CC Jan 2016 Prevention of asthma exacerbation

echoecho's version from 2016-03-21 03:04


Question Answer
List the classifications of asthma exacerbations? Mild, moderate, or severe
Is there a single parameter that has been shower to best predict severity?no
There are objective measurements of lung function that are helpful to assist in this classification and include what tests?1) Measurement of PEF (peak expiratory flow). 2) measurement of FEV1 (forced expiratory volume in one second)
A PEF or FEV1 > 70% of predicted or personal best indicates what type of exacerbation?mild
A reduction to 40-60% indicates what type of exacerbation?moderate
A level < 40 % is indicative of what type of exacerbation?severe
*** Many studies have shown that during an asthma exacerbation, the use of a metered-dose with a _________device is equally effective compared to treatment with a nebulized form of short-acting beta 2 agonist in both children and adults?spac
What is the cornerstone of treatment for acute asthma exacerbations?inhaled short acting beta 2 agonists
The administration of what is recommended for all patients presenting with a moderate or severe asthma exacerbation?oxygen
The early use (within one hour of presentation) of what reduces the need for hospitalization, aw well as the risk of symptom relapse?systemic corticosteroids
Use of what IV drug during severe exacerbations decreases hospital admission rates and improves lung function in children?magnesium sulfate (MgSO4)
*** A 2014 Cochrane review found that a single induction of 1.2-2 grams of what IV famed over 15-30 minutes reduces hospital admissions and improves lung function in adults with severe exacerbations who did not respond to inhaled beta-2 agonists, oxygen and IV steroids?magnesium sulfate
Prediction of a future asthma exacerbation must take into account multiple influencing factors, name these?1) exposure to allergen triggers. 2) improper use of medications 3) AA or Hispanic ethnicity. 4) current diagnosis of persistent asthma
Does regular monitoring of the PEF in the office setting or at home help to predict a future exacerbation?no
*** At the time of discharge, patient who receive a 10 day course of what have a decreased risk of relapse and repeat hospitalization?systemic corticosteroids
Is the data sufficient to recommend initiation of montelukast (Singulair) at the time of discharged after an exacerbation?no
The initiation of what medication or other step up therapy should be initiated and continued for several weeks subsequent to discharge?inhaled corticosteroids
*** SUMMARY = How is the severity of an asthma exacerbation determined?by the degree of reduction in the baseline peak expiratory flow (PEF) or forced expiratory volume in 1 second (FEV1)
*** SUMMARY = Oxygen administration is recommended for all patients presenting with what two types of exacerbations?moderate or severel
*** SUMMARY = Does monitoring of PEF in the home or office setting predict the likelihood of a future exacerbation?no