Podcast
Questions and Answers
A postmenopausal woman with a history of well-controlled asthma begins estrogen replacement therapy. Which of the following is the MOST likely effect of this therapy on her asthma?
A postmenopausal woman with a history of well-controlled asthma begins estrogen replacement therapy. Which of the following is the MOST likely effect of this therapy on her asthma?
- Improved asthma control due to estrogen's anti-inflammatory properties.
- Exacerbation of asthma symptoms, potentially requiring an adjustment in asthma management. (correct)
- No change in asthma control, as estrogen has no significant impact.
- Reduced need for inhaled corticosteroids due to estrogen's bronchodilatory effects.
A patient with asthma is prescribed a non-selective beta-blocker for hypertension. What is the MOST important consideration regarding the use of this medication in the context of their asthma?
A patient with asthma is prescribed a non-selective beta-blocker for hypertension. What is the MOST important consideration regarding the use of this medication in the context of their asthma?
- The beta-blocker will have no impact on the patient's asthma control or response to asthma medications.
- The beta-blocker will enhance the effectiveness of the patient's albuterol inhaler.
- Non-selective beta-blockers can trigger immediate bronchospasm in asthmatic patients.
- Non-selective beta-blockers can prevent the reversal of bronchospasm by reducing the effects of albuterol. (correct)
A patient experiencing an acute asthma exacerbation is being treated in the emergency department. After initial SABA administration, the patient's symptoms remain severe. Which of the following routes of administration for corticosteroids is MOST appropriate at this stage?
A patient experiencing an acute asthma exacerbation is being treated in the emergency department. After initial SABA administration, the patient's symptoms remain severe. Which of the following routes of administration for corticosteroids is MOST appropriate at this stage?
- Oral
- Topical
- Intravenous (correct)
- Inhaled
A 7-year-old child with chronic asthma is prescribed montelukast. What is the appropriate daily dose of montelukast for this patient?
A 7-year-old child with chronic asthma is prescribed montelukast. What is the appropriate daily dose of montelukast for this patient?
A patient with a known aspirin allergy experiences a mild asthma exacerbation. Which of the following preventative treatments is MOST appropriate to manage their underlying asthma?
A patient with a known aspirin allergy experiences a mild asthma exacerbation. Which of the following preventative treatments is MOST appropriate to manage their underlying asthma?
A 14-year-old patient is prescribed budesonide via a dry powder inhaler (DPI) for persistent asthma. What is the MAXIMUM number of inhalations per day that should be recommended for this patient?
A 14-year-old patient is prescribed budesonide via a dry powder inhaler (DPI) for persistent asthma. What is the MAXIMUM number of inhalations per day that should be recommended for this patient?
Montelukast is prescribed for a patient with asthma. Which of the following mechanisms of action BEST describes how montelukast helps to manage asthma symptoms?
Montelukast is prescribed for a patient with asthma. Which of the following mechanisms of action BEST describes how montelukast helps to manage asthma symptoms?
Advair Diskus is prescribed for a 6-year-old child with asthma. What is the recommended dosage for this patient?
Advair Diskus is prescribed for a 6-year-old child with asthma. What is the recommended dosage for this patient?
A patient presents with acute bacterial rhinosinusitis. Which of the following bacteria is LEAST likely to be the causative agent?
A patient presents with acute bacterial rhinosinusitis. Which of the following bacteria is LEAST likely to be the causative agent?
An alcoholic patient is diagnosed with pneumonia. Based on the patient's history, which of the following bacterial pathogens is the MOST likely cause of their pneumonia?
An alcoholic patient is diagnosed with pneumonia. Based on the patient's history, which of the following bacterial pathogens is the MOST likely cause of their pneumonia?
Which statement accurately describes the mechanism of action of neuraminidase inhibitors like oseltamivir and zanamivir?
Which statement accurately describes the mechanism of action of neuraminidase inhibitors like oseltamivir and zanamivir?
A 3-year-old child is diagnosed with influenza. Which of the following neuraminidase inhibitors is an appropriate treatment option?
A 3-year-old child is diagnosed with influenza. Which of the following neuraminidase inhibitors is an appropriate treatment option?
A 70-year-old patient presents with pneumonia, a respiratory rate of 32 breaths per minute, blood urea nitrogen (BUN) of 25 mg/dL, and confusion. Their blood pressure is 92/62 mmHg. What is their CURB-65 score?
