Asthma - Pharmacotherapy
short-acting inhaled β2-agonists
For chronic asthma management, what type of medication should be given to
patients who suffer from its acute symptoms?
ICS
What type of medications are preferred for long-term control therapy in
persistent asthma?
ICS
It is the only therapy that reduces the risk of dying from asthma but they do
not reduce airway remodeling nor do they enhance lung growth.
- Beclomethasone dipropionate
- Budesonide
- Fluticasone propionate
- Fluticasone furoate
- Mometasone furoate
- Ciclesonide
Give examples of ICS
- Montelukast
- Zafirlukast
Give examples of LTRAs
LTRAs and theophylline (long-term)
This class of drugs may demonstrate improvement in symptoms and lung
function but they have minimal anti-inflammatory activity.
- Increased dose of ICS
- ICS + LABA (combination)
,What medications should be used on patients with inadequately controlled
moderate persistent asthma?
- LTRAs
- Theophylline
What are the alternatives to long-term treatment of asthma?
ICS + LABA
This combination is more effective in reducing severe asthma exacerbations.
ICS (Higher doses) + LABA
What should be given for patients with SEVERE persistent asthma?
Addition of a third controller medication
What should be done if a patient's severe persistent asthma is still
uncontrolled? Given that this patient is already on high dose ICS + LABA
- Bronchial thermoplasty
- Oral corticosteroids
What are the other therapies reserved for the treatment of uncontrolled severe
asthma, excluding ICS, LABA and LAMA?
Bronchial thermoplasty
This treatment targets the hypertrophied smooth muscle in the airways
through delivery of thermal energy
in a controlled manner to the airway wall to reduce the airway smooth muscle
mass. This results in a reduced response to bronchoconstrictive stimuli
SubQ injections or subL allergen immunotherapy
Patients with documented allergen sensitization with clinical symptoms may
also be prescribed allergen immunotherapy given as?
, - ASSESS adherence, symptoms
- ADJUST therapy
- REVIEW RESPONSE (every 3 months)
What are the three components of the GINA approach?
MDI with a valved spacer and face mask
What is the preferred method of delivery for ICS when it is to be used in
pediatric populations?
Height (ICS causes reductions in growth in kids)
What should be regularly measured in children under ICS?
Oral corticosteroids
What is used to treat moderate-to-severe asthma exacerbations in children?
High-dose nebulized budesonide
(1 mg x twice/day x 7 days)
What is used to treat early signs of upper respiratory tract infections in
pediatric populations and how often are they administered?
ICS
What is the first-line therapy in asthma for children?
Montelukast
What can be an alternative to the first-line therapy in asthma for children?
Asthma (duh!)
What is the most common serious medical condition that can complicate
pregnancy?
low dose ICS - budesonide
( + LABA - if uncontrolled)
short-acting inhaled β2-agonists
For chronic asthma management, what type of medication should be given to
patients who suffer from its acute symptoms?
ICS
What type of medications are preferred for long-term control therapy in
persistent asthma?
ICS
It is the only therapy that reduces the risk of dying from asthma but they do
not reduce airway remodeling nor do they enhance lung growth.
- Beclomethasone dipropionate
- Budesonide
- Fluticasone propionate
- Fluticasone furoate
- Mometasone furoate
- Ciclesonide
Give examples of ICS
- Montelukast
- Zafirlukast
Give examples of LTRAs
LTRAs and theophylline (long-term)
This class of drugs may demonstrate improvement in symptoms and lung
function but they have minimal anti-inflammatory activity.
- Increased dose of ICS
- ICS + LABA (combination)
,What medications should be used on patients with inadequately controlled
moderate persistent asthma?
- LTRAs
- Theophylline
What are the alternatives to long-term treatment of asthma?
ICS + LABA
This combination is more effective in reducing severe asthma exacerbations.
ICS (Higher doses) + LABA
What should be given for patients with SEVERE persistent asthma?
Addition of a third controller medication
What should be done if a patient's severe persistent asthma is still
uncontrolled? Given that this patient is already on high dose ICS + LABA
- Bronchial thermoplasty
- Oral corticosteroids
What are the other therapies reserved for the treatment of uncontrolled severe
asthma, excluding ICS, LABA and LAMA?
Bronchial thermoplasty
This treatment targets the hypertrophied smooth muscle in the airways
through delivery of thermal energy
in a controlled manner to the airway wall to reduce the airway smooth muscle
mass. This results in a reduced response to bronchoconstrictive stimuli
SubQ injections or subL allergen immunotherapy
Patients with documented allergen sensitization with clinical symptoms may
also be prescribed allergen immunotherapy given as?
, - ASSESS adherence, symptoms
- ADJUST therapy
- REVIEW RESPONSE (every 3 months)
What are the three components of the GINA approach?
MDI with a valved spacer and face mask
What is the preferred method of delivery for ICS when it is to be used in
pediatric populations?
Height (ICS causes reductions in growth in kids)
What should be regularly measured in children under ICS?
Oral corticosteroids
What is used to treat moderate-to-severe asthma exacerbations in children?
High-dose nebulized budesonide
(1 mg x twice/day x 7 days)
What is used to treat early signs of upper respiratory tract infections in
pediatric populations and how often are they administered?
ICS
What is the first-line therapy in asthma for children?
Montelukast
What can be an alternative to the first-line therapy in asthma for children?
Asthma (duh!)
What is the most common serious medical condition that can complicate
pregnancy?
low dose ICS - budesonide
( + LABA - if uncontrolled)
