Asthma Management and Dosing Details Quiz
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Questions and Answers

What is the recommended dosing of fluticasone propionate in Step 2 of asthma management?

  • 100-250 mcg once daily
  • 100-250 mcg twice daily (correct)
  • 50 mcg twice daily
  • 250-500 mcg twice daily

What is the recommended dosing of salmeterol in Step 3 of asthma management?

  • 50 mcg once daily
  • 50 mcg twice daily (correct)
  • 25 mcg twice daily
  • 100 mcg twice daily

At what FEV1 level range may a patient be when considering increasing the dose of IGC in Step 4?

  • 60-80% predicted (correct)
  • 40-60% predicted
  • 80-100% predicted
  • <40% predicted

What is the next step advised for patients with severe uncontrolled asthma despite Step 4 treatment?

<p>Consult a specialist and consider alternative therapies (D)</p> Signup and view all the answers

What is the recommended emergency evaluation criteria for persons with signs and symptoms suggestive of respiratory compromise?

<p>Respiratory rate &gt;30/min, pulse rate &gt;120 beats per minute, O2 saturation &lt;90% on room air (B)</p> Signup and view all the answers

In asthma management, how often do patients experience symptoms 'Daily' according to the text?

<p>Every day (A)</p> Signup and view all the answers

Which lung function test result indicates a severe limitation on normal activity in asthma patients?

<p>FEV1 &gt;60% but &lt;80% of predicted (B)</p> Signup and view all the answers

What is the recommended respiratory rate threshold indicating a need for emergency evaluation in persons with signs and symptoms suggestive of respiratory compromise?

<p>&gt;30/min (B)</p> Signup and view all the answers

Which parameter is used to assess the effect on normal activity in asthma patients?

<p>Lung function tests (C)</p> Signup and view all the answers

In asthma management, what level of FEV1 indicates a normal lung function between exacerbations?

<p>&gt;80% of predicted (D)</p> Signup and view all the answers

Which of the following symptoms is NOT a clinical hallmark of asthma?

<p>Sore throat (A)</p> Signup and view all the answers

What is the recommended action for patients with PEF values below 50% predicted or personal best?

<p>Immediate medical care (A)</p> Signup and view all the answers

What initial treatment is recommended for less severe signs and symptoms of an asthma attack?

<p>Inhaled SABA (C)</p> Signup and view all the answers

Which sign or symptom should lead to immediate medical attention after initial treatment for a high-risk asthma attack patient?

<p>Marked breathlessness (D)</p> Signup and view all the answers

In asthma management, what level of PEF would indicate a Poor Response to initial treatment?

<p>PEF is 50%–79% predicted or personal best (B)</p> Signup and view all the answers

Which symptom assessment corresponds to a Marked wheezing and dyspnea response to asthma treatment?

<p>Persistent wheezing and dyspnea (C)</p> Signup and view all the answers

When assessing the effect on normal activity in asthma patients, which lung function test result would indicate Severe limitation?

<p>FEV1 &gt;60% but &lt;80% of predicted (B)</p> Signup and view all the answers

Which factor increases the risk of asthma exacerbations, even if the patient is experiencing few asthma symptoms?

<p>High SABA use (B)</p> Signup and view all the answers

When should risk factors for poor asthma outcomes be assessed?

<p>At diagnosis and every 1-2 years (D)</p> Signup and view all the answers

What lung function test should be measured periodically for ongoing assessment in asthma patients?

<p>FEV1 (A)</p> Signup and view all the answers

Which of the following is NOT a risk factor for poor asthma outcomes?

<p>High ICS adherence (D)</p> Signup and view all the answers

What is a significant risk factor for exacerbations in asthma patients?

<p>&gt;1 x 200-dose canister/month of SABA use (D)</p> Signup and view all the answers

How often should FEV1 be measured in asthma patients for ongoing assessment?

<p>Periodically for ongoing assessment (A)</p> Signup and view all the answers

What is the recommended frequency for assessing risk factors for poor asthma outcomes?

<p>Every 1-2 years (C)</p> Signup and view all the answers

Which of the following is considered an important risk factor for asthma exacerbations?

<p>High SABA use (D)</p> Signup and view all the answers

What lung function should be measured at the start of treatment and periodically for ongoing assessment in asthma patients?

<p>FEV1 (B)</p> Signup and view all the answers

Which of the following increases the risk of asthma exacerbations, even if the patient is experiencing few asthma symptoms?

<p>Incorrect inhaler technique (B)</p> Signup and view all the answers

What does a patient experience if needing reliever medication more than twice a week in the past 4 weeks?

<p>Uncontrolled asthma (B)</p> Signup and view all the answers

Which risk factor for poor asthma outcomes has an increased mortality risk if exceeding more than one 200-dose canister per month?