A 70-year-old patient presents with pneumonia, a respiratory rate of 32 breaths per minute, blood urea nitrogen (BUN) of 25 mg/dL, and confusion. Their blood pressure is 92/62 mmHg. What is their CURB-65 score?
According to GINA guidelines, which factor is MOST important when determining the appropriate step of asthma therapy for a patient?
According to GINA guidelines, which factor is MOST important when determining the appropriate step of asthma therapy for a patient?
A patient with asthma is prescribed a new Advair Diskus inhaler. What counseling point is MOST important to emphasize to the patient regarding its use and storage?
A patient with asthma is prescribed a new Advair Diskus inhaler. What counseling point is MOST important to emphasize to the patient regarding its use and storage?
A patient using a SABA inhaler for asthma is experiencing breakthrough symptoms. What is the correct advice regarding the administration of multiple puffs?
A patient using a SABA inhaler for asthma is experiencing breakthrough symptoms. What is the correct advice regarding the administration of multiple puffs?
Which statement accurately describes the use of spacers in asthma management?
Which statement accurately describes the use of spacers in asthma management?
A COPD patient is prescribed Spiriva Respimat. What key counseling point regarding its use is MOST important to convey?
A COPD patient is prescribed Spiriva Respimat. What key counseling point regarding its use is MOST important to convey?
In what scenario is it LEAST appropriate to consider stepping down the dose of an inhaled corticosteroid (ICS) in a patient with stable asthma?
In what scenario is it LEAST appropriate to consider stepping down the dose of an inhaled corticosteroid (ICS) in a patient with stable asthma?
Which of the following medications is NOT typically used as a component in the acute treatment of an asthma exacerbation?
Which of the following medications is NOT typically used as a component in the acute treatment of an asthma exacerbation?
Which of the following is a correct statement about the use of inhaled medications?
Which of the following is a correct statement about the use of inhaled medications?
A patient taking theophylline is also prescribed a fluoroquinolone antibiotic. What is the most likely effect of this drug interaction?
A patient taking theophylline is also prescribed a fluoroquinolone antibiotic. What is the most likely effect of this drug interaction?
A patient with COPD is interested in quitting smoking. They have a history of well-controlled hypertension but had a myocardial infarction (MI) 1 week ago. Which smoking cessation aid is contraindicated for this patient?
A patient with COPD is interested in quitting smoking. They have a history of well-controlled hypertension but had a myocardial infarction (MI) 1 week ago. Which smoking cessation aid is contraindicated for this patient?
Which of the following factors would suggest a patient with Community-Acquired Pneumonia (CAP) should be treated empirically for MRSA?
Which of the following factors would suggest a patient with Community-Acquired Pneumonia (CAP) should be treated empirically for MRSA?
A 7-year-old child presents with acute otitis media. The parent reports the child has taken amoxicillin in the past month and has purulent conjunctivitis. Which of the following is the MOST appropriate first-line antibiotic choice?
A 7-year-old child presents with acute otitis media. The parent reports the child has taken amoxicillin in the past month and has purulent conjunctivitis. Which of the following is the MOST appropriate first-line antibiotic choice?
A patient with CAP is treated initially with appropriate antibiotics. After 72 hours, the patient shows no improvement. What is the next appropriate step in managing this patient?
A patient with CAP is treated initially with appropriate antibiotics. After 72 hours, the patient shows no improvement. What is the next appropriate step in managing this patient?
A patient is diagnosed with CAP and meets the criteria for severe pneumonia. Which of the following CURB-65 criteria would classify the pneumonia as 'severe'?
A patient is diagnosed with CAP and meets the criteria for severe pneumonia. Which of the following CURB-65 criteria would classify the pneumonia as 'severe'?
A patient with a known theophylline allergy requires bronchodilation. Which medication would be the MOST appropriate alternative?
A patient with a known theophylline allergy requires bronchodilation. Which medication would be the MOST appropriate alternative?
What is the recommended duration of antibiotic treatment for a 5-year-old child with mild-to-moderate acute otitis media?
What is the recommended duration of antibiotic treatment for a 5-year-old child with mild-to-moderate acute otitis media?
