Asthma Flashcards
0-4yo using salbutamol, Montelukast and low dose fluticasone. What’s the next step?
Specialist referral
5-11yo on salbutamol and and formoterol with budesonide, next step in asthma?
- Continue SABA
- Increase ICS (budesonide) to low dose
- Continue LABA (formoterol) if response, or stop if no response
- Add LTRA e.g. Montelukast 5mg po od
0-4yo using salbutamol, Montelukast and v low dose fluticasone. What’s the next step?
Continue LTRA and SABA
Increase fluticasone (ICS) to low dose
0-4yo using salbutamol, what’s the next step?
Continue SABA
Add either:
- v low-dose ICS e.g. fluticasone 50ug bd / budesonide 125ug bd
or
- LTRA e.g. Montelukast 4mg po od
5-11yo on salbutamol, formoterol, low dose budesonide and Montelukast, next step in asthma?
Refer to specialist
5-11yo on salbutamol, fluticasone and Montelukast, next step in asthma?
Continue SABA and LTRA
Increase ICS to low dose
Add LABA e.g. fluticasone with formoterol/salmeterol inhaler 2 puffs bd
5-11yo on salbutamol and and fluticasone with salmeterol, next step in asthma?
- Continue SABA
- Increase ICS (fluticasone) to low dose
- Continue LABA (salmeterol) if response, or stop if no response
- Add LTRA e.g. Montelukast 5mg po od
5-11yo on salbutamol and budesonide, next step in asthma?
Continue SABA and v low dose ICS
Add either:
- LABA e.g. formoterol with budesonide inhaler 1-2 puffs bd
or
- LTRA e.g. Montelukast 5mg po od
5-11yo on salbutamol and fluticasone, next step in asthma?
Continue SABA and v low dose ICS
Add either:
- LABA e.g. fluticasone with formoterol/salmeterol inhaler 2 puffs bd
or
- LTRA e.g. Montelukast 5mg po od
5-11yo on salbutamol, next step in asthma?
Continue SABA
Add v low-dose ICS inhaler e.g.
Fluticasone 50ug bd,
Budesonide 125ug bd
Beclomethasone 100ug bd
5-11yo on salbutamol, salmeterol, low dose fluticasone and Montelukast, next step in asthma?
Refer to specialist
5-11yo on salbutamol, budesonide and Montelukast, next step in asthma?
Continue SABA and LTRA
Increase ICS to low dose
Add LABA e.g. formoterol with budesonide inhaler 1-2 puffs bd
When do you move up a step in paediatric asthma?
If using SABA >3 doses/week
Trial tx for paeds asthma?
SABA prn e.g. salbutamol 1-2 puffs 5 mins before exercise or every 4-6 hrs as required
Very low dose ICS inhaler e.g. fluticasone / budesonide
0-4yo using salbutamol, Montelukast and v low dose budesonide. What’s the next step?
Continue LTRA and SABA
Increase budesonide (ICS) to low dose
0-4yo using salbutamol, Montelukast and low dose budesonide. What’s the next step?
Specialist referral
What can be given for oral candidiasis?
Miconazole gel or nystatin oral/topical
Step 1 of 5-11yo asthma
SABA prn e.g. salbutamol 2 puffs (200ug) 5 mins before exercise or every 4-6 hrs as required
0-4yo using salbutamol and Montelukast, what’s the next step?
Continue SABA and LTRA
Add v low-dose ICS e.g. fluticasone 50ug bd / budesonide 125ug bd
0-4yo using salbutamol and budesonide, what’s the next step?
Continue SABA and v low dose ICS
Add LTRA e.g. Montelukast 4mg po od
Step 1 of asthma age 0-4yo
SABA prn e.g. salbutamol 1-2 puffs (100-200ug) 5 mins before exercise or every 4-6 hrs as required
0-4yo using salbutamol and fluticasone, what’s the next step?
Continue SABA and v low dose ICS
Add LTRA e.g. Montelukast 4mg po od
5-11yo on salbutamol and and fluticasone with formoterol, next step in asthma?
- Continue SABA
- Increase ICS (fluticasone) to low dose
- Continue LABA (formoterol) if response, or stop if no response
- Add LTRA e.g. Montelukast 5mg po od
What drugs are given for acute exacerbation of asthma?
Nebulisers:
- High flow O2
- Salbutamol
- Possibly add ipratropium bromide if not responding
Steroids:
- IV hydrocortisone 100mg if severe
- PO prednisolone 50mg if less severe
