Chronic asthma

Question 1

What are some of the factors that increase the probability of asthma being the diagnosis?

Answer 1

Diurnal variation (worse in morning)
Wheeze
Response to exercise, allergen, cold air
Symptoms after aspirin/beta blocker
History of atopy
Family history of atopy/ asthma
Widespread wheeze heard on auscultation
Unexplained low PEF

Question 2

What lifestyle advice can be given for managing chronic asthma?

Answer 2

Help quitting smoking
Avoid precipitants
Lose weight if overweight
Check inhaler technique
Monitor PEF twice a day
Educate self management through altering medications in light of symptoms
Written action plan for emergency

Question 3

What are the steps of the british thoracic society asthma guidelines?

Answer 3

Step 1 - SABA - salbutamol
Step 2 - SABA + steroid - Salbutamol + beclamethasone (200-800mcg a day)
Step - add leukotriene receptor antagonist (montelukast)
Step 4 - Add long acting B2 agonist (salmeterol 50mcg/12hr)
Step 5 - Add regular oral prednisolone

Question 4

What are some of the side effects of inhaled salbutamol?

Answer 4

Hypokalaemia
Tachyarrhythmias
Tremor
anxiety