer.
      • Side effects include tachyarrhythmias and tremors; contraindicated in patients with heart issues.

    • Inhaled Corticosteroids:

      • Reduce inflammation by inhibiting cytokines and chemotaxis of white blood cells.
      • Examples include fluticasone and budesonide.
      • Risks include oral thrush; mouth rinsing is recommended after use.

    • LABA (e.g., Salmeterol, Formoterol):

      • Long-acting; used with ICS, not alone for acute episodes.
      • Associated with risks like tachyarrhythmias; use must be combined with ICS.

    Alternative Treatment Options

    • Mast Cell Stabilizers:

      • Example: Cromolyn sodium; prevents histamine release, effective for exercise or cold-induced asthma.

    • Leukotriene Receptor Antagonists:

      • Example: Montelukast (Singulair); reduces bronchoconstriction and mucus production.
      • Risks include potential mood changes and suicidal ideation.

    • Omalizumab:

      • Anti-IgE treatment for severe allergic asthma; expensive and requires administration every 2-4 weeks.

    Management of Acute Exacerbation

    • Immediate intervention is crucial for life-threatening asthma exacerbations.
    • Administer SABA and monitor response rapidly.
    • High-dose oral corticosteroids or intravenous medications may be necessary if no improvement.
    • Continuous monitoring and supportive care are essential for stabilization.

    Asthma Exacerbation Management

    • Peak Expiratory Flow Rate (PEFR) is used for acute management when Pulmonary Function Tests are impractical.
    • Normal PEFR should exceed 70% of the predicted value based on age, gender, and height.

    Patient Assessment

    • Situation 1: If the patient improves post-SABA with peak flow likely >70%, discharge is appropriate.
    • Situation 2: If peak flow is 50%-70% with no SABA improvement, further assessment and ABG analysis are warranted.
    • ABG Analysis: Measures pH, pCO2, pO2, and bicarbonate levels; low pCO2 in hyperventilation indicates excessive CO2 exhalation.

    Severe Exacerbation Indicators

    • Situation 3: Elevated respiratory rate (20-25 breaths/min) and heart rate (>100 bpm); peak flow 25%-50% suggests severe asthma with expected abnormal ABG showing low pCO2.
    • Situation 4: Peak expiratory flow <25% indicates critical condition; O2 saturation is likely low.

    Asthma Classification and Treatment

    • Asthma is categorized based on the frequency of symptoms and FEV1 levels.

    • Intermittent Asthma:

      • Daytime symptoms <2 times/week; nocturnal symptoms <3 times/month.
      • FEV1 ≥ 80%.
      • Treatment: Short-acting beta-2 agonist (SABA) as needed.

    • Mild Persistent Asthma:

      • Daytime symptoms >2 times/week but <1 time/day; nighttime symptoms 3-4 times/month.
      • FEV1 ≥ 80%.
      • Treatment: SABA as needed + low-dose inhaled corticosteroids (ICS).

    • Moderate Persistent Asthma:

      • Daily daytime symptoms; nighttime symptoms at least once/week.
      • FEV1 between 60-80%.
      • Treatment: SABA as needed + medium-dose ICS, or low-dose ICS + long-acting beta-2 agonists (LABA).

    • Severe Persistent Asthma:

      • Daily symptoms; nighttime symptoms nightly.
      • FEV1 < 60%.
      • Treatment: SABA as needed + medium-dose ICS + LABA, or escalate to high-dose ICS + LABA. Oral corticosteroids may be necessary for severe cases.

    Medication Mechanism of Action

    • SABA (e.g., Albuterol):

      • Bronchodilation via beta-2 adrenergic receptor activation.
      • Available as metered-dose inhaler, dry powder inhaler, or nebulizer.
      • Side effects include tachyarrhythmias and tremors; contraindicated in patients with heart issues.

    • Inhaled Corticosteroids:

      • Reduce inflammation by inhibiting cytokines and chemotaxis of white blood cells.
      • Examples include fluticasone and budesonide.
      • Risks include oral thrush; mouth rinsing is recommended after use.

    • LABA (e.g., Salmeterol, Formoterol):

      • Long-acting; used with ICS, not alone for acute episodes.
      • Associated with risks like tachyarrhythmias; use must be combined with ICS.

    Alternative Treatment Options

    • Mast Cell Stabilizers:

      • Example: Cromolyn sodium; prevents histamine release, effective for exercise or cold-induced asthma.

    • Leukotriene Receptor Antagonists:

      • Example: Montelukast (Singulair); reduces bronchoconstriction and mucus production.
      • Risks include potential mood changes and suicidal ideation.