For a patient experiencing an asthma exacerbation with an initial FEV1 less than 30% of the predicted value, which of the following albuterol administration methods is MOST appropriate?
For a patient experiencing an asthma exacerbation with an initial FEV1 less than 30% of the predicted value, which of the following albuterol administration methods is MOST appropriate?
A 67-year-old patient with a history of COPD is discussing pneumonia vaccinations with their healthcare provider. According to the guidelines, which of the following is the MOST appropriate recommendation?
A 67-year-old patient with a history of COPD is discussing pneumonia vaccinations with their healthcare provider. According to the guidelines, which of the following is the MOST appropriate recommendation?
A patient with asthma is prescribed a long-acting beta-agonist (LABA). Which of the following statements is MOST accurate regarding LABA therapy for asthma?
A patient with asthma is prescribed a long-acting beta-agonist (LABA). Which of the following statements is MOST accurate regarding LABA therapy for asthma?
A child with acute asthma exacerbation is prescribed albuterol. What is the mechanism of action of albuterol in treating asthma symptoms?
A child with acute asthma exacerbation is prescribed albuterol. What is the mechanism of action of albuterol in treating asthma symptoms?
Which of the following inhaled corticosteroids is NOT used to reduce inflammation in asthma?
Which of the following inhaled corticosteroids is NOT used to reduce inflammation in asthma?
A patient with asthma is prescribed ipratropium. What is the mechanism of action of ipratropium?
A patient with asthma is prescribed ipratropium. What is the mechanism of action of ipratropium?
A patient with asthma is prescribed montelukast. What is the mechanism of action of montelukast?
A patient with asthma is prescribed montelukast. What is the mechanism of action of montelukast?
According to GINA guidelines, which inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA) combination is recommended for Maintenance and Reliever Therapy (MART) in asthma?
According to GINA guidelines, which inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA) combination is recommended for Maintenance and Reliever Therapy (MART) in asthma?
A 45-year-old patient with COPD is prescribed Symbicort (budesonide/formoterol) for maintenance therapy. They are using 2 inhalations twice daily of the 160 mcg budesonide strength. During an exacerbation, they use an additional 2 inhalations as needed, up to a maximum of 12 inhalations per day. What is the maximum total daily dose of budesonide this patient could potentially receive?
A 45-year-old patient with COPD is prescribed Symbicort (budesonide/formoterol) for maintenance therapy. They are using 2 inhalations twice daily of the 160 mcg budesonide strength. During an exacerbation, they use an additional 2 inhalations as needed, up to a maximum of 12 inhalations per day. What is the maximum total daily dose of budesonide this patient could potentially receive?
A patient with severe allergic asthma is prescribed omalizumab. Which factor is MOST important to consider when determining the appropriate dose of omalizumab?
A patient with severe allergic asthma is prescribed omalizumab. Which factor is MOST important to consider when determining the appropriate dose of omalizumab?
A 68-year-old COPD patient, who has experienced 5 exacerbations in the past year, presents with increased dyspnea, cough, and sputum production. Which of the following is the MOST appropriate initial treatment strategy?
A 68-year-old COPD patient, who has experienced 5 exacerbations in the past year, presents with increased dyspnea, cough, and sputum production. Which of the following is the MOST appropriate initial treatment strategy?
Which administration schedule is correct for omalizumab?
Which administration schedule is correct for omalizumab?
Which pneumococcal vaccine is recommended for adults aged 19-50 with COPD?
Which pneumococcal vaccine is recommended for adults aged 19-50 with COPD?
A patient with COPD is prescribed salmeterol. What is the route of administration for salmeterol?
A patient with COPD is prescribed salmeterol. What is the route of administration for salmeterol?
A COPD patient is prescribed azithromycin for a bacterial infection. What potential adverse effect should the healthcare provider specifically monitor for, considering the patient's COPD?
A COPD patient is prescribed azithromycin for a bacterial infection. What potential adverse effect should the healthcare provider specifically monitor for, considering the patient's COPD?
A patient with COPD is prescribed umeclidinium. What is the mechanism of action of umeclidinium?
A patient with COPD is prescribed umeclidinium. What is the mechanism of action of umeclidinium?
A patient with COPD is on triple therapy but continues to have persistent symptoms. Which of the following medications might be considered next, according to the guidelines?
