PHRM 514 - Asthma - Fall 2012 (1)

In dipiro jt talbert rl yee gc et al eds

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In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Diagnosis of Chronic Asthma n No single test for diagnosis n Based primarily on history n Physical examination n May have a family history of allergy or asthma or have symptoms of allergic rhinitis n Spirometry Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Spirometry n FEV1 = forced expiratory volume in 1 second n FVC = forced vital capacity n Demonstrates obstruction ¡ Reduced FEV1/FVC ¡ Reversibility following inhaled β2-agonist administration n At least 12% improvement in FEV1 Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Spirometry Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. National Institutes of Health, National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. http://www.nhlbi.nih.gov/guidelines/asthma/ asthgdln.pdf. Published August 28, 2007. Accessed October 16, 2011.
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Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. National Institutes of Health, National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. http://www.nhlbi.nih.gov/guidelines/asthma/ asthgdln.pdf. Published August 28, 2007. Accessed September 19, 2012.
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Signs of an Acute Severe Asthma Exacerbation n Expiratory and inspiratory wheezing on auscultation n Breath sounds diminished with severe obstruction n Dry hacking cough n Tachypnea n Tachycardia n Pale or cyanotic skin n Hyperinflated chest with intercostal and Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Symptoms of an Acute Severe Asthma Exacerbation n Anxious in acute distress n Severe dyspnea, shortness of breath, chest tightness, or burning n Only able to say a few words with each breath n Symptoms unresponsive to usual measures (inhaled short acting β2 Kelly HW, Sorkness CA. Asthma. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy a pathophysiologic approach. 8th ed. New York: McGraw Hill Medical; 2011:439-448.
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Diagnosis of an Acute Severe Asthma Exacerbation n Laboratory ¡ PEF (peak expiratory flow) and FEV1 less than normal predicted values (<40% considered severe) ¡ Decreased arterial oxygen ¡ O2 saturations by pulse oximetry ¡ Decreased arterial or capillary CO2 if mild, but in normal range or increased in moderate to severe obstruction n Other diagnostic tests ¡ Blood gases to assess metabolic acidosis (lactic acidosis) in severe obstruction ¡ Complete blood count if there are signs of infection (fever and purulent sputum) ¡ Serum electrolytes
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In DiPiro JT Talbert RL Yee GC et al eds Pharmacotherapy a...

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