    • Omalizumab:

      • Anti-IgE treatment for severe allergic asthma; expensive and requires administration every 2-4 weeks.

    Management of Acute Exacerbation

    • Immediate intervention is crucial for life-threatening asthma exacerbations.
    • Administer SABA and monitor response rapidly.
    • High-dose oral corticosteroids or intravenous medications may be necessary if no improvement.
    • Continuous monitoring and supportive care are essential for stabilization.

    Asthma Exacerbation Management

    • Peak Expiratory Flow Rate (PEFR) is used for acute management when Pulmonary Function Tests are impractical.
    • Normal PEFR should exceed 70% of the predicted value based on age, gender, and height.

    Patient Assessment

    • Situation 1: If the patient improves post-SABA with peak flow likely >70%, discharge is appropriate.
    • Situation 2: If peak flow is 50%-70% with no SABA improvement, further assessment and ABG analysis are warranted.
    • ABG Analysis: Measures pH, pCO2, pO2, and bicarbonate levels; low pCO2 in hyperventilation indicates excessive CO2 exhalation.

    Severe Exacerbation Indicators

    • Situation 3: Elevated respiratory rate (20-25 breaths/min) and heart rate (>100 bpm); peak flow 25%-50% suggests severe asthma with expected abnormal ABG showing low pCO2.
    • Situation 4: Peak expiratory flow <25% indicates critical condition; O2 saturation is likely low.

    Asthma Classification and Treatment

    • Asthma is categorized based on the frequency of symptoms and FEV1 levels.

    • Intermittent Asthma:

      • Daytime symptoms <2 times/week; nocturnal symptoms <3 times/month.
      • FEV1 ≥ 80%.
      • Treatment: Short-acting beta-2 agonist (SABA) as needed.

    • Mild Persistent Asthma:

      • Daytime symptoms >2 times/week but <1 time/day; nighttime symptoms 3-4 times/month.
      • FEV1 ≥ 80%.
      • Treatment: SABA as needed + low-dose inhaled corticosteroids (ICS).

    • Moderate Persistent Asthma:

      • Daily daytime symptoms; nighttime symptoms at least once/week.
      • FEV1 between 60-80%.
      • Treatment: SABA as needed + medium-dose ICS, or low-dose ICS + long-acting beta-2 agonists (LABA).

    • Severe Persistent Asthma:

      • Daily symptoms; nighttime symptoms nightly.
      • FEV1 < 60%.
      • Treatment: SABA as needed + medium-dose ICS + LABA, or escalate to high-dose ICS + LABA. Oral corticosteroids may be necessary for severe cases.

    Medication Mechanism of Action

    • SABA (e.g., Albuterol):

      • Bronchodilation via beta-2 adrenergic receptor activation.
      • Available as metered-dose inhaler, dry powder inhaler, or nebulizer.
      • Side effects include tachyarrhythmias and tremors; contraindicated in patients with heart issues.

    • Inhaled Corticosteroids:

      • Reduce inflammation by inhibiting cytokines and chemotaxis of white blood cells.
      • Examples include fluticasone and budesonide.
      • Risks include oral thrush; mouth rinsing is recommended after use.

    • LABA (e.g., Salmeterol, Formoterol):

      • Long-acting; used with ICS, not alone for acute episodes.
      • Associated with risks like tachyarrhythmias; use must be combined with ICS.

    Alternative Treatment Options

    • Mast Cell Stabilizers:

      • Example: Cromolyn sodium; prevents histamine release, effective for exercise or cold-induced asthma.

    • Leukotriene Receptor Antagonists:

      • Example: Montelukast (Singulair); reduces bronchoconstriction and mucus production.
      • Risks include potential mood changes and suicidal ideation.

    • Omalizumab:

      • Anti-IgE treatment for severe allergic asthma; expensive and requires administration every 2-4 weeks.

    Management of Acute Exacerbation

    • Immediate intervention is crucial for life-threatening asthma exacerbations.
    • Administer SABA and monitor response rapidly.
    • High-dose oral corticosteroids or intravenous medications may be necessary if no improvement.
    • Continuous monitoring and supportive care are essential for stabilization.

    Asthma Exacerbation Management

    • Peak Expiratory Flow Rate (PEFR) is used for acute management when Pulmonary Function Tests are impractical.
    • Normal PEFR should exceed 70% of the predicted value based on age, gender, and height.

