Asthma Module 1 session 2 | 24/03/201 | All

Asthma Dr Anne Boyter School of Pharmacy Strathclyde Institute of Pharmacy & Biomedical Sciences University of Strathclyde

Guideline History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Other guidelines ,[object Object],[object Object],[object Object],[object Object]

Asthma definition ,[object Object],ATS

Asthma definition ,[object Object],[object Object],SIGN 101

Diagnosis ,[object Object],[object Object]

Diagnosis -adults ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

High or low probability ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Intermediate probability ,[object Object],[object Object],[object Object],[object Object]

Reference steroid ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Over age 4   Seretide (Accuhaler) Over age 4   Seretide HFA Over age 4   Accuhaler Over age 4   200mcg MDI (HFA) Fluticasone   Over age 18 Symbicort (regular and as required dosing)  Over age 6  Symbicort  Over age 6  Novolizer  Over age 6  Easyhaler Over age 2   Metered dose inhaler    400mcg Turbohaler Budesonide No longer available 400mcg Beclometasone dipropionate CFC <5 years 5 – 12 years >12 years Equivalent dose Steroid

Aim of management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patient aims of treatment ,[object Object],[object Object],[object Object],[object Object],[object Object]

Stepwise management of asthma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Underlying principles of management ,[object Object],[object Object],[object Object],[object Object]

Step 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Inhaled steroids ,[object Object],[object Object],[object Object],[object Object],[object Object]

Starting dose of inhaled steroid ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Other preventer therapies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Add on therapy ,[object Object],[object Object],[object Object]

Add on therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Step 3: Add-on therapy Pharmacological management. SIGN 101 May 2008 Inadequate control on low dose inhaled steroids If control still inadequate go to Step 4 Add inhaled long-acting ß 2 agonist (LABA) ,[object Object],[object Object],Benefit from LABA but control still inadequate: Trial of other add-on therapy, e.g. leukotriene receptor antagonist or theophylline Control still inadequate: If control still inadequate go to Step 4 Assess control of asthma ,[object Object],[object Object],No response to LABA: Continue LABA Good response to LABA:

Regular and as required dosing of combination products ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Addition of a fourth drug ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Step 5 ,[object Object],[object Object],[object Object],[object Object]

Steroid sparing medication ,[object Object],[object Object],[object Object],[object Object],[object Object]

Safety of inhaled steroids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Safety of inhaled steroids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LABA ,[object Object],[object Object],[object Object]

Frequent or continuous oral steroids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Non-pharmacological management

Smoking cessation ,[object Object],[object Object],[object Object]

Non-pharmacological management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Non-pharmacological management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

© Imperial College London Assessment: Royal College of Physicians of London three questions Outcomes and audit. Thorax 2003; 58 (Suppl I): i1-i92 ,[object Object],[object Object],IN THE LAST WEEK / MONTH YES NO “ Have you had difficulty sleeping because of your asthma symptoms (including cough)?” “ Have you had your usual asthma symptoms during the day (cough, wheeze, chest tightness or breathlessness)?” “ Has your asthma interfered with your usual activities (e.g. housework, work, school, etc)?” Date / / /

Asthma Control Test™ (ACT) ,[object Object],[object Object],[object Object],[object Object],[object Object],Score Patient Total Score Copyright 2002, QualityMetric Incorporated. Asthma Control Test Is a Trademark of QualityMetric Incorporated.

Asthma Module 1 session 2 | 24/03/201 | All

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Asthma Module 1 session 2 | 24/03/201 | All

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