Chronic Asthma Flashcards
(12 cards)
What is Chronic Asthma?
Chronic inflammation of asthma - vary in severity
Can suddenly worsen provoking an asthma attack
May require going to hospital
Chronic Asthma Symptoms
Shortness of breath- this often occurs particularly with physical activity or at night
Wheezing - High pitched whilstling sound when breathing, especially during exhalation
Coughing: A persistent cough, often worse at night or early in the morning that doesn’t seem to go away
Chest tightness - a feeling of pressure or constriction in the chest
Aims of using Asthma medication
Complete control is defined as:
- No day time symptoms
- No waking up at night time due to Asthma
- No asthma attacks
- No need for rescue medication(amoxicillin/prednisolone)
- No limits on activity
-Normal lung function
-No side effects from their asthma medication
Reasons for uncontrolled Asthma
- lack of adherence- not using inhaler why?
- Poor inhaler technique -DPI or PMDI - spacer?
- Inappropriate medication or dose: as they on the right management plan?
- Are they taking their right dose
- Over using reliever techniques? And not using Maintenance inhaler enough?
- Smoking - referral to smoking cessation service
= Seasonal factors - dust mites, pollen - Environmental factors - pollution
Lifestyle Changes
-Weightloss
- Pharmacy - offer smoking cessation advice
- Asthma nurse - recommend breathing exercises
General advice on Asthma reviews
Always review any change in 4-8 weeks or sooner if it is required
Always aim for lowest dose on inhaler corticosteroids
Always counsel patients on device especially when changing device
Management approach
Aims to stop symptoms and improve peak flow
Before patient starts a new inhaler or has a change in treatment
- Asthma review by respiratory nurse
- Should have a diagnosis
- Adherence and inhalation technique - pharmacist NMS
If patient has trigger factors, find out what they are and advise them to be avoid these
Things that can exacerbate
Stress
Medication - BB/Nsaids
Allergens,pollen
Food
Physical activity
Uncontrolled asthma means what?
1) Asthma symptoms more than 3 times a week - are they using a reliever?
2) Waking up at night because of symptoms
3) Asthma control test scores not well controlled - on current management plan
The ACT 5 qs
How often your symptoms kept you from doing regular activities?
How often were you short of breath?
How often symptoms disrupt sleep?
How often you used your rescue medication?
How well you think your asthma is controlled?
Scores of 1-5
Decreasing treatment
Controlled asthma for at least 3 months by 25-50% each time
Decrease maintenance therapy usually the ICS
Aim to be on lowest possible dose for ICS
Only stop ICS treatment completely if on low dose ICS - step 2 and no symptoms
Stepping down
Allow 8-12 weeks between each step down to monitor the patients response