A patient with COPD is on triple therapy but continues to have persistent symptoms. Which of the following medications might be considered next, according to the guidelines?
An elderly patient with COPD is prescribed long-term oral corticosteroids. Which potential long-term adverse effect is of particular concern in this geriatric population?
An elderly patient with COPD is prescribed long-term oral corticosteroids. Which potential long-term adverse effect is of particular concern in this geriatric population?
A patient with acute COPD exacerbation presents with increased dyspnea and sputum production. They have no fever, but their sputum is purulent. According to current guidelines, what is the MOST appropriate initial treatment?
A patient with acute COPD exacerbation presents with increased dyspnea and sputum production. They have no fever, but their sputum is purulent. According to current guidelines, what is the MOST appropriate initial treatment?
A patient with COPD is prescribed azithromycin for long-term management. What is a potential adverse effect of azithromycin that the healthcare provider should monitor?
A patient with COPD is prescribed azithromycin for long-term management. What is a potential adverse effect of azithromycin that the healthcare provider should monitor?
Which medication is contraindicated with Theophylline due to similar MOA?
Which medication is contraindicated with Theophylline due to similar MOA?
A patient with a history of frequent COPD exacerbations is prescribed a new medication. After starting the medication, the patient reports experiencing muscle weakness and tremors. Which class of medications is MOST likely responsible for these adverse effects?
A patient with a history of frequent COPD exacerbations is prescribed a new medication. After starting the medication, the patient reports experiencing muscle weakness and tremors. Which class of medications is MOST likely responsible for these adverse effects?
A patient with end-stage COPD is experiencing severe dyspnea despite optimal bronchodilator therapy. Which of the following medications may be considered for symptomatic relief of dyspnea?
A patient with end-stage COPD is experiencing severe dyspnea despite optimal bronchodilator therapy. Which of the following medications may be considered for symptomatic relief of dyspnea?
Flashcards
Estrogen and asthma
Estrogen and asthma
Estrogen may worsen asthma during menopause and PMS; progesterone may mitigate effects.
Non-selective beta blockers
Non-selective beta blockers
Propranolol does not cause bronchospasm but can reduce albuterol effectiveness.
ICS's for asthma
ICS's for asthma
Inhaled corticosteroids are the primary preventive treatment for asthma.
Acute asthma exacerbation treatment
Acute asthma exacerbation treatment
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Montelukast (Singulair)
Montelukast (Singulair)
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Doses for Mometasone furoate
Doses for Mometasone furoate
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Severe asthma treatment
Severe asthma treatment
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Administer Montelukast timing
Administer Montelukast timing
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Asthma Step Therapy
Asthma Step Therapy
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Symbicort
Symbicort
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SABA Inhaler Technique
SABA Inhaler Technique
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Spiriva Respimat
Spiriva Respimat
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ICS Therapy Dosing
ICS Therapy Dosing
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Acute Asthma Exacerbation Medications
Acute Asthma Exacerbation Medications
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COPD Expiration Dates
COPD Expiration Dates
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Advair Diskus
Advair Diskus
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S.Pneumonia
S.Pneumonia
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Oseltamivir
Oseltamivir
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CURB-65
CURB-65
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Zanamivir
Zanamivir
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Klebsiella pneumoniae
Klebsiella pneumoniae
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GINA guidelines MART therapy
GINA guidelines MART therapy
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Doses of Symbicort
Doses of Symbicort
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Prednisone for COPD
Prednisone for COPD
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Cardinal symptoms of COPD
Cardinal symptoms of COPD
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Recommended antibiotics for COPD
Recommended antibiotics for COPD
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Short-term effects of steroids
Short-term effects of steroids
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COPD and pneumonia vaccines
COPD and pneumonia vaccines
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Theophylline therapeutic index
Theophylline therapeutic index
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Warnings for Theophylline use
Warnings for Theophylline use
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CYP enzymes and interactions
CYP enzymes and interactions
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Smoking effects on Theophylline
Smoking effects on Theophylline
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Nicotine replacement therapy (NRT) contraindications
Nicotine replacement therapy (NRT) contraindications
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Bupropion SR precautions
Bupropion SR precautions
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First line treatment for acute otitis media
First line treatment for acute otitis media
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Augmentin use criteria
Augmentin use criteria
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Continuous Nebulization
Continuous Nebulization
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Albuterol
Albuterol
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Guidelines for Vaccines
Guidelines for Vaccines
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Long-Acting Beta Agonists (LABA)
Long-Acting Beta Agonists (LABA)
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Inhaled Corticosteroids
Inhaled Corticosteroids
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Leukotriene Modifiers
Leukotriene Modifiers
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Tiotropium (Spiriva)
Tiotropium (Spiriva)
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Roflumilast
Roflumilast
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Methylxanthines
Methylxanthines
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Anticholinergics
Anticholinergics
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Biologics in Asthma
Biologics in Asthma
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Azithromycin
Azithromycin
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SABA/SAMA Use in COPD
SABA/SAMA Use in COPD
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Vaccination Post-50
Vaccination Post-50
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Study Notes
Estrogen Effects on Asthma
- Estrogen replacement during menopause may worsen asthma, especially without progesterone.
