Asthma Patient Assessment Quiz
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Questions and Answers

What percentage of bad asthma exacerbations are due to respiratory infections?

  • 90%
  • 80% (correct)
  • 50%
  • 70%
  • What type of cells are the main drivers of inflammation in asthma?

  • Neutrophils
  • Macrophages
  • Eosinophils (correct)
  • Lymphocytes
  • What is the primary function of immature dendritic cells in asthma?

  • Antigen presentation (correct)
  • Inflammation
  • Airway constriction
  • Cytokine production
  • What is the goal of counselling patients with asthma?

    <p>To reduce lung remodelling</p> Signup and view all the answers

    What is the main characteristic of asthma?

    <p>It is a chronic obstructive lung disease that can be controlled but not cured</p> Signup and view all the answers

    What is a common symptom of asthma?

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

    What is the process that allows gas exchange?

    <p>Inspiration-expiration cycle</p> Signup and view all the answers

    What is an example of an asthma trigger?

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

    What is the term for the respiratory system's ability to respond to stimuli?

    <p>Hyper-responsiveness</p> Signup and view all the answers

    What is the purpose of spirometry in asthma diagnosis?

    <p>To document variable airflow limitation</p> Signup and view all the answers

    What is believed to contribute to the development of asthma?

    <p>Gene-environment interactions</p> Signup and view all the answers

    What is a risk factor for asthma exacerbations?

    <p>All of the above</p> Signup and view all the answers

    What is the name of the system that manages respiration?

    <p>CNS respiratory control system</p> Signup and view all the answers

    What happens during inspiration?

    <p>Diaphragm contracts, decreasing intra-pleural pressure</p> Signup and view all the answers

    What is the result of the diaphragm relaxing?

    <p>Triggering passively the process of expiration</p> Signup and view all the answers

    What are the two main characteristics of asthma?

    <p>Respiratory symptoms and excessive variation in expiratory air flow function</p> Signup and view all the answers

    How can a patient's adherence to preventers be checked?

    <p>By reviewing pharmacy records</p> Signup and view all the answers

    What is an indicator of poorly controlled asthma?

    <p>Frequent use of SABA inhalers</p> Signup and view all the answers

    What is the purpose of providing a Symptom diary for a GP visit?

    <p>To monitor symptoms and identify patterns</p> Signup and view all the answers

    What is an important aspect of asthma management that patients should be aware of?

    <p>What to do in a serious asthma flare-up</p> Signup and view all the answers

    Why is it important to check if a patient knows the appropriate technique for using their SABA inhaler?

    <p>To ensure the patient is using the inhaler correctly and receiving the full benefit of the medication</p> Signup and view all the answers

    What resource can be provided to patients for asthma management information?

    <p>Asthma Australia website</p> Signup and view all the answers

    What is the formulation strength of Terbutaline dry powder inhaler?

    <p>500 µgs/puff x 120 doses in inhaler</p> Signup and view all the answers

    What is the duration of action of Terbutaline?

    <p>4-5 hours</p> Signup and view all the answers

    What is the recommended dose of Terbutaline?

    <p>1-3 inhalations (500-1500 micrograms) when required</p> Signup and view all the answers

    What is the importance of proper inhaler use with Terbutaline?

    <p>To reduce systemic absorption</p> Signup and view all the answers

    Why is Terbutaline no longer subsidised by PBS for S4 versions?

    <p>No specific reason mentioned in the text</p> Signup and view all the answers

    What is a key point to discuss with patients using as needed SABAs?

    <p>The risk of severe flare-ups without inhaled corticosteroids</p> Signup and view all the answers

    What is an advantage of Dry Powder Inhalers (DPIs)?

    <p>They are more environmentally friendly</p> Signup and view all the answers

    What is a key role for pharmacists in dispensing S3 Relievers?

    <p>No specific role mentioned in the text</p> Signup and view all the answers

    What is the primary function of bronchodilators in asthma treatment?

    <p>To relax airway muscles and relieve bronchospasm</p> Signup and view all the answers

    What is the purpose of adding inhaled corticosteroids (ICS) to asthma treatment?

    <p>To reduce inflammation in the airways</p> Signup and view all the answers

    What is the recommended medication for most children with asthma?

    <p>Short-acting beta agonists (SABAs)</p> Signup and view all the answers

    What is the recommended combination of medications for children aged 1-5 years?

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

    What is the name of the medication that can precipitate acute angle-closure glaucoma?

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

    What is the time to action of Salbutamol?