    Patient Assessment

    • Situation 1: If the patient improves post-SABA with peak flow likely >70%, discharge is appropriate.
    • Situation 2: If peak flow is 50%-70% with no SABA improvement, further assessment and ABG analysis are warranted.
    • ABG Analysis: Measures pH, pCO2, pO2, and bicarbonate levels; low pCO2 in hyperventilation indicates excessive CO2 exhalation.

    Severe Exacerbation Indicators

    • Situation 3: Elevated respiratory rate (20-25 breaths/min) and heart rate (>100 bpm); peak flow 25%-50% suggests severe asthma with expected abnormal ABG showing low pCO2.
    • Situation 4: Peak expiratory flow <25% indicates critical condition; O2 saturation is likely low.

    Asthma Classification and Treatment

    • Asthma is categorized based on the frequency of symptoms and FEV1 levels.

    • Intermittent Asthma:

      • Daytime symptoms <2 times/week; nocturnal symptoms <3 times/month.
      • FEV1 ≥ 80%.
      • Treatment: Short-acting beta-2 agonist (SABA) as needed.

    • Mild Persistent Asthma:

      • Daytime symptoms >2 times/week but <1 time/day; nighttime symptoms 3-4 times/month.
      • FEV1 ≥ 80%.
      • Treatment: SABA as needed + low-dose inhaled corticosteroids (ICS).

    • Moderate Persistent Asthma:

      • Daily daytime symptoms; nighttime symptoms at least once/week.
      • FEV1 between 60-80%.
      • Treatment: SABA as needed + medium-dose ICS, or low-dose ICS + long-acting beta-2 agonists (LABA).

    • Severe Persistent Asthma:

      • Daily symptoms; nighttime symptoms nightly.
      • FEV1 < 60%.
      • Treatment: SABA as needed + medium-dose ICS + LABA, or escalate to high-dose ICS + LABA. Oral corticosteroids may be necessary for severe cases.

    Medication Mechanism of Action

    • SABA (e.g., Albuterol):

      • Bronchodilation via beta-2 adrenergic receptor activation.
      • Available as metered-dose inhaler, dry powder inhaler, or nebulizer.
      • Side effects include tachyarrhythmias and tremors; contraindicated in patients with heart issues.

    • Inhaled Corticosteroids:

      • Reduce inflammation by inhibiting cytokines and chemotaxis of white blood cells.
      • Examples include fluticasone and budesonide.
      • Risks include oral thrush; mouth rinsing is recommended after use.

    • LABA (e.g., Salmeterol, Formoterol):

      • Long-acting; used with ICS, not alone for acute episodes.
      • Associated with risks like tachyarrhythmias; use must be combined with ICS.

    Alternative Treatment Options

    • Mast Cell Stabilizers:

      • Example: Cromolyn sodium; prevents histamine release, effective for exercise or cold-induced asthma.

    • Leukotriene Receptor Antagonists:

      • Example: Montelukast (Singulair); reduces bronchoconstriction and mucus production.
      • Risks include potential mood changes and suicidal ideation.

    • Omalizumab:

      • Anti-IgE treatment for severe allergic asthma; expensive and requires administration every 2-4 weeks.

    Management of Acute Exacerbation

    • Immediate intervention is crucial for life-threatening asthma exacerbations.
    • Administer SABA and monitor response rapidly.
    • High-dose oral corticosteroids or intravenous medications may be necessary if no improvement.
    • Continuous monitoring and supportive care are essential for stabilization.

    Asthma Exacerbation Management

    • Peak Expiratory Flow Rate (PEFR) is used for acute management when Pulmonary Function Tests are impractical.
    • Normal PEFR should exceed 70% of the predicted value based on age, gender, and height.

    Patient Assessment

    • Situation 1: If the patient improves post-SABA with peak flow likely >70%, discharge is appropriate.
    • Situation 2: If peak flow is 50%-70% with no SABA improvement, further assessment and ABG analysis are warranted.
    • ABG Analysis: Measures pH, pCO2, pO2, and bicarbonate levels; low pCO2 in hyperventilation indicates excessive CO2 exhalation.

    Severe Exacerbation Indicators

    • Situation 3: Elevated respiratory rate (20-25 breaths/min) and heart rate (>100 bpm); peak flow 25%-50% suggests severe asthma with expected abnormal ABG showing low pCO2.
    • Situation 4: Peak expiratory flow <25% indicates critical condition; O2 saturation is likely low.

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    Description

    Explore the different classifications of asthma based on symptom frequency and FEV1 measurements. This quiz covers intermittent, mild persistent, moderate persistent, and severe persistent asthma, along with their respective treatments. Test your knowledge on how to identify and manage asthma effectively.

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