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Corticosteroids and Bronchial Inflammation
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Corticosteroids and Bronchial Inflammation

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@CleanlyBoston

Questions and Answers

What is a key advantage of using this treatment method compared to inhaled β2 agonists?

  • It causes more oropharyngeal issues.
  • It is significantly more effective.
  • It has minimal systemic side effects. (correct)
  • It is easier to administer.

    • What adverse effect can result from the systemic use of this treatment?

  • Acute Addisonian crisis (correct)
  • Weight loss
  • Oropharyngeal candidiasis
  • Mild respiratory distress

    • What precaution should be taken to reduce the risk of candidiasis when using inhalation?

  • Increase inhalation dose.
  • Use a nasal spray instead.
  • Perform mouthwash and gargle after each inhalation. (correct)
  • Limit fluid intake.

    • Which dietary recommendation is suggested for patients using this treatment?

    <p>Rich in potassium and proteins.</p> Signup and view all the answers

    What should be continuously checked in patients using this treatment?

    <p>Increase in weight, edema, sugar in urine, or blood pressure.</p> Signup and view all the answers

    Which of the following is recommended if a patient develops a candida infection?

    <p>Use nystatin mouthwash or amphotericin-B lozenges.</p> Signup and view all the answers

    What must be done to avoid withdrawal complications?

    <p>Withdraw gradually.</p> Signup and view all the answers

    What should be administered in cases of acute infection while using this treatment?

    <p>Adequate antibiotics with decreased steroid dosage.</p> Signup and view all the answers

    Which drug is given twice daily for asthma management?

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

    Which mechanism of action is associated with Zileuton?

    <p>Inhibits 5-lipoxygenase enzyme</p> Signup and view all the answers

    What is the primary role of leukotriene inhibitors in asthma management?

    <p>Reduce frequency of asthma exacerbations</p> Signup and view all the answers

    What effect do leukotriene inhibitors have on drug metabolism?

    <p>Inhibit metabolism of multiple drugs</p> Signup and view all the answers

    Which of the following mast cell stabilizers is poorly soluble?

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

    For what age group is Montelukast approved for asthma management?

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

    Which option correctly describes dosing frequency for Montelukast?

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

    What form should Cromylyn and Nedocromil be given to patients?

    <p>Micronized powder through inhaler</p> Signup and view all the answers

    What is the primary mechanism of action of Omalizumab?

    <p>Inhibits the binding of IgE to mast cells</p> Signup and view all the answers

    In the stepwise approach to asthma management, what is the first line treatment for stable asthma?

    <p>Inhaled short-acting B2 agonist as required</p> Signup and view all the answers

    What treatment should be added to the management of asthma if inhaled steroid dose reaches 800 mcg/day and control is still inadequate?

    <p>Inhaled long-acting B2 agonist</p> Signup and view all the answers

    In the stepwise approach, if step 5 is reached for chronic asthma, what is a recommended action?

    <p>Refer the patient for specialist care</p> Signup and view all the answers

    How is acute severe asthma (status asthmaticus) primarily managed?

    <p>Hospital admission and oxygen therapy</p> Signup and view all the answers

    What is a role of the medication that inhibits mast cell degranulation?

    <p>Reducing frequency of allergic attacks</p> Signup and view all the answers

    Which of the following is true regarding the use of high doses of inhaled steroids in asthma treatment?

    <p>They can lead to poor patient compliance due to side effects</p> Signup and view all the answers

    What has largely replaced the use of mast cell inhibitors?

    <p>Leukotriene inhibitors</p> Signup and view all the answers

    What is one of the adverse effects that may occur with the use of these medications?

    <p>Local irritation of the throat</p> Signup and view all the answers

    What is Ketotifen classified as?

    <p>A second-generation antihistamine and mast cell stabilizer</p> Signup and view all the answers

    In which condition is Ketotifen commonly used as a prophylactic treatment?

    <p>Seasonal allergies</p> Signup and view all the answers

    What mixture is utilized to reduce the work of breathing in obstructed airways?

    <p>20% oxygen and 80% helium</p> Signup and view all the answers

    What function do expectorants and mucolytics serve in asthma treatment?

    <p>Decrease mucus viscosity</p> Signup and view all the answers

    What characteristic of helium contributes to its therapeutic effect in asthma treatment?

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

    What is one of the mechanisms by which corticosteroids reduce bronchial inflammation?

    <p>Inhibition of phospholipase A2 enzyme</p> Signup and view all the answers

    In the treatment of acute severe asthma, what is the typical intravenous dosage of hydrocortisone administered?

    <p>2000 mg every 4 hours</p> Signup and view all the answers

    Which of the following features is a benefit of inhaled corticosteroids in asthma treatment?

    <p>They are considered the first choice in newly diagnosed asthma.</p> Signup and view all the answers

    What is the effect of corticosteroids on mast cells in the context of asthma treatment?

    <p>Inhibition of mast cell degranulation</p> Signup and view all the answers

    Which corticosteroid is commonly used in chronic bronchial asthma treatment?

    <p>Prednisolone 20 mg daily</p> Signup and view all the answers

    In the context of cytokine release, what role do corticosteroids play?

    <p>They inhibit T cell functions which decrease cytokine release.</p> Signup and view all the answers

    What effect do corticosteroids have on beta-2 receptors?

    <p>They cause up-regulation of beta-2 receptors.</p> Signup and view all the answers

    Which of the following actions does NOT describe the effects of corticosteroids?

    <p>Increase in mucus gland activity</p> Signup and view all the answers

    The efficacy of systemic corticosteroids is equal to that of inhaled β2 agonists.

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

    Using inhaled corticosteroids can lead to oral thrush, but this can be prevented by using a mouthwash after inhalation.

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

    Immediate withdrawal of corticosteroids is recommended to avoid acute Addisonian crisis.

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

    A diet low in carbohydrates is advised for patients using systemic corticosteroids.

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

    If a patient develops a candida infection, they should stop using corticosteroids entirely.

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

    Systemic corticosteroids have no systemic side effects.

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

    Continuous monitoring for weight gain and elevated blood pressure is unnecessary in patients on corticosteroids.

