Chapter 11 - Drugs for Treating Asthma - Mixed

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Questions and Answers

Which of the following best explains the primary mechanism by which asthma rescue drugs like albuterol provide immediate relief during an asthma exacerbation?

  • Relax bronchial smooth muscle leading to bronchodilation. (correct)
  • Suppress the immune response to prevent allergen-induced bronchoconstriction.
  • Block the release of histamine from mast cells.
  • Reduce inflammation in the airways to prevent mucus production.

The primary mechanism of action for inhaled corticosteroids, such as fluticasone, in long-term asthma control involves immediate bronchodilation to alleviate acute symptoms.

False (B)

During an asthma exacerbation, if a patient presents with a 'quiet chest' despite obvious dyspnea, what critical underlying physiological condition should be suspected?

severe airflow obstruction

The combination drug DuoNeb combines albuterol, a beta-agonist, with __________, an anticholinergic, to provide bronchodilation through complementary mechanisms.

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

Match the following clinical presentations with the assessment of asthma severity:

<p>Respiratory rate &gt;30 breaths/min = Potentially fatal asthma attack Use of accessory muscles of respiration = Potentially fatal asthma attack Heart rate &gt;120 beats/min = Potentially fatal asthma attack Peak expiratory flow (PEF) = Potentially fatal asthma attack</p> Signup and view all the answers

Which of the following signs in a patient experiencing an asthma exacerbation is MOST indicative of impending respiratory failure?

<p>Altered level of consciousness with a quiet chest. (A)</p> Signup and view all the answers

Systemic corticosteroids, like prednisone, provide immediate bronchodilation and are therefore the first-line treatment for acute asthma exacerbations.

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

In the context of asthma management, what is the primary benefit of using a long-acting beta-adrenergic agonist (LABA) like salmeterol in conjunction with an inhaled corticosteroid?

<p>improved long-term asthma control</p> Signup and view all the answers

A patient experiencing difficulty speaking in full sentences due to dyspnea during an asthma attack would be demonstrating a symptom indicative of a __________ exacerbation.

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

Match the following medications with their primary mechanism of action in managing asthma:

<p>Albuterol = Beta-agonist - bronchodilation Ipratropium = Anticholinergic - reduces bronchoconstriction Fluticasone = Inhaled corticosteroid - reduces airway inflammation Salmeterol = Long-acting beta-agonist - long term bronchodilation</p> Signup and view all the answers

A patient with asthma presents to the emergency department. Which of the following findings would be MOST concerning for a potentially fatal asthma attack?

<p>Inability to lie supine and altered level of consciousness. (B)</p> Signup and view all the answers

Asthma is characterized by fixed and irreversible airway obstruction, making long-term management focused solely on symptom relief rather than addressing underlying inflammation.

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

Explain why monitoring peak expiratory flow (PEF) is clinically useful in managing patients with asthma.

<p>identifies worsening airflow obstruction</p> Signup and view all the answers

In the management of acute asthma exacerbations, administering oxygen is vital to counteract __________, a common consequence of reduced airflow.

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

Match the following asthma symptoms with their potential underlying pathophysiological mechanisms:

<p>Wheezing = Airflow obstruction through narrowed airways Chest tightness = Smooth muscle constriction increasing intra-thoracic pressure Dyspnea = Increased effort to breathe against increased resistance Cough = Airway irritation and mucus production</p> Signup and view all the answers

Which of the following medication regimens is MOST appropriate for long-term control of moderate persistent asthma in an adult patient?

<p>Daily inhaled corticosteroid with as-needed albuterol. (D)</p> Signup and view all the answers

A patient experiencing an asthma attack who is able to speak in full sentences and has a peak expiratory flow (PEF) greater than 70% of their personal best is likely experiencing a life-threatening exacerbation.

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

Explain the rationale behind using combination inhalers containing both an inhaled corticosteroid and a long-acting beta-agonist (LABA) in asthma management.

<p>synergistic anti-inflammatory and bronchodilator effects</p> Signup and view all the answers

The presence of __________ during auscultation of the lungs can be absent in severe asthma exacerbations if airflow is markedly reduced.

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

Match the following medications with their potential side effects:

<p>Albuterol = Tachycardia, tremor Ipratropium = Dry mouth, blurred vision Inhaled corticosteroids = Oral thrush, hoarseness Systemic corticosteroids = Hyperglycemia, mood changes</p> Signup and view all the answers

A patient experiencing an asthma exacerbation is diaphoretic. What is the most likely underlying cause?

