Asthma Flashcards
What features would classify someone as “High Probability” for asthma
Recurrent episodes of symptoms Symptom variability Recorded observation of wheeze History of atopy History of variable PEF or FEV1 Absence of features of an alternative diagnosis
Diagnostic procedure for someone who is “High Probability” of asthma?
Must have all the features
Code immediately as “suspected asthma”
Initiate trial - 6 weeks of ICS
Assess response through lung function test / symptom score and assess improvement
Diagnostic procedure for someone who is “Low probability” of asthma
Test of airway obstruction –> Spirometry + Bronchodilator therapy
What further tests are available after spirometry and bronchodilator - to confirm a diagnosis of asthma?
Test of variable lung function:
- reversibility
- PEF charting
- Challenge tests
- FeNO
Tests of atopy/eosinophilic inflammation
- blood eosinophils
- skin prick, IgE
What is a PAAP
Personalised Asthma Action Plan
All patients receiving a diagnosis of asthma should have one of these
What constitutes pharmacological control of asthma?
No daytime/nighttime symptoms
No need for rescue meds
No asthma attacks
no limitations of activity - particularly exercise
normal lung function - PEF >80%, normal FEV1
Minimal S/E from meds
Step 1 of adult asthma
Low Dose ICS - Beclometasone
SABA when required - throughout all steps
Step 2 - adult asthma
Low Dose ICS
+
LABA
Step 3 - adult asthma
If LABA not useful --> High dose ICS OR If LABA some use: Medium dose ICS + LABA OR Low dose ICS + LABA + LTRA/LAMA
Step 4 - adult asthma
High dose ICS + LABA + LTRA/LAMA + beta agonist tablet
Step 5 - adult asthma
Oral steroids + high dose ICS
Step 1 paediatric asthma
Very low dose ICS (If > 5yrs old)
OR
LTRA (If < 5 yrs old)
Step 2 - paediatric asthma
Very low dose ICS + LABA (>5 yrs) or LTRA (<5yrs)
Step 3 - paediatric asthma
Low dose ICS OR Low dose ICS + LABA OR Low dose ICS + LABA + LTRA
Step 4 - paediatric asthma
Medium dose ICS + SR theophylline