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

    Patients using inhaled corticosteroids should gargle with antifungal mouthwash after every dose.

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

    Zafirlukast is administered once daily for asthma management.

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

    Zileuton inhibits the synthesis of leukotrienes by acting on the lipoxygenase enzyme.

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

    Mast cell stabilizers such as Cromolyn and Nedocromil should be given in liquid form for better absorption.

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

    Montelukast has been shown to reduce the frequency of asthma exacerbations similarly to leukotriene receptor antagonists.

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

    Zafirlukast and Montelukast both work by blocking leukotriene (LTD4) receptors.

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

    Zileuton is a P450 inhibitor and can affect the metabolism of several other drugs.

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

    Leukotriene inhibitors have been clinically demonstrated to be superior to corticosteroids in reducing asthma exacerbations.

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

    Nedocromil is a more soluble compound than Cromolyn and is administered as a solution.

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

    Omalizumab inhibits the binding of IgE to B cells and prevents mast cell activation.

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

    In the stepwise approach for chronic asthma, an inhaled long-acting B2 agonist (LABA) is added only when the inhaled steroid dose reaches 800 mcg/day.

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

    Acute severe asthma, also known as status asthmaticus, is typically treated with immediate outpatient management and oral corticosteroids.

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

    Mast cell stabilizers primarily function by enhancing the activity of chloride channels in mast cell membranes.

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

    The maximum inhaled steroid dose in a stepwise approach for chronic asthma can reach up to 2000 mcg/day.

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

    Ketotifen is a first-generation antihistamine used for treating allergic rhinitis.

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

    Oxygen treatment for acute severe asthma aims to maintain peripheral capillary O2 saturation between 88-92%.

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

    Corticosteroids enhance B cell function in the treatment of asthma.

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

    The use of mast cell stabilizers has been largely replaced by leukotriene inhibitors due to their efficiency.

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

    The first step in treating chronic asthma involves the use of inhaled long-acting B2 agonists as required.

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

    Heliox is a mixture of oxygen and helium that helps reduce breathing work by increasing mucus viscosity.

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

    Inhaled corticosteroids are considered the second choice in newly diagnosed asthma.

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

    Mast cells release histamine, which corticosteroids help to inhibit.

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

    The primary adverse effect of mast cell stabilizers is systemic irritation of the throat.

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

    Corticosteroids are known to stabilize lysosomal membranes in macrophages.

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

    Mast cell stabilizers are sometimes used for prophylactic treatment in conditions like bronchial asthma.

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

    Dexamethasone is typically administered intravenously for chronic bronchial asthma.

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

    Ketotifen can be administered as eye drops for treating allergic conjunctivitis.

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

    Chloride channels in mast cells play a critical role in the mechanism of action of leukotriene inhibitors.

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

    Corticosteroids have no effect on the up-regulation of beta-2 receptors.

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

    Prednisolone is the typical oral corticosteroid prescribed for acute severe asthma management.

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

    Corticosteroids inhibit phospholipase A2 enzyme activity, reducing the synthesis of prostaglandins and leukotrienes.

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

    How do agents that inhibit mast cell degranulation likely alter mast cell function?

    <p>They likely alter the function of chloride channels in the mast cell membrane.</p> Signup and view all the answers

    For which allergic conditions is Ketotifen used as a prophylactic treatment?

    <p>Ketotifen is used for bronchial asthma and other seasonal allergies.</p> Signup and view all the answers

    What has largely replaced the use of mast cell stabilizers in asthma management?

    <p>Leukotriene inhibitors have largely replaced mast cell stabilizers.</p> Signup and view all the answers

    What are the common adverse effects associated with the administration of mast cell stabilizers?

    <p>Adverse effects include local irritation of the throat, chest tightness, and bronchosspasm.</p> Signup and view all the answers

    What is the primary mechanism of action for expectorants and mucolytics in asthma treatment?

    <p>They reduce mucus viscosity to facilitate easier clearance from the airways.</p> Signup and view all the answers

    How does the mixture of 20% oxygen and 80% helium aid in treating obstructed airways?

    <p>The low density of helium facilitates oxygen diffusion and reduces the work of breathing.</p> Signup and view all the answers

    What classification does Ketotifen fall into in terms of antihistamines?

    <p>Ketotifen is classified as a second-generation antihistamine and a mast cell stabilizer.</p> Signup and view all the answers

    What role do corticosteroids play in reducing bronchial inflammation during asthma treatment?

    <p>Corticosteroids reduce bronchial inflammation by inhibiting cytokine release.</p> Signup and view all the answers

    How do corticosteroids influence B cell function in the context of bronchial inflammation?

    <p>Corticosteroids inhibit B cell function, leading to a decrease in antigen-antibody reactions.</p> Signup and view all the answers

    What intravenous dosage of hydrocortisone is typically administered for acute severe asthma?

    <p>The typical intravenous dosage is 2000 mg of hydrocortisone.</p> Signup and view all the answers

    What effect do corticosteroids have on T cell-mediated responses in asthma?

    <p>Corticosteroids inhibit T cell functions, which results in reduced mediator and cytokine release.</p> Signup and view all the answers

    What is the significance of up-regulation of β2 receptors due to corticosteroid use?

    <p>The up-regulation of β2 receptors enhances bronchodilation and improves respiratory function.</p> Signup and view all the answers

    In chronic bronchial asthma management, what oral corticosteroid dosage is commonly prescribed for prednisolone?

    <p>The common oral dosage of prednisolone is 20 mg per day.</p> Signup and view all the answers

    How do corticosteroids affect macrophage activity in asthma treatment?

    <p>Corticosteroids inhibit macrophage activity, reducing their contribution to inflammation.</p> Signup and view all the answers

    What is the role of phospholipase A2 inhibition by corticosteroids in asthma management?

    <p>Inhibition of phospholipase A2 decreases the synthesis of prostaglandins and leukotrienes.</p> Signup and view all the answers

    Inhaled corticosteroids are considered the first choice for which patient group?

    <p>Inhaled corticosteroids are the first choice for newly diagnosed asthma patients.</p> Signup and view all the answers

    What type of drug is Zileuton, and what does it inhibit?