<p>The use of accessory muscles of respiration and increased work of breathing. (B)</p> Signup and view all the answers

Anticholinergic medications like ipratropium primarily work in asthma by directly relaxing the smooth muscles of the airways.

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

Why is it essential to educate asthma patients about the proper technique for using their inhalers?

<p>Ensures optimal drug delivery to the lungs.</p> Signup and view all the answers

In asthma, chronic airway inflammation can lead to structural changes, including __________ and airway remodeling, which can contribute to irreversible airflow obstruction.

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

Match the following signs/symptoms to their corresponding level of consciousness:

<p>Disorientation = Altered Confusion = Altered Agitation = Altered Lethargy = Altered</p> Signup and view all the answers

Which of the following represents the BEST approach to managing a patient who was recently discharged after being hospitalized for an asthma exacerbation?

<p>Schedule a follow-up appointment within 1 week and review their asthma action plan. (A)</p> Signup and view all the answers

The use of accessory muscles during respiration is a normal finding in healthy individuals and indicates efficient breathing.

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

In managing a severe asthma exacerbation, why might a physician consider administering intravenous magnesium sulfate?

<p>to act as a bronchodilator</p> Signup and view all the answers

The primary goal of a written asthma action plan is to provide patients with clear instructions on how to __________ their asthma and when to seek medical attention.

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

Match the following components of asthma pathogenesis with their corresponding therapeutic targets:

<p>Airway inflammation = Inhaled corticosteroids Bronchoconstriction = Beta-agonists, anticholinergics Mucus hypersecretion = Hydration, mucolytics Airway edema = Systemic corticosteroids</p> Signup and view all the answers

Which of the following statements is MOST accurate regarding the role of leukotriene modifiers (e.g., montelukast) in asthma management?

<p>They can be a useful add-on therapy for patients with persistent asthma not well controlled on inhaled corticosteroids. (A)</p> Signup and view all the answers

Patients with asthma should always avoid exercise, as it invariably triggers bronchoconstriction and exacerbates symptoms.

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

What specific advice should be given to a patient using an inhaled corticosteroid to minimize the risk of oral thrush?

<p>Rinse mouth thoroughly with water after each use.</p> Signup and view all the answers

In the context of asthma, airway __________ is the phenomenon where the airways become increasingly sensitive to various triggers, leading to amplified bronchoconstrictor responses.

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

Match the following pulmonary function tests with their primary clinical utility in assessing asthma:

<p>Spirometry = Assess airflow obstruction and reversibility Peak expiratory flow (PEF) monitoring = Assess diurnal variability and response to treatment Bronchial provocation testing = Assess airway hyperreactivity Lung volume measurements = Exclude other pulmonary diseases</p> Signup and view all the answers

A patient with a history of severe asthma presents to the emergency department with a peak expiratory flow (PEF) of 25% of their personal best, is unable to speak in full sentences, and appears confused. What is the MOST appropriate initial step in management?

<p>Administer supplemental oxygen and prepare for possible intubation and mechanical ventilation. (C)</p> Signup and view all the answers

Asthma is solely an inflammatory condition, and bronchoconstriction plays a minimal role.

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

Besides medications, what are some non-pharmacological strategies that can help improve asthma control?

<p>allergen avoidance, smoking cessation</p> Signup and view all the answers

Asthma is characterized by irreversible bronchoconstriction.

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

Name three signs of a potentially fatal asthma attack.

<p>Use of accessory muscles of respiration, Heart rate &gt;120 beats/min or increasing, Respiratory rate &gt;25-30 breaths/min</p> Signup and view all the answers

The drug class ___________ includes medications like albuterol, which are used as rescue medications for asthma.

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

Match each asthma medication with its corresponding drug class:

<p>Fluticasone = Inhaled corticosteroid Albuterol = Short-acting beta-agonist Ipratropium = Anticholinergic Salmeterol = Long-acting beta-adrenergic agonist</p> Signup and view all the answers

Which of the following is NOT a typical symptom or sign of asthma?

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

Systemic corticosteroids are considered long-term asthma control medications.

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

What is the generic name for the trade name drug Proventil used as a rescue medication?

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

A combination asthma medication containing both ipratropium and albuterol is known by the trade name ___________.

