Asthma- Management in children Flashcards
What are the goals of treatment for asthma
Minimal symptoms during day/night
Minimal need for reliever medication
No attacks
No limitation of physical activity
How do you measure a patients control of asthma
SANE
Short acting beta agonist/week
Absence school/nursery
Nocturnal symotoms/week
Excertional symptoms/week
What are some of the differerent class of medications for asthma
SABA
ICS
LABA
Leukotrine receptor agonists
Theophyllines
Oral steroids
What is the treatment if Asthma is suspected but not confirmed
What is the first set treatments for management of asthma
Regular preventer
Very low dose ICS
LTRA <5yrs
What is the second set of treatments for management of asthma
Initial add-on preventor
Very low ICS
+
Children 5+years- add LABA
Children <5 yrs- add LTRA
What is the third set of treatments for asthma
No LABA response- stop LABA
increase ICS to low dose
If LABA benefits, continue LABA
Increase ICS to low dose
If LABA benefits, continue LABA + l.d ICS
Add trial of LTRA
What is the 4th set of treatments
Increase ICS to Medium
Add SR theophylline
Refer to specialist
WHat are the 5th set of treatments for asthma
Daily steroid tablet in lowest dose
Maintain medium-dose ICS
Consider other treatments to improve condition
Refer to specialist
What is the difference in asthma treatment of adults compared to children
Max dose ICS 800 microg (<12 yo)
No oral B2 tablet
LTRA first line preventer in <5s
No LAMAs
Only two biologicals
When would Regular preventer be used
B2 agonists> 2 days a week
Symptomatic 3+ times a week
one night of wake up a week
What to know when using Add on preventers- LABA
Do not use without ICS
Use as fixed dose inhaler
What are the delivery systems for medication
MDI/Spacer
Dry powder device
What is the benefit of using a spacer with MDI
<5% lung deposition w/out spacer
<20% lung deposition with spacer
4x better
What is better MDI spacer or nebulizer
MDI spacer
Quieter
Quicker
Valve mechanism
Don’t break down
Portable
Cheaper
