Asthma and Stepwise Management PowerPoint presentation

Asthma management. By Day 7 of Week 3
Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following: Asthma and Stepwise Management PowerPoint presentation

Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
Explain the stepwise approach to asthma treatment and management for your patient. Asthma and Stepwise Management PowerPoint presentation
Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.
Introduction

According to the Centers for Disease Control and Prevention, Asthma is a condition characterized by narrowed airways that produce excess mucus making breathing difficult.

Common symptoms of asthma include wheezing, coughing, chest pains, shortness of breath and trouble sleeping.

Asthma is classified into the following categories according to the signs and symptoms. Asthma and Stepwise Management PowerPoint presentation

Mild intermittent

Mild persistent

Moderate persistent

Severe persistent.

Mild intermittent symptoms occur to up to two days in a week and two nights in a month.
Mild persistent symptoms occur more than twice a week but do not exceed once a day.
Moderate persistent symptoms occur once daily and exceed more than one night a week.
Severe persistent symptoms occur throughout the day and frequently at night.
Asthma and Stepwise Management PowerPoint presentation
Management of asthma.

Long-term control involves use of medications that reduce the inflammation of the airways.

Long term control medications include inhaled corticosteroids, leukotriene modifiers, long acting beta agonists, combination inhalers and theophylline.

uQuick relief management involves use of medications that open up the airways.

uQuick relief medications include Short acting Beta agonists, ipratropium, and oral and intravenous corticosteroids.

Leukotriene modifiers relieve symptoms up to 24 hours. They are however linked to agitation, aggression, hallucinations and depression adverse effects.
LABA eg salmeterol and formoterol are often taken in combination to prevent the adverse effect of severe asthma attack.
Combination inhalers include a LABA and a corticosteroid such as fluticasone-salmeterol and mometasone-formeterol. Asthma and Stepwise Management PowerPoint presentation
SABA such as albuterol and levalbuterol are taken using devices such as portable hand inhalers and nebulizers to offer relief within minutes.
Ipratropium act immediately by causing bronchodilation.
Oral and intravenous corticosteroids such as methylprednisolone and prednisolone manage the inflammation of the airways during severe asthma and are used in short term to avoid side effects. Asthma and Stepwise Management PowerPoint presentation
Management of asthma.

stepwise approach of asthma is the increment or decrement of dose, number of medications and frequency of dosage to achieve symptomatic control.

stepwise approach occurs when dosage of the medication is increased until the patient can sleep well as night, stay active during the day and reduces emergency visits.

The goal of this approach is to establish the least amount of medication required to obtain good control.

Stepwise management is divided into intermittent asthma and persistent asthma.

The stepwise approach is aimed at assisting in the decision making process during prescription so as to attain individualized patient care.

The stepwise approach is imperative in addressing patient specific needs. Asthma and Stepwise Management PowerPoint presentation

Steps in asthma management.

Intermittent asthma-

ustep 1 SABA

uPersistent asthma-

uStep2 – ICS

uStep 3 – low dose ICS + LABA or theophylline or LTRA

uStep 4 – medium dose ICS + LABA

uStep 5 – high dose ICS + LABA Asthma and Stepwise Management PowerPoint presentation

uStep 6 – High dose ICS + LABA + oral systemic Corticosteroid

Short acting beta-2 agonists such as salbutamol are used as needed for intermittent asthma. If symptoms recur more than two days in a week after treatment with SABA, the patient is treated for persistent asthma.
Inhaled corticosteroids (ICSs) are the preferred treatment for persistent asthma in step 2. Alternatives include theophylline, nedocromil, leukotriene receptor antagonist and cromolyn.
Long acting beta-2 agonists are used together with a low dose inhaled corticosteroid in step 3. Alternatives to LABA include Leukotriene receptor antagonists (e.g montelukast and zafirlukast) and theophylline.
A medium dose inhaled corticosteroid is used together with Long acting beta-2 agonist in step 4. A medium dose inhaled corticosteroid together with theophylline or LTRA.
A high dose inhaled corticosteroid is used together with long acting beta-2 agonist in step 5. alternative therapy includes a high dose inhaled corticosteroid together with theophylline or LTRA.
Step 6 include the use of oral systemic corticosteroid together with LABA and a high dose inhaled corticosteroid. Alternative therapy includes use of a high dose inhaled corticosteroid together with either LTRA or theophylline and oral systemic corticosteroid. Asthma and Stepwise Management PowerPoint presentation
uReference

uRosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

uhttps://www.cdc.gov/asthma/default.htm

uhttp://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

uKaplan, A., Mitchell, P. D., Cave, A. J., Gagnon, R., Foran, V., & Ellis, A. K. (2020). Effective Asthma Management: Is It Time to Let the AIR out of SABA?. Journal of clinical medicine, 9(4), 921. Asthma and Stepwise Management PowerPoint presentation

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