    <p>Zileuton is a leukotriene synthesis inhibitor that inhibits the 5-lipoxygenase enzyme.</p> Signup and view all the answers

    How do leukotriene inhibitors impact asthma management compared to corticosteroids?

    <p>Leukotriene inhibitors reduce the frequency of asthma exacerbations similarly to corticosteroids.</p> Signup and view all the answers

    What is the dosing frequency for Zafirlukast?

    <p>Zafirlukast is given twice daily.</p> Signup and view all the answers

    What major interaction should be considered when using Zileuton?

    <p>Zileuton can inhibit the metabolism of many drugs, including warfarin and theophylline.</p> Signup and view all the answers

    Which agents are classified as mast cell stabilizers?

    <p>Cromolyn sodium and nedocromil are classified as mast cell stabilizers.</p> Signup and view all the answers

    How should Cromolyn and Nedocromil be administered to ensure effectiveness?

    <p>Cromolyn and nedocromil should be given as micronized powder through a spinhaler.</p> Signup and view all the answers

    Describe the specific receptor that leukotriene inhibitors, such as Montelukast, block.

    <p>Leukotriene inhibitors block the leukotriene (LTD4) receptors.</p> Signup and view all the answers

    What is the significance of Montelukast being approved for children?

    <p>Montelukast's approval for children indicates its safety and effectiveness in pediatric asthma management.</p> Signup and view all the answers

    What potential benefit do corticosteroids provide compared to oral medications in asthma management?

    <p>Corticosteroids offer equal efficacy to inhaled β2 agonists while minimizing systemic side effects.</p> Signup and view all the answers

    What is a strategy to prevent oropharyngeal candidiasis when using inhaled corticosteroids?

    <p>Using a mouthwash and gargling after each inhalation can prevent oropharyngeal candidiasis.</p> Signup and view all the answers

    What dietary modifications are recommended for patients on systemic corticosteroids?

    <p>A diet rich in potassium and proteins, low in NaCl and carbohydrates is suggested.</p> Signup and view all the answers

    What is a critical precaution to take when withdrawing corticosteroids?

    <p>Corticosteroids must be withdrawn gradually to avoid acute Addisonian crisis.</p> Signup and view all the answers

    How should weight, edema, and blood pressure be monitored in patients using corticosteroids?

    <p>Continuous monitoring for an increase in weight, edema, sugar in urine, and blood pressure is essential.</p> Signup and view all the answers

    What should be done if a patient using corticosteroids develops an acute infection?

    <p>The patient must be treated with adequate antibiotics while decreasing the steroid dose.</p> Signup and view all the answers

    What is the significance of using antifungal treatment in patients with candidiasis while on inhaled corticosteroids?

    <p>Antifungal treatment, such as nystatin mouthwash or amphotericin-B lozenges, is necessary to manage candida infections.</p> Signup and view all the answers

    What should be continuously checked in patients receiving corticosteroid therapy?

    <p>Monitoring for any increase in weight, edema, sugar in urine, or blood pressure is critical.</p> Signup and view all the answers

    How does Omalizumab contribute to the management of asthma exacerbations?

    <p>Omalizumab inhibits the binding of IgE to mast cells, preventing degranulation and reducing asthma severity.</p> Signup and view all the answers

    What is the maximum recommended dose of inhaled steroids in the stepwise management of chronic asthma?

    <p>The maximum recommended dose is 2000 mcg/day.</p> Signup and view all the answers

    What should be utilized to maintain adequate oxygen levels in patients experiencing acute severe asthma?

    <p>Oxygen should be administered to maintain peripheral capillary O2 saturation (SpO2) between 94-98%.</p> Signup and view all the answers

    How is the stepwise approach adjusted if a patient on inhaled LABA still experiences inadequate asthma control?

    <p>The inhaled steroid dose should be increased to 800 mcg/day while continuing the LABA.</p> Signup and view all the answers

    What action should be taken if a patient reaches step 5 in the asthma management process?

    <p>Use an oral steroid tablet in the lowest dose in addition to the high-dose inhaled steroid.</p> Signup and view all the answers

    Define 'status asthmaticus' in the context of acute severe asthma.

    <p>Status asthmaticus is a condition where bronchodilators are poorly effective in relieving an asthma attack.</p> Signup and view all the answers

    Corticosteroids can effectively ↓ bronchial ______ and hyperreactivity activity.

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

    Corticosteroids inhibit ______ cell function → ↓ antigen-antibody reaction.

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

    Corticosteroids inhibit ______ cell functions → ↓ mediators and cytokine release.

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

    For acute severe asthma, hydrocortisone 2000 mg is given by ______ injection.

    <p>i.v.</p> Signup and view all the answers

    Chronic bronchial asthma may be treated with oral ______ 20 mg g/d.

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

    Inhaled corticosteroids, such as ______, should be considered the 1st choice in newly diagnosed asthma.

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

    Corticosteroids inhibit mast cells → ↓ ______ release.

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

    Corticosteroids cause up-regulation of ______ receptors.

    <p>β2</p> Signup and view all the answers

    Their efficacy is equal to inhaled ______.

    <p>β2 agonists</p> Signup and view all the answers

    Adverse effects may occur if used ______.

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

    Candidiasis can be avoided by using mouthwash and ______ after each inhalation.

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

    Candida infection can be treated by nystatin mouthwash or ______ lozenges.

    <p>amphotericin-B</p> Signup and view all the answers

    Patients must be withdrawn from corticosteroids ______ to avoid acute Addisonian crisis.

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

    A diet should be rich in potassium and proteins and low in ______.

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

    Continuous monitoring for weight increase, edema, and ______ in urine is necessary.

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

    If a patient develops acute infection, adequate ______ must be administered with a decreased steroid dose.

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

    Zafirlukast and montelukast are types of ______ inhibitors.

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

    Zileuton inhibits the synthesis of leukotrienes by acting on the ______ enzyme.

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

    Montelukast is approved to control asthma in ______.

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

    Cromolyn sodium and nedocromil are ______ soluble drugs.

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

    Cromolyn and nedocromil should be given as micronized powder through a ______.

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

    Zafirlukast is taken ______ daily.