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

Match the following signs with their significance in assessing a potentially fatal asthma attack:

<p>Altered level of consciousness = Indicates severe hypoxemia and/or hypercapnia Inability to lie supine = Suggests significant respiratory distress Diaphoresis = May indicate increased work of breathing and sympathetic response Quiet chest = Signifies minimal air movement due to severe obstruction</p> Signup and view all the answers

Which statement best describes the pathophysiology of asthma?

<p>Diffuse airway inflammation leading to reversible bronchoconstriction (A)</p> Signup and view all the answers

The worsening of airflow obstruction in asthma always occurs rapidly over minutes.

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

Name the inhaled corticosteroid mentioned for long-term asthma control.

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

__________ is a long-acting beta-adrenergic agonist used for long-term asthma control and is not used as a rescue medication.

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

Match the asthma medication with its appropriate use:

<p>Albuterol (ProAir) = Rescue medication for acute asthma symptoms Fluticasone (Flovent) = Long-term control of airway inflammation Salmeterol (Serevent) = Long-term bronchodilation (use with inhaled corticosteroid) Prednisone = Short-term control of severe asthma exacerbations</p> Signup and view all the answers

Which of the following findings suggests the MOST severe airflow obstruction in a patient experiencing an asthma exacerbation?

<p>Absence of wheezing with decreased level of consciousness (D)</p> Signup and view all the answers

Heart rate variability is typically increased during a severe asthma exacerbation.

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

Other than oxygen saturation, what single numeric measurement obtained at the bedside provides the best assessment of airflow obstruction?

<p>Peak expiratory flow</p> Signup and view all the answers

Inhaled __________ are considered first-line therapy for the long-term control of asthma due to their potent anti-inflammatory effects in the airways.

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

Match the feature with the most appropriate phase of asthma management:

<p>Short acting beta-agonist = Acute exacerbation Systemic corticosteroids = Acute exacerbation Inhaled corticosteroid = Long-term maintenance Long-acting beta-agonists = Long-term maintenance</p> Signup and view all the answers

A patient has a history of asthma brought on by seasonal allergies. Which medication would be the MOST appropriate for long-term management to prevent exacerbations?

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

A patient presenting with a PEF of 90% requires immediate admission to a hospital.

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

What is the potential consequence of over-reliance on short-acting beta-agonists without addressing the underlying inflammation in asthma?

<p>Increased risk of exacerbations</p> Signup and view all the answers

When using a combination inhaler containing an inhaled corticosteroid and a long-acting beta-agonist, it is important to rinse the mouth with water after each use to prevent __________.

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

Match each drug with the most likely mechanism of action

<p>Albuterol = Beta-2 adrenergic agonist Fluticasone = Synthetic Glucocorticoid Ipratropium = Muscarinic antagonist</p> Signup and view all the answers

Which finding would be LEAST indicative of a potentially fatal asthma attack?

<p>Respiratory rate of 18 breaths/min (A)</p> Signup and view all the answers

A patient presents with dyspnea, wheezing, and a peak expiratory flow (PEF) of <40% of their personal best. They are using accessory muscles to breathe. What class of medication would be most appropriate for initial acute management?

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

In severe asthma exacerbations, a 'quiet chest' upon auscultation in a patient experiencing dyspnea may indicate significant air trapping and reduced airflow and is an ominous ______.

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

Match each medication to its primary classification for asthma management:

<p>Albuterol = Short-acting beta-agonist Fluticasone = Inhaled corticosteroid Salmeterol = Long-acting beta-adrenergic agonist Ipratropium = Anticholinergic</p> Signup and view all the answers

Which of the following medications is classified as a long-acting beta-adrenergic agonist?

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

Systemic corticosteroids are typically used as first-line rescue medications for mild asthma exacerbations.

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

Name two signs, besides vital sign abnormalities, that might suggest a potentially fatal asthma attack.

<p>Altered level of consciousness, inability to lie supine</p> Signup and view all the answers

The combination drug DuoNeb contains both albuterol and ______.

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

Match the following medications with their corresponding trade names:

<p>Albuterol = Proventil Ipratropium = Atrovent Fluticasone = Flovent Salmeterol = Serevent Diskus</p> Signup and view all the answers

A patient with asthma uses albuterol frequently. Which of the following is the primary mechanism of action of this medication?

<p>Relaxes smooth muscle in the airways (A)</p> Signup and view all the answers

Long-acting beta-agonists like salmeterol are appropriate for treating acute asthma symptoms.

