1. Asthma and dose inhalers (32, 27, 34:00 29
a. Most effective drug available for relieving acute bronchospasm and (When) preventing
exercise-induced bronchoconstriction (EIB)(We use?). Bronchodilator (Albuterol) and
ICS??
b. Teach atients to use spacer: 9% without spacer, 21 with
Treatment: Asthma & COPD
• MDI inhaler with Spacer - (Albuterol-RESCUE) - 1-2 puffs Q 4 hours PRN –
**Wait 1 full minute in between puffs.** Must inhale prior to activating device.
Monitor HR & BP
• Dry-Powder Inhaler - fluticasone/salmeterol (Advair-prophylaxis) - Twice Daily -
**Must rinse mouth out after use to prevent oral Thrush (candidiasis)**
2. Why we use glucocorticoids- most effective drugs available for long-term control of airway
inflammation. Decrease inflammation. Reduce bronchial hyperreactivity. Decrease mucous in
airway. if it causes hyperglycemia check glucose (13, 15, 16-20, 24, 35, 38-40, 79) when patient
is on an inhaled corticosteroid ICS always rinse with water, thrush. Prednisone can cause
immune suppression and delay would healing, monitor signs of infection, CBC, fever, when
discontinue taper or Addison disease.
3. How to manage asthma in emergency situations. SABA-Albuterol (14
a. Duoneb
i. Albuterol (open airways) / ipratropium bromide (decrease inflammation)
ii. Inhaled SABA = albuterol
iii. Inhaled anticholinergic (bronchodilator) = ipratropium bromide
b. IM or IV glucocorticoids = methylprednisolone (Solu-Medrol)
c. Oxygen
d. If resistant to treatment, consider mechanical ventilation (BiPAP or intubation)
4. How to treat COPD (13, 14, 17)
a. Chronic obstructive pulmonary disease (COPD) is a chronic, progressive, largely
irreversible inflammatory lung disease that causes obstructed airflow from the lungs.
b. Drug therapy does not slow disease progression
c. If they get too much oxygen, it may knock out their respiratory drive.
Treatment Drugs:
a. SABA (short-acting beta2 agonist) = albuterol (quick relief only)
b. ICS (inhaled corticosteroid) = fluticasone
c. LABA (long-acting beta2 agonist) = salmeterol
d. fluticasone/salmeterol (Advair)
Treatment: Asthma & COPD
a. MDI inhaler with Spacer - (Albuterol-RESCUE) - 1-2 puffs Q 4 hours PRN –
**Wait 1 full minute in between puffs.** Must inhale prior to activating device.