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

    Zileuton is a microsomal P450 ______ and can inhibit the metabolism of many drugs.

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

    Mast cell stabilizers work by preventing the release of ______ from mast cells.

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

    Omalizumab is a new drug that inhibits the binding of IgE to ______ cells.

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

    The stepwise approach for treating chronic asthma includes adding an inhaled ______ at 400 mcg/day.

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

    In the management of acute severe asthma, oxygen is used to maintain peripheral capillary ______ saturation between 94-98%.

    <p>O2</p> Signup and view all the answers

    If control is still inadequate after increasing inhaled steroid dose to 800 mcg/day, the next step is to add an inhaled long-acting ______ agonist (LABA).

    <p>B2</p> Signup and view all the answers

    In step 5 of asthma management, patients should be referred for ______ care.

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

    Mast cell degranulation is influenced by altering the function of chloride ______ in the mast cell membrane.

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

    Acute severe asthma is a condition in which ______ are poorly effective in relieving the attack.

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

    Ketotifen is used as an eye drop to treat allergic ______.

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

    Expectorants and ______ are used to reduce mucus viscosity.

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

    Heliox is a mixture of oxygen (20%) and ______ (80%).

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

    The use of certain mast cell stabilizers has become very ______ and has been largely replaced by leukotriene inhibitors.

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

    Local irritation of the throat and chest tightness are examples of ______ effects at the site of administration.

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

    Ketotifen is classified as a second-generation ______.

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

    Helium's low density facilitates O2 diffusion through ______ airways.

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

    Match the following advantages of corticosteroids with their descriptions:

    <p>Efficacy equal to inhaled β2 agonists = Demonstrates similar effectiveness in treating asthma Minimal systemic side effects = Reduced adverse reactions compared to systemic treatments Oropharyngeal candidiasis prevention = Avoided by proper mouth rinse and gargle Gradual withdrawal necessity = Prevents acute Addisonian crisis complications</p> Signup and view all the answers

    Match the recommended dietary considerations for patients on corticosteroids:

    <p>Rich in potassium and proteins = Important for maintaining electrolyte balance Low in NaCl = Helps manage blood pressure and fluid retention Low in carbohydrates = Aids in glucose management Increased fluid intake = Supports kidney function in steroid therapy</p> Signup and view all the answers

    Match the treatment for candidiasis with the recommended method:

    <p>Nystatin mouthwash = Topical antifungal for oral thrush Amphotericin-B lozenges = Systemic treatment for severe fungal infections Mouthwash use after inhalation = Prevents fungal infection during steroid use Gargling with salt water = Provides general oral hygiene after corticosteroid inhalation</p> Signup and view all the answers

    Match the monitoring aspects with their importance in corticosteroid use:

    <p>Weight = Indicates potential fluid retention Urine sugar levels = Monitors for steroid-induced diabetes Blood pressure = Checks for hypertension due to steroid therapy Edema = Assesses fluid overload in treatment response</p> Signup and view all the answers

    Match the following corticosteroid uses with their respective dosages:

    <p>Acute severe asthma = Hydrocortisone 2000 mg IV every 4 hours Chronic bronchial asthma (oral) = Prednisolone 20 mg per day Chronic bronchial asthma (inhaled) = Beclomethasone Chronic bronchial asthma (dex) = Dexamethasone 4-8 mg per day</p> Signup and view all the answers

    Match the required precautions when using corticosteroids:

    <p>Monitor for acute infections = Ensures timely antibiotic treatment Gradual withdrawal = Avoids adrenal insufficiency risks Check weight gain = Identifies fluid retention early Maintain regular blood glucose checks = Prevents complications from steroid-induced diabetes</p> Signup and view all the answers

    Match the mechanisms of action of corticosteroids to their effects:

    <p>Inhibition of B cell function = Decreased antigen-antibody reaction Inhibition of mast cells = Decreased histamine release Inhibition of phospholipase A2 = Decreased synthesis of PGs and LTs Up-regulation of β2 receptors = Enhanced bronchodilation</p> Signup and view all the answers

    Match the type of immune cell with the action suppressed by corticosteroids:

    <p>B cells = Decreased antibody production T cells = Decreased cytokine release Macrophages = Reduced activity Mast cells = Reduced histamine release</p> Signup and view all the answers

    Match the adverse effects with their corresponding scenarios:

    <p>Oropharyngeal candidiasis = Common with inhaled steroid use Systemic side effects = Can occur when steroids are used systemically Acute Addisonian crisis = Resulting from abrupt steroid withdrawal Increased body weight = Possible consequence of long-term steroid use</p> Signup and view all the answers

    Match the treatment strategies with their purpose:

    <p>Mouth rinse after inhalation = Reduces risk of fungal infections Gradual steroid tapering = Prevents withdrawal symptoms Diet low in NaCl = Minimizes hypertension risk Antibiotics for infections = Treats infections without increasing steroid dose</p> Signup and view all the answers

    Match the type of corticosteroid administration with the appropriate condition:

    <p>Intravenous hydrocortisone = Acute severe asthma Oral prednisolone = Chronic bronchial asthma Inhaled beclomethasone = Newly diagnosed asthma Oral dexamethasone = Chronic bronchial asthma</p> Signup and view all the answers

    Match the intervention with its expected outcome in corticosteroid therapy:

    <p>Gargling after use = Prevents oropharyngeal infections Monitoring blood sugar = Addresses potential steroid-induced diabetes Gradual tapering = Maintains adrenal function Low-carb diet = Helps control blood sugar levels</p> Signup and view all the answers

    Match the inflammatory mediator with the corticosteroid effect:

    <p>Histamine = Release inhibited by mast cell suppression Cytokines = Release suppressed by T cell inhibition Antigens = Response reduced by B cell inhibition Prostaglandins = Synthesis decreased by phospholipase inhibition</p> Signup and view all the answers

    Match the statement about corticosteroids with the appropriate description:

    <p>Corticosteroids reduce bronchial inflammation = By inhibiting multiple immune responses Inhaled corticosteroids are first choice = For newly diagnosed asthma Hydrocortisone is administered IV = For severe acute asthma management Dexamethasone can be inhaled = To manage chronic asthma effectively</p> Signup and view all the answers

