asthma management in children Flashcards
what are the goals of asthma treatment
minimal symptoms during day and night
no need for reliever meds
no attacks
no limitation of activity
how do u mesure control
SANE SHORT acting beta agonist/ week Absence school Nocturnal symptoms/week Exceptional symptoms/ week
what is the step up step down approach
start on low dose ICS
review after 2 months
what are the different classes of medications
short acting beta agonists inhaled corticosteroids (ICS) long acting beta agonists leukotriene receptor antagonists théophyllines oral steroids
what are the BTS/SIGN guidelines
regular preventer
initial add on preventer
add on therapies
high dose therapies continuous or frequent oral steroids
how does this overlap w adults
max dose ICS 800mg no orla bêta LTRA first line preventer under 5s no LAMAS only two biological
what are the adverse effects of ICS
height suppression
oral candidiasis
adrenocortical suppression
what must you remember when adding on LABA
do not use without ICS
use as fixed dose inhaler
what are the two types of delivery sysetms
MSI/spacer
dry powder device
how does a spacer effect lung deposition
<5% without it
<= 20% with it
who can dry powder devices be used by
licensed in over 5s, most under 8s cannot use them.
achieves 20% lung deposition
how are MDI spacers better than nebuliser
quieter quicker cheaper valve mechanism dont break down
how do you choose what treatment to do
resp rate work of breathing heart rate oxygen saturation ability to complete sentences confusion air entry
how are steroids delivered in acute and chronic asthma
acute - orally
chronic - inhaled
