Asthma Flashcards Preview

Pediatrics > Asthma > Flashcards

Flashcards in Asthma Deck (71)
Loading flashcards...
1

What is the most common chronic disorder in children and adolescents?

Asthma

2

Define Asthma

Recurrent symptoms of airway obstruction that respond to a bronchodilator and often have specific triggers

3

Second Way to Define Asthma

Chronic inflammatory disease of the airways with airway obstruction that's reversible, airway inflammation, increased airway hyper responsiveness, or airway remodeling

4

Development of Asthma

Genetics
Environment
Airway Inflammation
Bronchoconstriction

5

Types of Allergens

Dust mites
Pet dander
Pollen
Rodents
Mold
Natural oils
Organics

6

Types of Irritants

Smoke
Strong fumes
Pollution
Ozone
Chemicals
Petroleum
VOCs

7

Other Triggers of Asthma

URI
Tobacco
Exercise
Cold air
GERD
Chronic sinus diseaes

8

Presentation of Asthma and NSAIDs

Chronic rhinitis
Nasal polyps
Asthma
Malaise
Rhinorrhea
Bronchospasm
Productive cough
Angioedema

9

When to Suspect Asthma

Persistent cough
Recurrent pneumonia
Responds to albuterol

10

History is Most Important

Recurrent cough
Wheeze
Shortness of breath
Improvement of bronchodilator
Clear triggers
PMH: allergic child
Family Hx: maternal

11

Physical Exam Findings in Asthma

Tripod breathing
Tachypnea
Hypoxemia
Dyspnea
Retractions
Poor aerations
Wheezing
Prolonged I:E ration

12

Differential Diagnosis of Asthma

Allergic rhinitis
Sinusitis
FB
Vascular ring/sling
Laryngo/tracheo/ bronchomalacia
Vocal cord dysfunction
Bronchiololitis
CF
Bronchopulmonary dysplasia
Heart disease
Aspiration/GERD
Asthma

13

Goals of Treatment of a Pediatric Asthmatic

Sleep
Learn
Play

14

Risk of Exacerbations

Severe obstructive disease
2+ ED/hosp in the last year
Patients frightened by exacerbations
Non-white
Women
No ICS
Lower SES
Depression
Stress

15

Mechanism of ICS in Asthmatics

Anti-inflammatory
Reverse beta2 receptor down regulation

16

Treatment Options of Moderate Persistent Asthma

Medium dose ICS
Low dose ICS with LABA
Low dose ICS with LTRA

17

MOA of Leukotriene Blockers

Inhibit inflammation through different pathway

18

What can Leukotriene Blockers Assist with?

Toddlers who wheeze with viruses
Spare steroids
Pill vs. inhaler vs. nebulizer
Not as effective as ICS
May have psych SE

19

Tools for Asthma Care

Handouts
Peak flow meters
Spacers
Spirometry

20

Treatment of Asthma

Asthma Action Plan (AAP)
Symptom or peak flow

21

Management of Asthma

Follow up
Education
Medications
Spirometry annually

22

Step Up or Step Down Therapy

Step up therapy if no response in 4-6 weeks
Step down therapy if good control for 3 months

23

Instances for Referrals

High risk asthma
Atypical signs/symptoms
Comorbid disease
Need for additional resources: psychosocial

24

Define High Risk Asthma

Multiple hospitalizations or ED visits
More than 3 steroid bursts/year
Requiring high dose ICS

25

Possible Options of Comorbid Disease that Complicate Asthma

Allergies
Chronic sinusitis
GERD

26

Types of Medication Delivery

MDI's
Spacers
DPI's: dry powder inhalers
Nebulizers
Pari nebulizers

27

MDI Delivery with Spacer

Shake vigorously
Fully exhale breath/ place spacer in mouth
Press down on inhaler
Slow, deep breath
Hold breath 10 secs
Wait between 30-60 seconds btw doses
Rinse mouth

28

MDI Delivery with Mask Spacer

Shake vigorously
Fully exhale
Place mask over spacer
Press down on inhaler
Keep mask in place 5-8 breaths
Wait 30-60 seconds btw doses
Rinse mouth

29

DPI Delivery

Hold inhaler steadily
Actuate inhaler
Deep, fast breath
Hold breath for 10 seconds
Rinse mouth

30

Define Asthma Action Plan

Written plan of care from health care provider, includes zones & symptoms