Management of asthma in children and adults

Question 1

Contrast the management of asthma with strategies for management of COPD.

Answer 1

CPOD you won’t full be able to get rid of symptoms, age of onset is usually younger and most common cause is smoking.
treatment of asthma is driven by the need to suppress the chronic inflammation, whereas in COPD, treatment is driven by the need to reduce symptoms.

Question 2

Explain how to assess the severity of acute asthma.

Answer 2

SANE- Short acting beta agonist, Absence from school or nursery, Nocturnal symtpoms, Exceptional symptoms

Respiratory rate, work of breathing, heart rate, oxygen saturation, ability to complete sentences, confusion and air entry

Question 3

Describe the clinical management of acute asthma.

Answer 3

Start on low dose and review after 2 months, stop smoke exposure, remove environmental triggers

Question 4

Outline the stepwise approach to management of asthma based on the Scottish Intercollegiate Guidelines Network and British Thoracic Society Guidelines.

Answer 4

One figure for all children, ICS doses overlap with adults, acknowledges areas of uncertainty when ICS are not sufficient.

Question 5

Describe the classes of drugs and modes of delivery available in the management of obstructive lung diseases, both asthma and COPD.

Answer 5

short acting beta agonists- BLUE (salbutamol)/terbutaline
inhaled corticosteroids- Brown
*long acting beta agonists
*leukotriene receptors agonists (oral)
*theophyllines (oral)
oral steroids
*add ons

Question 6

MDI vs nebulisers

Answer 6

MDI are quieter, quicker, portable, cheaper, don’t break down

Question 7

what does complete control of asthma look like

Answer 7

no daytime symtoms, no night time awakening, no need for rescue medication, no asthma attacks, no limit on daily activity, minimal side effects from mediation