- Estrogen levels during premenstrual syndrome (PMS) may also worsen asthma.
- Non-selective beta blockers, such as propranolol, reduce the effectiveness of albuterol.
- Aspirin allergies should be considered when treating asthma.
Acute Asthma Exacerbation
- Initial treatment involves short-acting beta agonists (SABAs), like albuterol.
- Severe exacerbations require systemic corticosteroids (e.g., prednisone, methylprednisolone, dexamethasone) in combination with inhaled ipratropium (anticholinergic), intravenous magnesium sulfate, and supplemental oxygen (O2).
- Moderate to mild cases may benefit from oral corticosteroids.
- Recommended dosage of inhaled corticosteroids (ICS) varies by age and severity.
Montelukast (Singulair)
- A leukotriene receptor antagonist (LTRA).
- Reduces inflammation and smooth muscle contraction in the airways.
- Improves symptoms of chronic asthma.
Asthma Patient Management
- Management should follow GINA (Global Initiative for Asthma) guidelines.
- Appropriate inhalers, such as budesonide, mometasone, or advair, should be considered.
- Counseling points for asthma patients: prime inhalers, timing between puffs, and proper inhaler techniques (spacing, usage with mouth, etc.).
COPD Products
- Inhalers for COPD, such as Spiriva Respimat and Combivent, may be used. Important to check expiration dates.
- Proper use of inhalers: use appropriate techniques and spacers to ensure medication reaches the lungs properly -Turn, Open, Press (soft mist).
ICS Therapy
- Step-wise approach to manage asthma.
- Reduce dose by 25-50% every three months, if possible.
- Avoid dose reduction during pregnancy.
COPD Medications
- Long-acting beta agonists (LABAs) are not recommended for monotherapy in asthma.
- Medications for acute exacerbation should include short-acting beta agonists (SABAs)
- Know the mechanism of action of different classes of asthma medications
- Consider comorbidities and risks related to particular medications.
Asthma Management Guidelines
- Follow GINA guidelines for asthma management and treatment strategies.
- Consider other potential therapies based on severity.
- Dosage and frequency of medication should be considered carefully based on age and individual needs.
Vaccines and COPD
- Patients with COPD should receive annual influenza vaccines.
- Tetanus, diptheria and pertussis (Tdap) vaccines every 10 years.
- Review other recommended vaccines.
COPD Exacerbation Treatment
- Consider pneumonia and other bacterial infections when assessing COPD exacerbations.
- Consider appropriate antibiotics based on possible bacterial pathogens.
- Ensure proper dosages and treatment duration are considered.
Other Asthma/COPD Considerations
- Be aware of specific drug interactions and side effects.
- Patient history, allergies and comorbidities should be considered.
- Proper dosage should be considered, in relation to age and clinical situation.
- Review the information and focus on acute exacerbations and treatment strategies, particularly of COPD.
- Consider appropriate follow up.
Asthma and COPD Medications
- Thoroughly review each medication's mechanism of action (MOA).
Additional Treatments and Guidelines
- Review all available information for current treatment guidelines and indications.
- Review all adverse effects of relevant treatments.
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Description
The lesson covers hormonal influences on asthma, specifically estrogen's potential to worsen symptoms during menopause and PMS. It details acute exacerbation treatments, including SABAs, corticosteroids, and other therapies. It also includes the role of Montelukast in asthma management.