    <p>1-2 minutes</p> Signup and view all the answers

    What is the formulation strength of Salbutamol in a pressurised metered dose inhaler?

    <p>100 µgs/puff</p> Signup and view all the answers

    What is a common side effect of Salbutamol?

    <p>Skeletal muscle tremor</p> Signup and view all the answers

    Study Notes

    Asthma Control

    • Check patient's asthma control by assessing symptoms, medication use, and lung function
    • Check if patient has been prescribed preventers and is adherent to medication
    • Check level of SABA usage and patient's technique for using SABA inhaler
    • Check for comorbid conditions (AR, OSA, GORD) and refer if needed
    • Check if patient has an asthma action plan

    Asthma Management

    • Provide Reliver PuEer and demonstrate proper technique
    • Provide Bisolvon Dry Cough Liquid if necessary
    • Educate patient on preventer use and asthma management
    • Raise awareness about serious asthma flare-ups and asthma first aid
    • Suggest keeping a symptom diary for GP visits
    • Provide information on asthma management (Asthma Australia) and record key counseling

    Asthma Trajectories

    • Variable pathways: early onset (atopic), post-puberty resolution/new development, adult onset (late onset asthma)
    • Importance of understanding trajectories to answer patient questions about growing out of asthma

    Respiratory Tract

    • Inspiration: contraction of diaphragm and external intercostal muscles increase thoracic cavity space and decrease intra-pleural pressure
    • Expiration: relaxation of diaphragm and increase in intra-pleural pressure
    • Inspiration-expiration cycle allows for gas exchange

    Respiration Control

    • Managed by CNS respiratory control system
    • Central neural respiratory generator
    • Sensory input system (thoracic neural receptors, peripheral and central medullary chemoreceptors)
    • Muscular effector system

    Asthma Pathogenesis and Pathophysiology

    • Asthma is a chronic obstructive lung disease that can be controlled but not cured
    • Characterized by respiratory symptoms (cough, wheeze, dyspnoea, or chest tightness) and excessive variation in expiratory airflow function
    • Associated with airway inflammation and airway hyper-responsiveness

    Risk Factors for Asthma

    • House dust mites
    • Mould
    • Pets
    • Pollen
    • Cigarette smoke
    • Exercise
    • Smoke
    • Chemicals
    • Stress
    • Emotions
    • Hormonal changes (women)
    • Respiratory infections (common cold = 80% of bad asthma exacerbations)
    • Weather (e.g. thunderstorms)
    • Medications
    • Occupational exposures

    Asthma Pathophysiology

    • Repeated infections/exposures disrupt airway epithelial barrier leading to danger signaling and chemokine secretion
    • Immature dendritic cells (DC) act as antigen-presenting cells (APCs)
    • Allergen-linked APCs stimulate naïve T helper cells to differentiate to Th2 cells
    • Cytokines linked to Th2 cell response drive inflammation (majority of asthma cases) - eosinophils are the main driver

    Counselling on Controlling Asthma

    • Educate patients on controlling asthma to reduce lung remodeling
    • Importance of preventers in asthma management

    Asthma Diagnosis

    • History (family, symptoms, pattern)
    • Physical examination (wheeze)
    • Consideration of other diagnoses
    • Documenting variable airflow limitation (spirometry)

    Assessing Asthma Control

    • Risk factors for asthma flare-ups

    Asthma Treatment Principles

    • Bronchodilators (relievers): SABAs, LABAs, SAMAs/LAMAs
    • Anti-inflammatory agents (preventers): ICS, LTRAs, targeted biologic agents
    • Need for preventers if symptoms occur more than twice a month
    • Most children can be treated with SABA alone or with ICS or montelukast additions
    • No ICS+LABA combination allowed for 1-5 years children

    Reliever Medications - Schedule 3

    • Short-acting beta agonists (SABAs): salbutamol and terbutaline
    • Salbutamol: formulation type, strength, time to action, elimination half-life, dose, precautions, side effects
    • Terbutaline: formulation type, strength, time to action, elimination half-life, dose, precautions, side effects

    Dry Powder Inhalers - Turbuhalers

    • Teach back method: key steps

    Key Roles for Pharmacists

    • Educate patients on proper inhaler use
    • Counsel patients on asthma management and control
    • Monitor patient adherence to medication and asthma control
    • Identify and address SABA use issues

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    Asthma PDF

    Description

    Assess your knowledge on evaluating asthma control in patients, including symptom assessment, medication adherence, and comorbidity checks. Learn about asthma management techniques and best practices.

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