Asthma Lecture

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  • 1. DrSTSA

2. Wheeze A high-pitched whistling/musical sound produced bythe passage of air through narrowed airways/ bronchi Louder during expiration A manifestation of lower respiratory tract obstruction Site of obstruction may be anywhere from theintrathoracic trachea to the small bronchi or largebronchioles Sound is generated by turbulence in larger airways thatcollapse with forced expiration 3. Wheezing in Children Episodic wheezing and cough are common in children Infants and young children (95%)2. Bronchodilator therapy 2-agonists Ipratropium bromide Aminophylline3. Maintenance therapySupportive Treatment1.Hydration & fluid maintenance2.+/- antibiotics(ONLY if bacterial infection suspected) 31. GINA 2009..Under 5 32. >5 years 33. Upon Discharge Review asthma medications Provide Asthma Action Plan How to recognize worsening asthma How to treat worsening asthma How & when to seek medical attention Schedule regular follow-ups to monitor asthma control 34. Asthma Education To provide the person with asthma, their family and othercaregivers with suitable information and training so that theycan keep well and adjust treatment according to a medicationplan developed with the health care professional Asthma Education should include : What is asthma? Types of treatment available Drugs relievers & controllers Inhalation devices how to use them Trigger factors and how to avoid them Personal Asthma Action Plan 35. Prevention Identifying and avoiding the following common triggers may be useful Environmental allergens (house dust mites, animaldander, insects, mould and pollen) Cigarette smoking Respiratory tract infections Food allergy uncommon trigger, occurring in 1-2% ofchildrenvigorous exercise should not restrict 36. Assessment of level of controlManagement based on controlDrug therapy types,dosages,delivery 37. Assessment of severity Classification based on frequency, chronicity and severity ofsymptoms Management according to severity:DaytimeLimitatioNocturnalNeed forLungExacerbasymptoms of symptoms/relieverfunctiontions activitesawakeningtestssControlledNoneNoneNone NoneNoneNoneAll of thefollowing:Partly>2 / week Any Any2/week 5 years) 46. GINA 2009 47. Monitoring Assessment during follow-up Assess severity Response to treatment Interval symptoms Frequency and severity of acute exacerbation Morbidity secondary to asthma Quality of life PER monitoring on each visit Compliance Frequency, technique, reason and excuses Education Technique, factual information, written action plan, PEF monitoringmay not be practical for all asthmatics but is essential especially forthose have poor perception of symptoms and those with lifethreatening attacks 48. References Pediatric Protocols Illustrated Textbook of Pediatric GINAReport 2009 GINA_Under 5 Report 2009 Nelson Textbook of Pediatric 18th Edition, chapter 381