    Match the action associated with corticosteroids with its result:

    <p>Inhibition of macrophage activity = Reduced bronchial inflammation Stabilization of lysosomal membranes = Prevention of cell damage Up-regulation of β2 receptors = Improved bronchodilation response Inhibition of capillary permeability = Reduced swelling in airway tissues</p> Signup and view all the answers

    Match the type of asthma with the appropriate corticosteroid treatment:

    <p>Acute severe asthma = Hydrocortisone should be given Chronic asthma with inhalers = Beclomethasone is preferred Chronic asthma oral treatment = Prednisolone or dexamethasone Mild asthma = Inhaled corticosteroids recommended</p> Signup and view all the answers

    Match the following asthma management steps with their corresponding actions:

    <p>Step 1 = Inhaled short-acting B2 agonist as required Step 3 = Increase inhaled steroid dose to 800 mcg/day Step 4 = Add a leukotriene antagonist Step 2 = Add inhaled steroid at 400 mcg/day</p> Signup and view all the answers

    Match the following drugs with their primary mechanisms in asthma treatment:

    <p>Omalizumab = Inhibits IgE binding to mast cells SABA = Provides quick relief of bronchospasm Inhaled corticosteroids = Reduces bronchial inflammation Leukotriene antagonist = Blocks leukotriene action on receptors</p> Signup and view all the answers

    Match the stages of acute treatment for severe asthma with their appropriate actions:

    <p>Hospital admission = Immediate management for acute severe asthma Oxygen therapy = Maintain SpO2 between 94-98% High dose inhaled steroids = Additional medication to manage inflammation Bronchodilators = First line for acute asthma attacks</p> Signup and view all the answers

    Match the following drug classes with their indicated uses in asthma management:

    <p>Inhaled steroids = Long-term control of asthma inflammation Oral corticosteroids = Used in severe cases or exacerbations LABA = Added for persistent symptoms despite low steroid use Antileukotriene agents = Adjunct therapy for uncontrolled asthma</p> Signup and view all the answers

    Match the stepwise treatment approach for asthma management with the correct drug doses:

    <p>Step 2 = Inhaled steroid at 400 mcg/day Step 4 = Inhaled steroid up to 2000 mcg/day Step 3 = Inhaled steroid dose increase to 800 mcg/day Step 5 = Oral steroid at the lowest effective dose</p> Signup and view all the answers

    Match the following definitions with their corresponding conditions in asthma management:

    <p>Stepwise approach = Systematic escalation of asthma treatment Status asthmaticus = Acute severe asthma episodes Mast cell degranulation = Release of inflammatory mediators B2 agonist = Bronchodilator that relaxes airway muscles</p> Signup and view all the answers

    Match the following leukotriene inhibitors with their key characteristics:

    <p>Montelukast = Approved for children, given once daily Zafirlukast = Given twice daily, blocks LTD4 receptors Zileuton = Inhibits leukotriene synthesis via lipoxygenase Both Montelukast and Zafirlukast = Reduce frequency of asthma exacerbations</p> Signup and view all the answers

    Match the mast cell stabilizers with their properties:

    <p>Cromolyn = Poorly soluble, should be given via inhaler Nedocromil = Microcrystalline powder form for better delivery Cromolyn Sodium = Disodium cromoglycate alternative Both Cromolyn and Nedocromil = Inhibit mast cell degranulation</p> Signup and view all the answers

    Match the following statements with the corresponding drug action:

    <p>Zafirlukast = Blocks leukotriene receptors Montelukast = Single daily dosage Zileuton = Microsomal P450 inhibitor Cromolyn = Stabilizes mast cells</p> Signup and view all the answers

    Match the drug with its dosing schedule:

    <p>Montelukast = Once daily Zafirlukast = Twice daily Zileuton = Not specified in dosing schedule Cromolyn = Administered through inhalation</p> Signup and view all the answers

    Match the following actions of leukotriene inhibitors:

    <p>Montelukast = Prophylactic treatment for asthma Zafirlukast = Reduced exacerbations equal to corticosteroids Zileuton = Inhibits 5-lipoxygenase enzyme Both Zafirlukast and Zileuton = Alter drug metabolism effects</p> Signup and view all the answers

    Match the following drugs with their potential drug interactions:

    <p>Montelukast = Minimal interactions expected Zafirlukast = Interacts with warfarin Zileuton = Inhibits metabolism of theophylline Cromolyn = No significant drug interactions</p> Signup and view all the answers

    Match the following characteristics of mast cell stabilizers:

    <p>Cromolyn Sodium = Used as micronized powder Nedocromil = Poor solubility affects absorption Both drugs = Require inhalation for effectiveness Cromolyn = Stabilizes mast cells to prevent asthma attacks</p> Signup and view all the answers

    Match the following statements about asthma management:

    <p>Montelukast = Approved for pediatric use Zafirlukast = Taken twice a day versus Montelukast Zileuton = Given for leukotriene synthesis inhibition Cromolyn and Nedocromil = Alternative options to prevent asthma symptoms</p> Signup and view all the answers

    Match the following drugs with their primary usage:

    <p>Ketotifen = Prophylactic treatment for bronchial asthma Expectorants = Reduce mucus viscosity Heliox = Facilitates O2 diffusion through obstructed airways Mast cell stabilizers = Inhibit mast cell degranulation</p> Signup and view all the answers

    Match the side effects with their associated treatments:

    <p>Local irritation of the throat = Mast cell stabilizers Chest tightness = Prophylactic asthma treatment Bronchospasm = Antihistamines Irritation of the eyes = Ketotifen eye drops</p> Signup and view all the answers

    Match the drugs with their classifications:

    <p>Ketotifen = 2nd generation antihistamine and mast cell stabilizer Expectorants = Mucus viscosity reducers Heliox = Mixture of oxygen and helium Mast cell stabilizers = Prevent allergic reactions</p> Signup and view all the answers

    Match the drug with the allergic condition it treats:

    <p>Ketotifen = Allergic conjunctivitis Expectorants = Bronchial asthma Heliox = Obstructive airways Mast cell stabilizers = Seasonal allergies</p> Signup and view all the answers

