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what are the 2 categories used to manage asthma
- long term control medications
- short term/quick relief medications
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anti-inflammatory agents/non steroidal anti-inflamm agents
- intal (cromolyn sodium)
- tilade (nedocromal sodium)
prophylaxis and maintanance treatment
-
how do intal and tilade work
inhibits mast cell degranulator during antigen antibody reaction
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intal and tilade prevents releasing
- chem mediators
- histamine
- serotonin
- slow reacting substance of anaphylaxis
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ICS- inhaled corticosteroids
- pulmicort (budesonide)
- flovent (fluticosone)
- qvar (beclomethasone or beclovent)
- asmanex (mometasone)
- aerobid (flunisolide)
- alvesco (this is a MDI)
-
LABA- long acting b2 agonists
- serevent (salmeterol)
- foradil (formeterol)
- arformoterol (brovana)
-
combo drugs
- duoneb (alb / ipra bromide)
- advail (serevent / flovent)
- symbicort (budesonide / formoterol)
- dulera (asmanex / formoterol)
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xanthines-given to babies to stimulate their respiratory drive
- theophylline (theo-dur)
- aminophylline
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leukotrine inhibitors- prevents the whole inflam process
- singulair (montewkast sodium)
- accolate (safirlukast)
- zyflo (zileuton)
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xolair is given
once a month
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quick relief medications/ short acting b2 agonist SABA
- albuterol (proventil, proair, ventolin) 2.5mg
- levalbuterol (xopenex) .31mg, .63mg, 1.25
- pirbuterol (maxair)
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what is the dosage for a cont neb for SABA
10mg
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NAEPP cont neb recommended dose for adults
10-15mg/hr
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NAEPP cont neb recommended dose for child under 12 yrs
.5mg/kg/hr
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anticholinergic blocks
acetylcholine
-
anticholinergic is a parasympathetic, which affect the
- smooth muscles w/ the opposite effect of sympathetic
- bronchoconstricts
- dec hr
-
anticholinergics works better if combined with an SABA
- spiriva handihaler (tiotropium bromide)
- atrovent (ipra bromide)
- duoneb and combivent
-
systemic steroids
- methylprednisolone (solu-medrol)
- prednisone
- hydrocortisone
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how do you teach an asthmatic to control their exposure to their triggers/antogens causing their reactions
- identify what their allergens are/ what is causing their exacerbation of their symptoms
- reduce their exposure to their allergens
- help monitor their symp by doing peak flow measurements
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biggest most common allergen is
dust mites (found in mattress)
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why do people do peak flow monitoring, what does it show us
measures expiratory flow rate- will tell how able the lungs are at expelling the air
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when are peak flow rates used
before and after SABA
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what is a persons peak exp flow rate based on
-
peak flow zone system
- zone system that uses the peak flow meter
- green yellow red
-
green PEF rate is
80-100% of a pt personal best or the predicted
-
yellow PEF rate is
- 50-80%
- means pt may be in mist of exacerbation and to increase treatments
inc freq, or add a medication SABA
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red zone pef is less than
- 50%
- pt needs to get to ED or call their DR and get into the clinic ASAP
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action plan is a written plan that spells out what to do for each of the 3 zones based on the pt
peak flow reading, increase or decrease treatment
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