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Flashcards in Asthma Management in Children Deck (54)
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1

What is the most important thing to remember when diagnosing asthma?

No wheeze, no asthma

2

What can you say about a cure for asthma?

There is no cure, only palliation or spontaneous resolution

3

What are the goals of asthma treatment?

Minimal symptoms during the day and night

Minimal need for reliever medication

No attacks (exacerbations)

No limitations of physical activity

Normal lung function (FEV1 > 70%)

4

What is the acronym for measuring the control of asthma?

SANE

Short acting beta agonist/week

Absence from school

Nocturnal symptoms/week

Exertional symptoms/week

5

What must be asked when deciding to treat if the asthma is well controlled?

No change?

Reduce?

6

What must be asked when deciding to treat when symptoms are not well controlled?

Not taking the treatment? (no change)

Not taking treatment correctly? (no change)

Not asthma? (stop asthma treatment)

None of the above? (increase treatment)

7

What is the step up and step down approach?

Start on a low dose

Review after 2 months

8

Why do you start on a low dose and increase after reviews?

Severe may respond to minimal treatment

It is easier to step up than down

9

What are some different classes of asthma medicine?

Short acting beta agonist

Inhaled corticosteroids (ICS)

Long acting beta agonist

Leukotriene receptor antagonist

Theophylline

Oral steroids

10

What does ICS stand up for?

Inhaled corticosteroids

11

What should you remember about the guidelines for the treatment of asthma from country to country?

They may change

12

What are contrasts between childrens medication and adults?

Max dose ICS 800mg

No oral B2 tablet

LTRA first line prevent in <5s

No LAMAs

13

What is the max dose of ICS for children?

800mg

14

What does LAMA stand up for?

Long acting muscarinic antagonist

15

When should you use a regular inhaler?

B2 agonist > 2 times per week

Symptomatic 3 times a week or more, or waking one night a week

16

What should be used as a regular inhaler if required?

Very low dose corticosteroids (or LTRA in <5s)

17

What does LTRA stand up for?

Leukotreine receptor antagonist

18

What are advantages of inhaled corticosteroids?

Very useful for diagnosis

Very effective

Very safe

19

What should be remembered about increasing the dose of ICS?

Positive effects plateua while adverse effects increase

20

What are some adverse effects of ICS?

Height suppresion

Oral candidiasis

Adrenocortical suppresion

Hypertension

Cataracts

21

What could be used as additional add on preventors?

LABA or LTRA

LTRA

Increase ICS dose

22

What 2 things should be remembered about long acting beta agonists (LABA)?

Do not use without ICS

Use as a fixed dose inhaler

23

What is the drug used as a leukotriene receptor antagonist?

Montelukast

24

What is montelukast?

Leukotriene receptor antagonist

25

What are advantages of leukotriene receptor antagonists?

Better adherance

Granules for reluctant toddlers

26

What are high dose therpies used for in under 5s?

Confirmation of diagnosis

27

What should you do if a high dose therapy is required for over 5s?

Increase to medium dose ICS and consider referral

28

What should be done if no changes to asthma treatment allows the control of the asthma?

Experimental medicine

50% psychological issues

>50% compliance issues

Question the diagnosis

Minority with genuine severe disease

29

What are the 2 kinds of delivery systems?

MDI/spacer

Dry powder device (DPD)

30

What should be remembered about children compared to adults?

They are less compliant