    Match the following descriptions to the correct drug:

    <p>Heliox = Low density facilitates O2 diffusion Expectorants = Used to reduce mucus viscosity Ketotifen = Used as eye drops for allergic conjunctivitis Mast cell stabilizers = Limited use in current treatments</p> Signup and view all the answers

    Match the following therapies with their mechanisms:

    <p>Expectorants = Reduce viscosity of mucus Heliox = Decrease work of breathing Ketotifen = Stabilizes mast cells Mast cell stabilizers = Alter chloride channel functions</p> Signup and view all the answers

    Match the drug with its limitation in use:

    <p>Mast cell stabilizers = Replaced by leukotriene inhibitors Ketotifen = Limited to prophylactic use Expectorants = Effectiveness may vary Heliox = Requires specific mixture ratios</p> Signup and view all the answers

    Match the adverse effects to the correct drug category:

    <p>Mast cell stabilizers = Local irritation Ketotifen = Systemic absorption complications Expectorants = Possible nausea Heliox = Risk of hypoxia without oxygen</p> Signup and view all the answers

    Study Notes

    Reduction of Bronchial Inflammation

    • Corticosteroids are effective in decreasing bronchial inflammation and hyperreactivity.
    • Mechanisms of action include inhibiting B and T cell functions, macrophage activity, mast cells, and phospholipase A2, leading to reduced antigen-antibody reactions, cytokine release, histamine release, and prostaglandins/leukotrienes synthesis.
    • Increased regulation of β2 receptors enhances the efficacy of corticosteroids.

    Use in Asthma

    • Acute severe asthma treated with intravenous hydrocortisone at 2000 mg, repeated every 4 hours if needed.
    • Chronic bronchial asthma managed with oral prednisone (20 mg/day) or dexamethasone (4-8 mg/day), or inhaled corticosteroids like beclomethasone.
    • Inhaled corticosteroids should be the first-line treatment for newly diagnosed asthma due to their equivalent efficacy to inhaled β2 agonists and minimal systemic side effects.
    • Potential side effects include oropharyngeal candidiasis, which can be prevented with mouth rinsing post-inhalation, and treated with antifungal agents.

    Precautions for Corticosteroid Use

    • Gradual withdrawal is crucial to prevent acute Addisonian crisis.
    • Diet should be potassium and protein-rich but low in sodium and carbohydrates.
    • Regular monitoring for weight gain, edema, elevated blood sugar, or blood pressure changes is necessary.
    • Antibiotics may be required for acute infections with adjusted steroid dosages.

    Prophylactic Treatment

    • Leukotriene inhibitors (e.g., zafirlukast, montelukast) are used to reduce asthma exacerbation frequency.
    • Zafirlukast taken twice daily and montelukast once daily, both blocking leukotriene receptors.
    • Zileuton inhibits leukotriene synthesis but can interact with other medications like warfarin and theophylline.

    Mast Cell Stabilizers

    • Cromolyn sodium and nedocromil are poorly soluble drugs that prevent mast cell degranulation, mainly used in allergic conditions but largely replaced by leukotriene inhibitors due to limited efficacy.
    • Ketotifen functions as both an antihistamine and mast cell stabilizer, administered as eye drops or in oral form for allergic conjunctivitis and asthma prophylaxis.

    Other Treatments

    • Expectorants and mucolytics decrease mucus viscosity.
    • Heliox (20% oxygen, 80% helium) facilitates oxygen diffusion in obstructed airways, reducing breathing effort.
    • Omalizumab, an anti-IgE monoclonal antibody, prevents IgE binding to mast cells, reducing the severity of asthma attacks and corticosteroid requirements.

    Stepwise Approach to Chronic Asthma Management

    • Step 1: Use inhaled short-acting β2 agonists (SABA) as needed.
    • Step 2: Add inhaled corticosteroids at 400 mcg/day.
    • Step 3: Incorporate long-acting β2 agonists (LABA) and increase inhaled steroids to 800 mcg/day if inadequate control.
    • Step 4: Further increase inhaled steroids up to 2000 mcg/day and consider adding a fourth drug (e.g., leukotriene antagonist or oral β2 agonists).
    • Step 5: Use oral steroids at the lowest effective dose in combination with high-dose inhaled steroids and refer to specialist care if needed.

    Management of Acute Severe Asthma (Status Asthmaticus)

    • Defined as unresponsive bronchodilator relief during asthma attacks.
    • Requires hospitalization, with oxygen supplied to maintain peripheral capillary saturation (SpO2) between 94-98%.

    Reduction of Bronchial Inflammation

    • Corticosteroids are effective in decreasing bronchial inflammation and hyperreactivity.
    • Mechanisms of action include inhibiting B and T cell functions, macrophage activity, mast cells, and phospholipase A2, leading to reduced antigen-antibody reactions, cytokine release, histamine release, and prostaglandins/leukotrienes synthesis.
    • Increased regulation of β2 receptors enhances the efficacy of corticosteroids.

    Use in Asthma

    • Acute severe asthma treated with intravenous hydrocortisone at 2000 mg, repeated every 4 hours if needed.
    • Chronic bronchial asthma managed with oral prednisone (20 mg/day) or dexamethasone (4-8 mg/day), or inhaled corticosteroids like beclomethasone.
    • Inhaled corticosteroids should be the first-line treatment for newly diagnosed asthma due to their equivalent efficacy to inhaled β2 agonists and minimal systemic side effects.
    • Potential side effects include oropharyngeal candidiasis, which can be prevented with mouth rinsing post-inhalation, and treated with antifungal agents.

    Precautions for Corticosteroid Use

    • Gradual withdrawal is crucial to prevent acute Addisonian crisis.
    • Diet should be potassium and protein-rich but low in sodium and carbohydrates.
    • Regular monitoring for weight gain, edema, elevated blood sugar, or blood pressure changes is necessary.
    • Antibiotics may be required for acute infections with adjusted steroid dosages.

    Prophylactic Treatment

    • Leukotriene inhibitors (e.g., zafirlukast, montelukast) are used to reduce asthma exacerbation frequency.
    • Zafirlukast taken twice daily and montelukast once daily, both blocking leukotriene receptors.
    • Zileuton inhibits leukotriene synthesis but can interact with other medications like warfarin and theophylline.