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

Which class of asthma medication is known to potentially cause thrush (oral candidiasis) as a side effect, and what is a recommended way to prevent it?

<p>Inhaled corticosteroids; rinse mouth after use</p> Signup and view all the answers

The primary effect of anticholinergic medications like ipratropium in asthma is to block ______ receptors in the airways, leading to bronchodilation.

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

Match the following characteristics to the appropriate asthma medication:

<p>Fast onset of action = Albuterol Prolonged duration of action = Salmeterol Anti-inflammatory effects = Fluticasone Used in combination with albuterol in DuoNeb = Ipratropium</p> Signup and view all the answers

A patient presents to the emergency department with a severe asthma exacerbation. Despite initial treatment with albuterol, their symptoms have not improved. Which medication would be most appropriate to administer next?

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

Patients experiencing a fatal asthma attack will always exhibit wheezing upon auscultation.

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

Provide two possible triggers that can cause asthma symptoms.

<p>allergens, exercise</p> Signup and view all the answers

The presence of ________ muscles of respiration suggests an increased work of breathing and may indicate a severe asthma exacerbation.

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

Match signs of a potentially fatal ashma attack with their possible values

<p>Heart rate = &gt;120 beats/min Respiratory rate = &gt;25-30 breaths/min Speak Difficulty = dyspnea or fatigue</p> Signup and view all the answers

Which of the following inhaled medications is primarily used for long-term asthma control rather than acute symptom relief?

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

The primary mechanism of action of ipratropium is to stimulate beta-2 adrenergic receptors in the lungs.

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

Name two symptoms that would prompt you to believe a patient is suffering from asthma

<p>wheezing, shortness of breath</p> Signup and view all the answers

Diaphoresis, or excessive ______, can indicate a person is suffering from a potentially fatal asthma attack.

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

Match each medication with its appropriate role in asthma management:

<p>Albuterol = Relief of acute asthma symptoms Fluticasone = Reduction of airway inflammation Salmeterol = Prevention of asthma symptoms Prednisone = Treatment of severe asthma exacerbations</p> Signup and view all the answers

A patient using a fluticasone inhaler should be educated about what potential side effect?

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

If a patient with asthma is able to speak in full sentences without difficulty, it is unlikely they are experiencing a severe exacerbation.

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

What is a 'quiet chest' and what does it indicate?

<p>absence of wheezing; reduced airflow</p> Signup and view all the answers

A peak expiratory flow (PEF) of less than ________ % of a patient's personal best may indicate a severe asthma exacerbation.

<p>40</p> Signup and view all the answers

Match the following drug classes with their corresponding time to symptom relief:

<p>Short-Acting Beta-Agonists = Rapid Relief Inhaled Corticosteroids = Long-Term Control Long-Acting Beta-Adrenergic Agonists = Sustained Improvement Anticholinergics = Moderate Relief</p> Signup and view all the answers

Which of the symptoms most clearly indicates that an asthma patient is suffering a severe or potentially fatal asthma attack?

<p>Altered level of consciousness (B)</p> Signup and view all the answers

Asthma symptoms typically develop over a period of days.

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

What is the generic name and respective trade name for a short acting beta-agonist?

<p>albuterol; Proventil</p> Signup and view all the answers

Most severe exacerbations of asthma that are treated in the emergency department resolve within ________ hours after presentation.

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

Match each drug trade name with its drug class:

<p>ProAir = Short-acting beta-agonists Atrovent = Anticholinergics Flovent = Inhaled corticosteroids Serevent Diskus = Long-acting beta-adrenergic agonists</p> Signup and view all the answers

Which of the following statements best describes the underlying cause of asthma?

<p>Diffuse airway inflammation caused by a variety of triggering stimuli resulting in reversible bronchoconstriction. (D)</p> Signup and view all the answers

The use of asthma rescue drugs such as short acting beta-agonists have no adverse effects.

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

Name a systemic corticosteroid used in asthma management.

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

The symptoms of asthma include dyspnea, chest tightness, ______ and wheezing.

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

Which of the following signs, if observed during an asthma exacerbation, would be MOST indicative of a potentially fatal asthma attack?

<p>Quiet chest in a patient with reduced level of consciousness. (B)</p> Signup and view all the answers

Asthma is characterized by irreversible bronchoconstriction, regardless of the triggering stimuli.

