Clinical Management of Asthma

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Clinical Management of Asthma

• Expert Panel Report 3
• National Asthma Education and Prevention Program
• National Heart, Lung and Blood Institute, 2007

Source http//www.nhlbi.nih.gov/guidelines/asthma
/asthgdln.pdf
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2007 NAEPP EPR-3

• Treatment recommendations based on
• Severity
• Control
• Responsiveness
• Provide patient self-management education at
  multiple points of care
• Reduce exposure to inhaled indoor allergens to
  control asthma-multifaceted approach

Source http//www.nhlbi.nih.gov/guidelines/asthma
/asthgdln.pdf
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What is GIP?

• Guidelines Implementation Panel Report for
  Expert Panel Report 3
• Recommendations and strategies to implement EPR-3
• Six key messages

Source http//www.nhlbi.nih.gov/guidelines/asthma
/gip_rpt.pdf
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GIPs Six Key Messages

• Inhaled Corticosteroids
• Asthma Action Plan
• Asthma Severity

• Asthma Control
• Follow-up Visits
• Allergen and Irritant Exposure Control

Source http//www.nhlbi.nih.gov/guidelines/asthma
/gip_rpt.pdf
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Diagnosing Asthma Medical History

• Symptoms
• Coughing
• Wheezing
• Shortness of breath
• Chest tightness
• Symptom Patterns
• Severity
• Family History

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Diagnosing Asthma

• Troublesome cough, particularly at night
• Awakened by coughing
• Coughing or wheezing after physical activity
• Breathing problems during particular seasons
• Coughing, wheezing, or chest tightness after
  allergen exposure
• Colds that last more than 10 days
• Relief when medication is used

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Diagnosing Asthma

• Wheezing sounds during normal breathing
• Hyperexpansion of the thorax
• Increased nasal secretions or nasal polyps
• Atopic dermatitis, eczema, or other allergic skin
  conditions

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Diagnosing AsthmaSpirometry

• Test lung function when diagnosing asthma

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Medications to Treat Asthma

• Medications come in several forms.
• Two major categories of medications are
• Long-term control
• Quick relief

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Medications to Treat AsthmaLong-Term Control

• Taken daily over a long period of time
• Used to reduce inflammation, relax airway
  muscles, and improve symptoms and lung function
• Inhaled corticosteroids
• Long-acting beta2-agonists
• Leukotriene modifiers

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Medications to Treat Asthma Quick-Relief

• Used in acute episodes
• Generally short-acting beta2agonists

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Medications to Treat Asthma How to Use a Spray
Inhaler

• The health-care provider should evaluate inhaler
  technique at each visit.

Source What You and Your Family Can Do About
Asthma by the Global Initiative for Asthma
Created and funded by NIH/NHLBI
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Medications to Treat Asthma Inhalers and Spacers

• Spacers can help patients who have difficulty
  with inhaler use and can reduce potential for
  adverse effects from medication.

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Medications to Treat AsthmaNebulizer

• Machine produces a mist of the medication
• Used for small children or for severe asthma
  episodes
• No evidence that it is more effective than an
  inhaler used with a spacer