<p>High SABA use (C)</p> Signup and view all the answers

What is the recommended controller choice for asthma patients with symptoms more often than twice a month and waking due to asthma more than once a month?

<p>Medium-dose ICS + LTRA (D)</p> Signup and view all the answers

For purely seasonal allergic asthma, when should ICS treatment be started?

<p>Immediately upon onset of symptoms (B)</p> Signup and view all the answers

In Step 3 of asthma management, what is a preferred controller option besides low-dose ICS/LABA?

<p>Tiotropium by mist inhaler (A)</p> Signup and view all the answers

What is a recommended controller choice for patients with a history of exacerbations in Step 4 of asthma management?

<p>High-dose ICS/LABA (D)</p> Signup and view all the answers

In Step 2 of asthma management, what is an alternative controller option to low-dose ICS?

<p>Leukotriene receptor antagonist (LTRA) (A)</p> Signup and view all the answers

For patients with purely seasonal allergic asthma, when should the use of ICS be discontinued?

<p>After 4 weeks of exposure (D)</p> Signup and view all the answers

In Step 3 of asthma management, what is an alternative to low-dose ICS/LABA as a preferred controller choice?

<p>Medium-dose ICS + LTRA (D)</p> Signup and view all the answers

What is the recommended daily dosage range for budesonide suspension for nebulization in children aged 1-8 years?

<p>250-500 mcg/day (A)</p> Signup and view all the answers

What is the recommended dosage of montelukast (Singulair) for a 6-year-old patient?

<p>One 5-mg chewable tablet every evening (A)</p> Signup and view all the answers

What is the correct dosage of beclomethasone dipropionate (QVAR) MDI for adults?

<p>40-320 mcg twice daily (B)</p> Signup and view all the answers

What is the recommended dosage of zafirlukast (Accolate) for a 13-year-old patient?

<p>20-mg twice daily (A)</p> Signup and view all the answers

What is the recommended dosage range for fluticasone propionate (Flovent Diskus) DPI in children aged 4-11 years?

<p>50-100 mcg twice daily (D)</p> Signup and view all the answers

What is the initial dosage of albuterol (ProAir HFA) for children using a solution for nebulization?

<p>0.63–2.5 mg/kg every 4–6 h PRN (B)</p> Signup and view all the answers

What is the correct dosing schedule for mometasone furoate (Asmanex Twisthaler) DPI in children aged 4-11 years?

<p>110 mcg once daily (B)</p> Signup and view all the answers

What is the recommended dosage of formoterol (Foradil Aerolizer) for adults using a DPI?

<p>1 inhalation every 12 h (D)</p> Signup and view all the answers

What is the recommended dosage of ciclesonide (Alvesco) MDI for children aged 12 years and above?

<p>80-320 mcg twice daily (C)</p> Signup and view all the answers

What is the dosage of ipratropium (Atrovent HFA) for nebulization in a patient who requires it four times daily?

<p>500 mcg/vial (A)</p> Signup and view all the answers

What is the correct dosage range for flunisolide (AeroBid) MDI in children aged 6-11 years?

<p>160-320 mcg twice daily (C)</p> Signup and view all the answers

What is the correct daily dosage of tiotropium (Spiriva) for patients using HandiHaler DPI?

<p>18 mcg once daily (A)</p> Signup and view all the answers

What is the recommended dosing for budesonide/formoterol (Symbicort) HFA 160 mcg/4.5 mcg?

<p>2 inhalations twice daily (A)</p> Signup and view all the answers

How many times a day is Combivent Respimat Inhaler (ipratropium/albuterol) recommended to be used?

<p>4 times daily (B)</p> Signup and view all the answers

What is the formulation per inhalation for Stiolto Respimat Inhaler (olodaterol/tiotropium)?

<p>2.5 mcg olodaterol/2.5 mcg tiotropium (D)</p> Signup and view all the answers

What is the recommended dosing for Mometasone/formoterol (Dulera) HFA 100 mcg/5 mcg?

<p>2 inhalations twice daily (D)</p> Signup and view all the answers

How many times a day should Utibron Neohaler Inhaler (indacaterol/glycopyrronium) be used?

<p>Twice daily (B)</p> Signup and view all the answers

What is the formulation per inhalation for Anoro Ellipta Inhaler (umeclidinium/vilanterol)?

<p>62.5 mcg umeclidinium/25 mcg vilanterol (C)</p> Signup and view all the answers

Which adverse effect is commonly associated with theophylline therapy in elderly men with prostatism?

<p>Difficulty in urination (B)</p> Signup and view all the answers

What is the recommended serum concentration range of theophylline at steady state?

<p>5–15 mcg/mL (C)</p> Signup and view all the answers

Which factor is essential due to wide interpatient variability in theophylline metabolic clearance?