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

A patient with asthma presents to the emergency department. List three primary symptoms or signs commonly associated with an asthma exacerbation.

<p>Dyspnea, chest tightness, wheezing</p> Signup and view all the answers

The drug __________ is a short-acting beta-agonist used as a rescue medication for asthma.

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

Match each asthma medication with its primary mechanism of action:

<p>Albuterol = Bronchodilation via beta-2 adrenergic receptor agonism Ipratropium = Bronchodilation via anticholinergic effects Fluticasone = Reduction of airway inflammation via corticosteroid action Salmeterol = Long-acting bronchodilation via beta-2 adrenergic receptor agonism</p> Signup and view all the answers

Which of the following factors is LEAST likely to contribute to fatal or near-fatal asthma attacks?

<p>Early recognition and aggressive treatment of symptoms. (B)</p> Signup and view all the answers

Systemic corticosteroids, such as Prednisone, are typically used as first-line rescue medications for immediate relief of asthma symptoms.

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

Name two drug classes used for long-term asthma control and provide an example of a generic medication from each class.

<p>Inhaled corticosteroids (e.g., Fluticasone) and Long-acting beta-adrenergic agonists (e.g., Salmeterol)</p> Signup and view all the answers

Match each clinical sign with the corresponding severity level it suggests in an asthma exacerbation:

<p>Respiratory rate &gt; 30 breaths/min = Indicates moderate to severe distress Difficulty speaking = Indicates moderate to severe distress Altered level of consciousness = Indicates potentially fatal attack Peak expiratory flow (PEF) 60-80% predicted = Indicates mild to moderate distress</p> Signup and view all the answers

In the context of asthma management, what is the primary benefit of using inhaled corticosteroids?

<p>Reduction of airway inflammation to prevent future exacerbations. (C)</p> Signup and view all the answers

The primary mechanism of action of Ipratropium in asthma treatment is the stimulation of beta-2 adrenergic receptors in the lungs.

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

What are two potential signs or symptoms that distinguish a potentially fatal asthma attack from a moderate asthma exacerbation?

<p>Altered level of consciousness, quiet chest</p> Signup and view all the answers

__________ and __________ are both trade names for the generic medication Albuterol.

<p>Proventil, Ventolin</p> Signup and view all the answers

Match the following signs with their potential implications during an asthma exacerbation:

<p>Diaphoresis = Sign of increased work of breathing and potential respiratory distress Inability to lie supine = Indicates severe breathing distress Increasing heart rate = Sign of worsening distress or response to hypoxemia Use of accessory muscles = Indicates increased effort to breathe</p> Signup and view all the answers

Why is it critical to recognize the potential for early intervention in even the most severe asthma attacks?

<p>Because even in fatal or near-fatal attacks, there is potential for improvement with aggressive treatment. (C)</p> Signup and view all the answers

Long-acting beta-agonists (LABAs) like Salmeterol are recommended as first-line monotherapy for persistent asthma.

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

Name three factors that can contribute to the variability in the onset, duration, and severity of asthma symptoms prior to a patient seeking emergency care.

<p>Triggering stimuli, individual patient response, adherence to medications.</p> Signup and view all the answers

__________ is a generic name for inhaled corticosteroids that is often prescribed for long-term asthma control.

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

Which characteristic of asthma distinguishes it most clearly from other chronic obstructive pulmonary diseases (COPD)?

<p>Partially or completely reversible bronchoconstriction. (D)</p> Signup and view all the answers

The primary goal of long-term asthma control medications is to provide immediate relief during acute asthma exacerbations.

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

Describe the physiological process underlying asthma, naming the key elements that contribute to airway obstruction.

<p>Airway inflammation, bronchoconstriction, mucus production</p> Signup and view all the answers

The presence of __________ during an asthma attack suggests increased work of breathing and potential respiratory distress.

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

Match the following assessment findings with their corresponding significance in evaluating an asthma patient:

<p>PEF &gt; 80% predicted = Indicates mild to no airflow obstruction Accessory muscle use = Suggests significant respiratory effort Heart rate &gt; 120 bpm = May indicate hypoxemia or distress Altered mental status = Serious sign of hypoxemia or respiratory failure</p> Signup and view all the answers

Flashcards

Albuterol

Albuterol, available as Proventil, ProAir, and Ventolin, is a short-acting beta-agonist used as a rescue medication for asthma.