    Mast Cell Stabilizers

    • Cromolyn sodium and nedocromil are poorly soluble drugs that prevent mast cell degranulation, mainly used in allergic conditions but largely replaced by leukotriene inhibitors due to limited efficacy.
    • Ketotifen functions as both an antihistamine and mast cell stabilizer, administered as eye drops or in oral form for allergic conjunctivitis and asthma prophylaxis.

    Other Treatments

    • Expectorants and mucolytics decrease mucus viscosity.
    • Heliox (20% oxygen, 80% helium) facilitates oxygen diffusion in obstructed airways, reducing breathing effort.
    • Omalizumab, an anti-IgE monoclonal antibody, prevents IgE binding to mast cells, reducing the severity of asthma attacks and corticosteroid requirements.

    Stepwise Approach to Chronic Asthma Management

    • Step 1: Use inhaled short-acting β2 agonists (SABA) as needed.
    • Step 2: Add inhaled corticosteroids at 400 mcg/day.
    • Step 3: Incorporate long-acting β2 agonists (LABA) and increase inhaled steroids to 800 mcg/day if inadequate control.
    • Step 4: Further increase inhaled steroids up to 2000 mcg/day and consider adding a fourth drug (e.g., leukotriene antagonist or oral β2 agonists).
    • Step 5: Use oral steroids at the lowest effective dose in combination with high-dose inhaled steroids and refer to specialist care if needed.

    Management of Acute Severe Asthma (Status Asthmaticus)

    • Defined as unresponsive bronchodilator relief during asthma attacks.
    • Requires hospitalization, with oxygen supplied to maintain peripheral capillary saturation (SpO2) between 94-98%.

    Reduction of Bronchial Inflammation

    • Corticosteroids are effective in decreasing bronchial inflammation and hyperreactivity.
    • Mechanisms of action include inhibiting B and T cell functions, macrophage activity, mast cells, and phospholipase A2, leading to reduced antigen-antibody reactions, cytokine release, histamine release, and prostaglandins/leukotrienes synthesis.
    • Increased regulation of β2 receptors enhances the efficacy of corticosteroids.

    Use in Asthma

    • Acute severe asthma treated with intravenous hydrocortisone at 2000 mg, repeated every 4 hours if needed.
    • Chronic bronchial asthma managed with oral prednisone (20 mg/day) or dexamethasone (4-8 mg/day), or inhaled corticosteroids like beclomethasone.
    • Inhaled corticosteroids should be the first-line treatment for newly diagnosed asthma due to their equivalent efficacy to inhaled β2 agonists and minimal systemic side effects.
    • Potential side effects include oropharyngeal candidiasis, which can be prevented with mouth rinsing post-inhalation, and treated with antifungal agents.

    Precautions for Corticosteroid Use

    • Gradual withdrawal is crucial to prevent acute Addisonian crisis.
    • Diet should be potassium and protein-rich but low in sodium and carbohydrates.
    • Regular monitoring for weight gain, edema, elevated blood sugar, or blood pressure changes is necessary.
    • Antibiotics may be required for acute infections with adjusted steroid dosages.

    Prophylactic Treatment

    • Leukotriene inhibitors (e.g., zafirlukast, montelukast) are used to reduce asthma exacerbation frequency.
    • Zafirlukast taken twice daily and montelukast once daily, both blocking leukotriene receptors.
    • Zileuton inhibits leukotriene synthesis but can interact with other medications like warfarin and theophylline.

    Mast Cell Stabilizers

    • Cromolyn sodium and nedocromil are poorly soluble drugs that prevent mast cell degranulation, mainly used in allergic conditions but largely replaced by leukotriene inhibitors due to limited efficacy.
    • Ketotifen functions as both an antihistamine and mast cell stabilizer, administered as eye drops or in oral form for allergic conjunctivitis and asthma prophylaxis.

    Other Treatments

    • Expectorants and mucolytics decrease mucus viscosity.
    • Heliox (20% oxygen, 80% helium) facilitates oxygen diffusion in obstructed airways, reducing breathing effort.
    • Omalizumab, an anti-IgE monoclonal antibody, prevents IgE binding to mast cells, reducing the severity of asthma attacks and corticosteroid requirements.

    Stepwise Approach to Chronic Asthma Management

    • Step 1: Use inhaled short-acting β2 agonists (SABA) as needed.
    • Step 2: Add inhaled corticosteroids at 400 mcg/day.
    • Step 3: Incorporate long-acting β2 agonists (LABA) and increase inhaled steroids to 800 mcg/day if inadequate control.
    • Step 4: Further increase inhaled steroids up to 2000 mcg/day and consider adding a fourth drug (e.g., leukotriene antagonist or oral β2 agonists).
    • Step 5: Use oral steroids at the lowest effective dose in combination with high-dose inhaled steroids and refer to specialist care if needed.

    Management of Acute Severe Asthma (Status Asthmaticus)

    • Defined as unresponsive bronchodilator relief during asthma attacks.
    • Requires hospitalization, with oxygen supplied to maintain peripheral capillary saturation (SpO2) between 94-98%.

    Reduction of Bronchial Inflammation

    • Corticosteroids are effective in decreasing bronchial inflammation and hyperreactivity.
    • Mechanisms of action include inhibiting B and T cell functions, macrophage activity, mast cells, and phospholipase A2, leading to reduced antigen-antibody reactions, cytokine release, histamine release, and prostaglandins/leukotrienes synthesis.
    • Increased regulation of β2 receptors enhances the efficacy of corticosteroids.

    Use in Asthma

    • Acute severe asthma treated with intravenous hydrocortisone at 2000 mg, repeated every 4 hours if needed.
    • Chronic bronchial asthma managed with oral prednisone (20 mg/day) or dexamethasone (4-8 mg/day), or inhaled corticosteroids like beclomethasone.
    • Inhaled corticosteroids should be the first-line treatment for newly diagnosed asthma due to their equivalent efficacy to inhaled β2 agonists and minimal systemic side effects.
    • Potential side effects include oropharyngeal candidiasis, which can be prevented with mouth rinsing post-inhalation, and treated with antifungal agents.

