Management of Asthma

Question 1

What would the FEV1/FVC be of an asthmatics patient?

Answer 1

<0.7

Question 2

What monitoring should HCP’s take into consideration with asthmatics?

Answer 2

Adherence
Number of asthma attacks
Their asthma action plan
Does it effect their quality of life
Bronchodilation overuse

Question 3

What is the step wise treatment for asthma?

Answer 3

1. SABA as reliever (throughout)
2. Add low dose ICS
3. Add LABA
4. Increase ICS dose, or add LTRA (e.g. montelukast)
5. Refer

Question 4

What are some examples of SABAs, LABAs, and ICS’s?

Answer 4

SABA - salbutamol, terbutaline
LABA - salmeterol, formoterol
ICS - beclometasone, mometasone

Question 5

What are the 3 severities of asthma, and what occurs during each one?

Answer 5

1. Moderate - normal speech, PEF 0.5-0.7
2. Severe - PEF 0.3-0.5, increased HR/RR
3. Life-threatening - PEF <0.3, pO2 <92%, silent chest, cyanosis

Question 6

What is the treatment for a severe/life-threatening asthma attack?

Answer 6

Nebulised salbutamol, or SAMA
40mg prednisolone or 200mg IV hydrocortisone
Supplementary oxygen

Question 7

What are some side effects of SABAs?

Answer 7

Tremor
Hypokalaemia
Palpitations
Tachycardia
Headaches

Question 8

What are some side effects of ICSs?

Answer 8

sore throat/mouth
Oral thrush
Croaky voice
Coughing

Question 9

What range should a patients peak expiratory flow be?

Answer 9

400-700L/min (dependent on age/gender/height)

Question 10

What can occur during an asthma action plan review?

Answer 10

Review of peak flow diary
Check spirometry
Review inhaler technique
Decreasing ICS doses
Increase therapy if control is poor