Asthma Management in Children Flashcards
What is the most important thing to remember when diagnosing asthma?
No wheeze, no asthma
What can you say about a cure for asthma?
There is no cure, only palliation or spontaneous resolution
What are the goals of asthma treatment?
Minimal symptoms during the day and night
Minimal need for reliever medication
No attacks (exacerbations)
No limitations of physical activity
Normal lung function (FEV1 > 70%)
What is the acronym for measuring the control of asthma?
SANE
Short acting beta agonist/week
Absence from school
Nocturnal symptoms/week
Exertional symptoms/week
What must be asked when deciding to treat if the asthma is well controlled?
No change?
Reduce?
What must be asked when deciding to treat when symptoms are not well controlled?
Not taking the treatment? (no change)
Not taking treatment correctly? (no change)
Not asthma? (stop asthma treatment)
None of the above? (increase treatment)
What is the step up and step down approach?
Start on a low dose
Review after 2 months
Why do you start on a low dose and increase after reviews?
Severe may respond to minimal treatment
It is easier to step up than down
What are some different classes of asthma medicine?
Short acting beta agonist
Inhaled corticosteroids (ICS)
Long acting beta agonist
Leukotriene receptor antagonist
Theophylline
Oral steroids
What does ICS stand up for?
Inhaled corticosteroids
What should you remember about the guidelines for the treatment of asthma from country to country?
They may change
What are contrasts between childrens medication and adults?
Max dose ICS 800mg
No oral B2 tablet
LTRA first line prevent in <5s
No LAMAs
What is the max dose of ICS for children?
800mg
What does LAMA stand up for?
Long acting muscarinic antagonist
When should you use a regular inhaler?
B2 agonist > 2 times per week
Symptomatic 3 times a week or more, or waking one night a week
What should be used as a regular inhaler if required?
Very low dose corticosteroids (or LTRA in <5s)
What does LTRA stand up for?
Leukotreine receptor antagonist
What are advantages of inhaled corticosteroids?
Very useful for diagnosis
Very effective
Very safe
What should be remembered about increasing the dose of ICS?
Positive effects plateua while adverse effects increase
What are some adverse effects of ICS?
Height suppresion
Oral candidiasis
Adrenocortical suppresion
Hypertension
Cataracts
What could be used as additional add on preventors?
LABA or LTRA
LTRA
Increase ICS dose