Asthma (2.7) Flashcards
What is Asthma? Provide a definition
Common respiratory condition affecting one in nine people (~ 2.5 million) living in Australia
- More common in individual with family history of asthma, eczema and hay fever
Asthma = laboured breathing in Greek
Defined as chronic inflammatory disorder of the airways associated with airway hyper-responsiveness leading to acute “flare up”
What signs and symptoms characterise asthma?
- Wheezing
- Breathlessness
- Chest tightness
- Continuing cough
What happens in the airway?
- Red & swollen (inflammation)
- Extra mucus (blocking up airways)
- Constricted (i.e. bronchoconstriction)
What are the trigger factors for asthma
- Respiratory infections
- Allergen exposure
- Air pollutants
- Smoking
- Foods and additives
- Medications
- Exercise
What medications are associated with asthma attacks?
See attached image
How is asthma diagnosed?
> Presence of one of the following: wheeze, breathlessness, chest tightness and cough particularly if:
- worse at night and in the early morning
- in response to exercise, cold air or allergen exposure
- occur after taking aspirin or beta blockers
> Family history of asthma or atopic disorder
> Sx vary from person to person –> the absence of a typical symptom does not include asthma
What tests are used with the diagnosis of asthma? Describe how.
Spirometry testing
- Breathe in as deeply as you can and place your lips tightly around the mouth piece
- Try your hardest and blast out your air as quickly as possible
- Keep blowing out until your lungs are empty and the doctor/nurse tells you to sop, usually after 6 seconds
Spirometer measure
- Forced vital capacity (FVC): total amount of air blown out in one breath
- Forced Expiratory Volume (FEV1) : amount of air blown out within one second
> Important parameter in the diagnosis of asthma
Reduced FEV1/FVC (less than lower limit of normal for age) strongly suggestive of asthma.
For signs and symptoms of acute flare up (acute asthma attack);
A) Describe mild to moderate attack/symptoms
B) Severe attack/symptoms
C) Life threatening/symptoms
A)
- Minor difficulty breathing
- Able to talk in full sentences
- Able to walk/move around
- May have cough or wheeze
B)
- Obvious difficulty breathing
- Cannot speak a full sentence in one breath
- Tugging in of the skin between ribs or at base of neck
- May have cough or wheeze
- Reliever medication not lasting as long as usual
C)
- Gasping for breath
- Unable to speak or 1-2 words per breath
- Confused or exhausted
- Turning blue
- Collapsing
- May no longer have wheeze or cough
- Not responding to reliever medication
For the treatment of asthma;
A) What is used to treat it?
B) What is the active ingredients?
C) What is its mode of action
D) What is its indication
E) What delivery device it it available in?
F) Adverse effects?
A)
- Short acting B2 agonist (SABA)
B)
- Salbutamol and Terbutaline
- Known as reliever medication
C)
- Mode of action: Acts on B2 adrenoceptors in the lungs –> bronchodilatation
D)
- Acute relief of asthma
- Prevention and relief of exercise induced stamina
E)
- Multi dose inhaler
- Autohaler
- Turbuhaler
F)
- Tremor, palpitation, headache
For spacers (delivery aid); –> Used with MDI only
A) What is its purpose?
B) Who is it recommended for
C) What are some care instructions?
A)
- Increase delivery of medication into lungs
- Reduce risk of triggering cough reflex
B)
- Children
- During acute attack
- Adults with poor hand-breath coordination
C)
- Once a month, wash in warm water with dish washing detergent; DO NOT RINSE
- Allow to air dry
- Replace spacer every 12 months or earlier if there is sign of damage
List the steps for the first aid treatment of asthma
See attached image
Whats the pharmacist’ role to assist asthma management?
- Educate patient on the use of their asthma medications
> Indication (reliever vs preventer)
> Dose
> Inhaler technique
- Educate patient on how to recognise symptoms of worsening asthma control and what constitute “good asthma control”
- Emphasize on the importance of asthma action plan
What is good asthma control
- Daytime symptoms ≤2 days per week
- Need for reliever ≤2 days per week
- No limitation of activities
- No symptoms during night or on waking
What is the asthma action plan?
A set of personalised written instruction on asthma management
AIm
- Reduce hospitalisation associated with acute attack
- Improve lung function
- Reduce no of days off work or school due to asthma
What is in the plan?
- What puffer is patient on
- Sign and symptoms of worsening asthma
- What to do at the onset or worsening of asthma symptom
- What to do in the event of an acute attack