<p>Routine serum theophylline level monitoring (D)</p> Signup and view all the answers

What adverse effects are commonly associated with inhaled short-acting β2 agonists?

<p>Tachycardia and skeletal muscle tremor (A)</p> Signup and view all the answers

What is a characteristic of ipratropium when used in the ED setting?

<p>It provides less bronchodilation compared to SABAs (B)</p> Signup and view all the answers

What does the combination of ipratropium with albuterol nebulizer solution contain to prevent discoloration?

<p>EDTA (D)</p> Signup and view all the answers

What is the advantage of administering corticosteroids for long-term treatment of severe persistent asthma on alternate days?

<p>To reduce the risk of adrenal suppression (A)</p> Signup and view all the answers

Which side effect is associated with inhaled long-acting β2 agonists like salmeterol and formoterol?

<p>Tachycardia (B)</p> Signup and view all the answers

What precaution should be taken when administering zafirlukast for asthma treatment?

<p>Monitor hepatic enzymes (ALT) regularly (C)</p> Signup and view all the answers

What is a dose-related acute toxicity associated with theophylline use in asthma patients?

<p>Tachycardia (B)</p> Signup and view all the answers

What is a potential complication of using budesonide/formoterol for asthma management?

<p>Diminished bronchoprotective effects (D)</p> Signup and view all the answers

Which enzyme inhibition can occur due to zileuton usage in asthma patients?

<p>Microsomal P450 enzyme inhibition (C)</p> Signup and view all the answers

What is a potential reversible abnormality in glucose metabolism associated with short-term use of systemic corticosteroids?

<p>Hyperglycemia (A)</p> Signup and view all the answers

In addition to weight gain, which of the following is another adverse effect associated with the use of systemic corticosteroids?

<p>Muscle weakness (B)</p> Signup and view all the answers

What condition should be considered for worsened outcomes if coexisting with systemic corticosteroid use?

<p>Osteoporosis (D)</p> Signup and view all the answers

For how long should a short course 'burst' of systemic corticosteroids typically be continued until the patient achieves 80% PEF or symptom resolution?

<p>10-14 days (B)</p> Signup and view all the answers

'There is no evidence that tapering the dose after improvement prevents relapse in asthma exacerbations' implies which of the following?

<p>Tapering the dose is essential for preventing relapse. (C)</p> Signup and view all the answers

Which other systemic corticosteroid is likely to be as effective as prednisolone when given in equipotent daily doses?

<p>Hydrocortisone (C)</p> Signup and view all the answers

'May be used in place of a short burst of oral steroids in patients who are vomiting or if adherence is a problem' refers to the usage of which medication?

<p>Methylprednisolone acetate Repository injection (C)</p> Signup and view all the answers

'Action may begin within an hour.' indicates the rapid onset of action of which medication?

<p>Methylprednisolone acetate Repository injection (C)</p> Signup and view all the answers

'Consideration should be given to coexisting conditions that could be worsened by systemic corticosteroids' includes all EXCEPT:

<p>'Hyperthyroidism' (B)</p> Signup and view all the answers

'May require longer' refers to what aspect of treatment with systemic corticosteroids?

<p>'Duration' (D)</p> Signup and view all the answers

What is the recommended action to reduce exposures to domestic dust mite allergens?

<p>Replace carpets with linoleum or wood flooring (A)</p> Signup and view all the answers

How should patients and parents handle exposure to tobacco smoke based on the text?

<p>Stay away from tobacco smoke (B)</p> Signup and view all the answers

What action should be taken to reduce exposure to allergens from animals with fur?

<p>Remove animals from the home, or at least from the sleeping area (D)</p> Signup and view all the answers

Which action reduces exposure to indoor mold according to the text?

<p>Reduce dampness in the home and clean any damp areas frequently (D)</p> Signup and view all the answers

How should physical activity be managed for asthma patients according to the text?

<p>Prevent symptoms by taking certain medications before exercise (A)</p> Signup and view all the answers

What is the recommended method for assessing pulmonary function in asthma management, as emphasized in the text?

<p>Monitoring with peak expiratory flow meters (C)</p> Signup and view all the answers

Why is it important for individuals with moderate to severe asthma to monitor their PEF levels at home?

<p>To assess their response to treatment accurately (B)</p> Signup and view all the answers

In the context of asthma management, what is the purpose of the zone system that uses green, yellow, and red zones?

<p>To assist patients in interpreting their symptoms and PEF results (C)</p> Signup and view all the answers

What does the yellow zone in the zone system for asthma management suggest about a patient's condition?

<p>Their condition is deteriorating and requires caution (C)</p> Signup and view all the answers

Why is it important to reassess an individual's personal best PEF periodically in asthma management?