Ipratropium

Ipratropium (Atrovent) is an anticholinergic drug used as a rescue medication for asthma.

DuoNeb

DuoNeb combines ipratropium and albuterol, providing both anticholinergic and beta-agonist bronchodilation for asthma rescue.

Prednisone

Prednisone is a systemic corticosteroid used, mainly in generic form, for asthma rescue to reduce inflammation.

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Fluticasone

Fluticasone (Flovent) is an inhaled corticosteroid used for long-term asthma control to reduce airway inflammation.

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Salmeterol

Salmeterol (Serevent Diskus) is a long-acting beta-adrenergic agonist used for long-term asthma control.

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Asthma

Asthma is an inflammatory disease causing reversible bronchoconstriction, leading to symptoms like dyspnea, chest tightness, cough, and wheezing.

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Dyspnea

Dyspnea is shortness of breath or difficulty breathing, a common symptom of asthma.

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Quiet Chest

A quiet chest in a dyspneic patient can indicate severe airway obstruction and is a sign of a potentially fatal asthma attack.

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Accessory Muscle Use

Accessory muscle use indicates increased effort to breathe, suggesting a potentially severe asthma exacerbation.

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Diaphoresis

Diaphoresis, or excessive sweating, can be a sign of respiratory distress and a potentially fatal asthma attack.

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Speech Difficulty (Asthma)

Difficulty speaking due to breathlessness or fatigue, indicating a severe asthma attack.

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Inability to lie supine (Asthma)

Inability to lie flat due to breathing distress, a sign of a potentially dangerous asthma exacerbation.

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Asthma Definition

A disease characterized by diffuse airway inflammation and reversible bronchoconstriction due to various stimuli.

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Elevated Heart Rate (Asthma)

Greater than 120 beats per minute or an increasing rate, indicating a potentially severe asthma attack.

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Increased Respiratory Rate (Asthma)

Exceeding 25-30 breaths per minute, signaling respiratory distress during an asthma attack.

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Altered Consciousness (Asthma)

A decreased level of awareness suggesting a severe asthma exacerbation.

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Low Peak Expiratory Flow (PEF)

Reduced airflow, measured by peak expiratory flow (PEF), indicating airway obstruction during an asthma attack.

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Study Notes

  • Asthma is characterized by diffuse airway inflammation.
  • Asthma is caused by a variety of triggering stimuli.
  • Asthma results in partially or completely reversible bronchoconstriction.
  • Asthma symptoms include dyspnea, chest tightness, cough, and wheezing.
  • Most severe asthma exacerbations that are treated in the emergency department resolve within 2 hours after presentation.
  • The onset and duration of symptoms and the worsening of airflow obstruction before presentation are variable, but these problems usually occur over several hours.
  • Even in fatal or near-fatal asthma attacks, there is potential for early recognition and aggressive treatment.
  • Rarely, a patient has rapid, catastrophic onset of acute asthma, which can be fatal.

Asthma Rescue Drugs

  • Short-acting beta-agonists like Albuterol are available under the trade names Proventil, ProAir, and Ventolin
  • Anticholinergics like Ipratropium are available under the trade name Atrovent
  • Combination drugs such as Ipratropium and albuterol are available under the trade name DuoNeb.
  • Systemic corticosteroids such as Prednisone are mainly generic.

Long-Term Asthma Control

  • Inhaled corticosteroids like Fluticasone are available under the trade name Flovent.
  • Long-acting beta-adrenergic agonists like Salmeterol are available under the trade name Serevent Diskus.

Signs of a Potentially Fatal Asthma Attack

  • Use of accessory muscles of respiration is a sign of a potentially fatal asthma attack
  • Heart rate greater than 120 beats/min or increasing could mean a potentially fatal asthma attack.
  • Respiratory rate greater than 25-30 breaths/min is a sign of a potentially fatal asthma attack
  • Difficulty speaking because of dyspnea or fatigue may suggest a potentially fatal asthma attack
  • Altered level of consciousness might be a sign of a potentially fatal asthma attack
  • Quiet chest in a patient who has dyspnea or reduced level of consciousness may suggest the patient is experiencing a potentially fatal asthma attack
  • Diaphoresis may be a sign of a potentially fatal asthma attack
  • Inability to lie in the supine position because of breathing distress may suggest a potentially fatal asthma attack
  • Peak expiratory flow (PEF) is a sign of a potentially fatal asthma attack

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