Asthma Management

Question 1

What is the Salbutamol Inhaler known as and what’s it’s mechanism? Side effect?

Answer 1

‘Reliever’
Smooth muscle relaxation = dilation of bronchial passages
Tremor

Question 2

What is the Steroid Inhaler known as and what’s it’s mechanism? How often is taken? Side effects?

Answer 2

‘Preventer’
Activates anti-stress & anti-inflammatory pathways
Taken every day
Oral candidiasis & stunted growth

Question 3

1st Mx step of asthma in adults?

Answer 3

SABA + ICS (SABA more than 3 times per week is considered a sign that further add-on therapy is needed)

Question 4

2nd Mx step of asthma in adults?

Answer 4

SABA + ICS + LABA

Question 5

Name a LABA and how often is taken?

Answer 5

Salmeterol and taken daily

Question 6

3rd Mx step of asthma in adults?

Answer 6

SABA + ICS + LABA (stop LABA if not working)

Increased ICS to medium dose

Question 7

What is the alternative 3rd Mx step?

Answer 7

SABA + ICS + LABA

Add Leukotriene receptor antagonist (LTRA), SR Theophylline or Long-acting muscarinic antagonist (LAMA)

Question 8

4th Mx step of asthma in adults?

Answer 8

Trials of:

Increasing ICS to higher dose

OR

SABA + ICS + LABA (+ LRTA or SR Theophylline or LAMA)

Patient should be referred to respiratory specialist at this point.

Question 9

5th Mx step of asthma in adults?

Answer 9

Daily oral prednisolone

Refer