ASTHMA MANAGEMENT

Question 1

What is the first step in medical management of asthma in children < 5 years?

Answer 1

The first step is to offer a SABA (e.g. salbutamol) as reliever therapy.

Question 2

When should you go to step 2 straightaway in managing asthma in children < 5 years?

Answer 2

Go to step 2 if there are asthma-related symptoms 3 times a week or more, waking at night due to asthma, or asthma not controlled by SABA reliever alone.

Question 3

What is the next step if asthma symptoms do not resolve after an 8-week trial of paediatric moderate-dose ICS in children < 5 years?

Answer 3

If symptoms do not resolve at 8 weeks, go to step 3 or consider an alternative diagnosis.

Question 4

What should be done if asthma symptoms reoccur within 4 weeks of stopping ICS in children < 5 years?

Answer 4

Restart ICS at a low-dose if symptoms reoccur within 4 weeks of stopping.

Question 5

What should be added to low-dose ICS if symptoms persist in children < 5 years?

Answer 5

Add a LTRA (e.g. montelukast) to the low-dose ICS.

Question 6

What should be done if asthma symptoms do not improve with a low-dose ICS and LTRA in children < 5 years?

Answer 6

Stop LTRA and refer to a healthcare professional with expertise in asthma.

Question 7

What is the first step in medical management of asthma in children aged 5-16 years?

Answer 7

The first step is to offer a SABA (e.g. salbutamol) as reliever therapy.

Question 8

What is the next step if asthma-related symptoms occur 3 times a week or more in children aged 5-16 years?

Answer 8

Go to step 2 if there are asthma-related symptoms 3 times a week or more, waking at night due to asthma, or asthma not controlled by SABA reliever alone.

Question 9

What should be added if asthma symptoms are not controlled by SABA reliever alone in children aged 5-16 years?

Answer 9

Add a paediatric low-dose ICS.

Question 10

What is the next step if asthma symptoms are not controlled by low-dose ICS and LTRA in children aged 5-16 years?

Answer 10

Stop LTRA and add a LABA.

Question 11

What is MART regimen in asthma management for children aged 5-16 years?

Answer 11

MART regimen is Maintenance And Reliever Therapy with a paediatric low-dose ICS and LABA.

Question 12

What should be done if asthma symptoms are not controlled by a MART regimen or fixed-dose ICS and LABA in children aged 5-16 years?

Answer 12

Increase ICS to paediatric moderate-dose ICS or seek advice from a healthcare professional with expertise in asthma.

Question 13

What should be assessed in non-pharmacological management of asthma?

Answer 13

Assess the patient’s baseline asthma status using tools like the Asthma Control Questionnaire or lung function tests.

Question 14

What should be provided to patients for self-management of asthma?

Answer 14

Provide self-management education and a personalised asthma action plan.

Question 15

What should be advised regarding trigger avoidance in asthma management?

Answer 15

Advise about avoiding specific allergens, smoke, beta-blockers, and NSAIDs.

Question 16

What should be done at review of asthma management?

Answer 16

Confirm adherence to medication, review inhaler technique, assess if treatment needs to be changed, and ask about occupational asthma and triggers.

Question 17

How should the severity of asthma attacks be determined?

Answer 17

Determine the severity of asthma as moderate, severe, or life-threatening.

Question 18

What are the PEFR ranges for moderate, severe, and life-threatening asthma?

Answer 18

Moderate: PEFR >50-75% best or predicted; Severe: PEFR 33-50% best or predicted; Life-threatening: PEFR <33% best or predicted.

Question 19

What is the initial management for life-threatening or severe asthma awaiting hospital admission?

Answer 19

Give high-flow oxygen, nebulised salbutamol, nebulised ipratropium bromide, and nebulised magnesium sulphate.

Question 20

What is the role of corticosteroids in the management of severe/life-threatening asthma?

Answer 20

Corticosteroids (e.g. prednisolone) should be given to all patients with severe/life-threatening asthma.

Question 21

What additional treatments should be considered if initial management of severe asthma fails?

Answer 21

Consider IV salbutamol, IV aminophylline, or IV magnesium sulphate and discuss with a senior clinician.

Question 22

When should follow-up be conducted for asthma management after an attack?

Answer 22

Follow-up within 48 hours of presentation if not admitted to hospital or within 2 working days of discharge if admitted.

Question 23

SUMMARISE ASTHMA MANAGEMENT

Answer 23

Question 24

SUMMARISE LAZ SUMMARY OF ASTHMA PART 1

Answer 24

Question 25

SUMMARISE LAZ SUMMARY OF ASTHMA PART 2

Answer 25

Question 26

SUMMARISE LAZ SUMMARY OF ASTHMA PART 3

Answer 26