<p>To account for any progression in the severity of their disease (D)</p> Signup and view all the answers

What is the significance of the yellow zone in an asthma action plan?

<p>It signals a deterioration in airway obstruction that needs intervention (C)</p> Signup and view all the answers

What immediate actions are recommended in the red zone of an asthma action plan?

<p>Use inhaled rescue bronchodilator therapy and initiate or increase oral corticosteroids (A)</p> Signup and view all the answers

What is the central focus for improving asthma adherence according to the text?

<p>Therapeutic provider-patient relationship (A)</p> Signup and view all the answers

Why is it recommended for patients with chronic severe asthma to be evaluated by an asthma specialist after a hospitalization?

<p>To prevent future exacerbations and improve control (A)</p> Signup and view all the answers

What has been the impact of obesity on asthma outcomes according to the information provided?

<p>Obesity is associated with worsened asthma control and increased risk of morbidity (B)</p> Signup and view all the answers

Why is it recommended for pregnant women with asthma to monitor pulmonary function throughout pregnancy?

<p>To detect a 20% drop in peak flow that often precedes symptoms (C)</p> Signup and view all the answers

Why does asthma tend to be less well recognized among older adults?

<p>Because older adults often have symptoms that mimic other respiratory ailments (B)</p> Signup and view all the answers

What is a key consideration when managing asthma in pregnant women?

<p>Maintaining good asthma control before and during pregnancy (C)</p> Signup and view all the answers

Why is it important to distinguish between asthma and COPD in older adults?

<p>Because the treatment approaches differ for each condition (C)</p> Signup and view all the answers

What is a characteristic of asthma management in older adults?

<p>Older adults generally experience symptoms at a later age than younger individuals (D)</p> Signup and view all the answers

What may enhance drug delivery in older adults with asthma?

<p>Spacers (C)</p> Signup and view all the answers

What is a common complication of asthma that is characterized by symptoms not improving with initial treatment?

<p>Status asthmaticus (D)</p> Signup and view all the answers

Which factor has been identified to increase the risk of fatal asthma?

<p>Comorbidity such as cardiovascular disease (A)</p> Signup and view all the answers

What is recommended for patients with signs and symptoms suggestive of respiratory compromise?

<p>Early intubation (B)</p> Signup and view all the answers

What is a significant challenge in patient education related to asthma management?

<p>Ongoing maintenance and prevention requirements (D)</p> Signup and view all the answers

What should patients and their families be well educated about in order to achieve goals of asthma treatment besides episodic relief of symptoms?

<p>Understanding the role of airway inflammation in asthma (C)</p> Signup and view all the answers

What is the definition of asthma control?

<p>Being able to engage in normal activities without limitations (D)</p> Signup and view all the answers

What is the purpose of long-term control medications in asthma treatment according to the text?

<p>To prevent symptoms by reducing inflammation (A)</p> Signup and view all the answers

What self-monitoring skills are asthma patients advised to have that are tied to an action plan?

<p>Recognizing intensity and frequency of asthma symptoms (A)</p> Signup and view all the answers

What is a key aspect of the written Asthma Action Plan (AAP) that patients should be familiar with?

<p>Instructions for recognizing and handling worsening asthma only (C)</p> Signup and view all the answers

What is a key focus area during subsequent visits for asthma patients, as recommended in the text?

<p>Reviewing asthma control and medications (C)</p> Signup and view all the answers

What specific technique should be taught or reviewed for asthma management, as highlighted in the text?

<p>Peak flow monitoring technique (A)</p> Signup and view all the answers

Which aspect of asthma management should patients be educated on in simple language, according to the text?

<p>Medication self-assessment (B)</p> Signup and view all the answers

What is a crucial step to confirm during patient education regarding asthma exacerbations, as mentioned in the text?

<p>Confirming patients' knowledge of what to do if asthma worsens (D)</p> Signup and view all the answers

Which item should be reviewed and demonstrated to patients for effective asthma management, per the text?

<p>Inhaler/spacer technique (B)</p> Signup and view all the answers

In the context of asthma management, what should patients be confirmed to know in case of worsening symptoms?

<p>What to do if asthma gets worse (D)</p> Signup and view all the answers

Which factor should be prioritized during patient education sessions for effective asthma control?

<p>'Asthma control and medications' (D)</p> Signup and view all the answers

What type of assessment should patients be able to perform for asthma control, as indicated in the text?

<p>'Self-assessment of asthma control' (D)</p> Signup and view all the answers

'Quality of life' is mentioned as an important focus area during subsequent visits to assess what aspect of asthma management?

<p>'Quality of life' related to asthma management (A)</p> Signup and view all the answers

'Teach or review and demonstrate' are actions recommended for which specific technique in the text?

<p>'Inhaler/spacer or VHC technique' (A)</p> Signup and view all the answers

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