    Precautions for Corticosteroid Use

    • Gradual withdrawal is crucial to prevent acute Addisonian crisis.
    • Diet should be potassium and protein-rich but low in sodium and carbohydrates.
    • Regular monitoring for weight gain, edema, elevated blood sugar, or blood pressure changes is necessary.
    • Antibiotics may be required for acute infections with adjusted steroid dosages.

    Prophylactic Treatment

    • Leukotriene inhibitors (e.g., zafirlukast, montelukast) are used to reduce asthma exacerbation frequency.
    • Zafirlukast taken twice daily and montelukast once daily, both blocking leukotriene receptors.
    • Zileuton inhibits leukotriene synthesis but can interact with other medications like warfarin and theophylline.

    Mast Cell Stabilizers

    • Cromolyn sodium and nedocromil are poorly soluble drugs that prevent mast cell degranulation, mainly used in allergic conditions but largely replaced by leukotriene inhibitors due to limited efficacy.
    • Ketotifen functions as both an antihistamine and mast cell stabilizer, administered as eye drops or in oral form for allergic conjunctivitis and asthma prophylaxis.

    Other Treatments

    • Expectorants and mucolytics decrease mucus viscosity.
    • Heliox (20% oxygen, 80% helium) facilitates oxygen diffusion in obstructed airways, reducing breathing effort.
    • Omalizumab, an anti-IgE monoclonal antibody, prevents IgE binding to mast cells, reducing the severity of asthma attacks and corticosteroid requirements.

    Stepwise Approach to Chronic Asthma Management

    • Step 1: Use inhaled short-acting β2 agonists (SABA) as needed.
    • Step 2: Add inhaled corticosteroids at 400 mcg/day.
    • Step 3: Incorporate long-acting β2 agonists (LABA) and increase inhaled steroids to 800 mcg/day if inadequate control.
    • Step 4: Further increase inhaled steroids up to 2000 mcg/day and consider adding a fourth drug (e.g., leukotriene antagonist or oral β2 agonists).
    • Step 5: Use oral steroids at the lowest effective dose in combination with high-dose inhaled steroids and refer to specialist care if needed.

    Management of Acute Severe Asthma (Status Asthmaticus)

    • Defined as unresponsive bronchodilator relief during asthma attacks.
    • Requires hospitalization, with oxygen supplied to maintain peripheral capillary saturation (SpO2) between 94-98%.

    Reduction of Bronchial Inflammation

    • Corticosteroids are effective in decreasing bronchial inflammation and hyperreactivity.
    • Mechanisms of action include inhibiting B and T cell functions, macrophage activity, mast cells, and phospholipase A2, leading to reduced antigen-antibody reactions, cytokine release, histamine release, and prostaglandins/leukotrienes synthesis.
    • Increased regulation of β2 receptors enhances the efficacy of corticosteroids.

    Use in Asthma

    • Acute severe asthma treated with intravenous hydrocortisone at 2000 mg, repeated every 4 hours if needed.
    • Chronic bronchial asthma managed with oral prednisone (20 mg/day) or dexamethasone (4-8 mg/day), or inhaled corticosteroids like beclomethasone.
    • Inhaled corticosteroids should be the first-line treatment for newly diagnosed asthma due to their equivalent efficacy to inhaled β2 agonists and minimal systemic side effects.
    • Potential side effects include oropharyngeal candidiasis, which can be prevented with mouth rinsing post-inhalation, and treated with antifungal agents.

    Precautions for Corticosteroid Use

    • Gradual withdrawal is crucial to prevent acute Addisonian crisis.
    • Diet should be potassium and protein-rich but low in sodium and carbohydrates.
    • Regular monitoring for weight gain, edema, elevated blood sugar, or blood pressure changes is necessary.
    • Antibiotics may be required for acute infections with adjusted steroid dosages.

    Prophylactic Treatment

    • Leukotriene inhibitors (e.g., zafirlukast, montelukast) are used to reduce asthma exacerbation frequency.
    • Zafirlukast taken twice daily and montelukast once daily, both blocking leukotriene receptors.
    • Zileuton inhibits leukotriene synthesis but can interact with other medications like warfarin and theophylline.

    Mast Cell Stabilizers

    • Cromolyn sodium and nedocromil are poorly soluble drugs that prevent mast cell degranulation, mainly used in allergic conditions but largely replaced by leukotriene inhibitors due to limited efficacy.
    • Ketotifen functions as both an antihistamine and mast cell stabilizer, administered as eye drops or in oral form for allergic conjunctivitis and asthma prophylaxis.

    Other Treatments

    • Expectorants and mucolytics decrease mucus viscosity.
    • Heliox (20% oxygen, 80% helium) facilitates oxygen diffusion in obstructed airways, reducing breathing effort.
    • Omalizumab, an anti-IgE monoclonal antibody, prevents IgE binding to mast cells, reducing the severity of asthma attacks and corticosteroid requirements.

    Stepwise Approach to Chronic Asthma Management

    • Step 1: Use inhaled short-acting β2 agonists (SABA) as needed.
    • Step 2: Add inhaled corticosteroids at 400 mcg/day.
    • Step 3: Incorporate long-acting β2 agonists (LABA) and increase inhaled steroids to 800 mcg/day if inadequate control.
    • Step 4: Further increase inhaled steroids up to 2000 mcg/day and consider adding a fourth drug (e.g., leukotriene antagonist or oral β2 agonists).
    • Step 5: Use oral steroids at the lowest effective dose in combination with high-dose inhaled steroids and refer to specialist care if needed.

    Management of Acute Severe Asthma (Status Asthmaticus)

    • Defined as unresponsive bronchodilator relief during asthma attacks.
    • Requires hospitalization, with oxygen supplied to maintain peripheral capillary saturation (SpO2) between 94-98%.

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    Description

    This quiz focuses on the role of corticosteroids in reducing bronchial inflammation, including their mechanisms of action. Learn how these medications impact B and T cell functions to alleviate symptoms associated with hyperreactive conditions. Test your knowledge on the pharmacological effects of corticosteroids and their clinical applications.

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