PHRM 514 - Asthma - Fall 2012 (1)

Gastroesophageal reflux disease gerd n symptoms of

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Gastroesophageal Reflux Disease (GERD) n Symptoms of GERD common in asthma patients n Nocturnal asthma may be associated with nocturnal reflux n Vagally mediated reflex bronchoconstriction secondary to reflux of gastric contents into esophagus n Medications used to decrease airway smooth muscle tone also have a relaxant effect on gastroesophageal sphincter tone 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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Female Hormones n 30 to 40% of women report premenstrual worsening of asthma n BHR and symptoms improve in asthmatics during pregnancy 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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Food, Drugs, and Additives n No documentation that food allergens trigger asthma n Preservatives may trigger life threatening asthma exacerbations n Aspirin and NSAIDs may precipitate asthma attacks n Non-selective β blocking agents 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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Signs of Chronic Asthma n Expiratory wheezing on auscultation n Dry hacking cough n Signs of atopy ¡ Allergic rhinitis ¡ Eczema 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 Chronic Asthma n Episodes of dyspnea n Chest tightness n Coughing ¡ Particularly at night n Wheezing n Symptoms may occur in association with exercise or in association with known allergens 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 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.
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