Asthma Flashcards
what is it
hyperplasia of smooth muscle oedema accumulation increased mucus secretion bronchoconstriction chronic airway inflammation (eosinophilic) airway remodelling
what type hypersensitivity
type 1
when does it come on
it is an episodic reversible bronchoconstriction
early or late onset
what are intrinsic causes
exercise, cold
what are extrinsic causes
drugs, chemical, smoke, pollen, dust, animal dander, fungi, viral infection
what are symptoms
dyspnoea tight chest wheezing non-productive cough diurnal variation non-progressive episodic/intermittent
how is it diagnosed
salbutamol reversibility >15% diurnal variation in peak flow rate normal gas exchange reduced FEV1 to under 75% preserved FVC and TLCO provocation testing - exercise or allergen may find crackles if infection
1st line treatment
SABA (salbutamol)
2nd line treatment
low dose ICS (beclomethasone, budesonide, prednisolone)
3rd line treatment
add LABA (salmeterol) to low dose ICS
4th line treatment
leukotriene receptor antagonist (monteleukast)
Xanthines (theophylline)
LAMA (tiotropium)
5th line treatment
consider increasing ICS up to high dose or addition of fourth drug eg LTRA, xanthine or LAMA - refer to specialist
6th line treatment
use daily steroid tablet in lowest dose providing adequate control
maintain high dose ICS and consider other treatments to minimise use of steroid tablets
refer to specialist
