Assignment: Asthma and Stepwise Management ppt Essay

Long-term Asthma Control

ICS (Inhaled Corticosteroids) – Reduce airway sensitivity and inflammation. Block late reaction to allergens. Inhibit cytokine production and inflammatory cell migration.
Oral corticosteroids – Similar to inhaled corticosteroids. Can have short-term and long-term side effects.
LABAs (Long-Acting Beta Agonists) – Relax bronchial smooth muscles, bronchodilation. May cause increased heart rate, tremors.
Leukotriene modifiers – Block synthesis of leukotrienes, elevate liver enzymes.
Immunomodulators – Adjunctive therapy for older patients.

Long-term medications for asthma control include inhaled corticosteroids (ICS) that reduce inflammation, and LABAs that relax airway muscles. Oral corticosteroids have similar effects as inhaled ones but with side effects. Leukotriene modifiers block leukotriene synthesis. Immunomodulators are used as adjunctive therapy.

Short-Term Asthma Management

Quick-relief inhalers – Fast-acting bronchodilators.
Short-acting Beta-agonists – Common for asthma attacks.
Oral steroids – For frequent attacks, not quick relief.

Quick-relief drugs provide fast relief during asthma attacks. Short-acting Beta-agonists are common quick-relief options. Oral steroids are for frequent attacks, not immediate relief.

Quick-Relief Medications

Short-acting Beta-agonists – Relax airway muscles within minutes.
Increase airflow and relieve symptoms.
Side effects – tachycardia, tremors, arrhythmia potential.
Non-pharmacological effects – allergens, exercise, airway inflammation.

Short-acting Beta-agonists relax airway muscles quickly and relieve symptoms within hours. They may cause tachycardia and tremors, with potential for arrhythmia. Non-pharmacological effects include allergens, exercise, and increased airway inflammation.

Stepwise Management Importance

Prevent asthma exacerbations and lung function loss.
Optimize pharmacotherapy with minimal side effects.
Reduce ED visits and hospitalization.
Provider and patient asthma control.
Complements decision-making.
Alternative treatment for unresponsive cases.

Stepwise management prevents exacerbations, optimizes treatment, and reduces hospitalizations. It aids provider and patient control, offering alternatives for unresponsive cases.

Stepwise Management of Asthma

Step 1: ICS with SABA
Step 2: Low-dose ICS with SABA or LABA
Step 3: Low-dose ICS with LABA
Step 4: Medium dose ICS with LABA
Step 5: Higher dose ICS-LABA or pulmonologist referral.

References

[References]

Asthma Management and Stepwise Approach

Assignment: Asthma and Stepwise Management ppt Essay

Asthma affects people of all ages and requires tailored treatment plans. As a healthcare provider, you need to differentiate between mild and severe asthma symptoms, identifying triggers and providing effective management. One approach to asthma care is the stepwise method, which you’ll explore in this assignment.

To Prepare

– Reflect on various asthma medications, both for long-term control and quick relief, and their effects on patients of different ages.
– Think about how the stepwise approach could address the needs of patients in your care.
– Consider how stepwise management benefits both healthcare providers and patients in achieving asthma control.

By Day 7 of Week 3

Create a PowerPoint presentation of 5-6 slides, suitable for a staff development meeting. The presentation should discuss implementing the stepwise approach for asthma treatment. Cover the following points:

– Describe long-term control and quick relief options for asthma treatment, along with their potential effects.
– Explain the stepwise approach to asthma management and how it can benefit patients.
– Describe how stepwise management assists healthcare providers and patients in gaining control over asthma.

Submit and Grading

To submit your assignment, follow these steps:

1. Save your presentation with the file name “WK3Assgn+LastName+FirstInitial.(extension)”.
2. Review the grading criteria in the Week 3 Assignment Rubric.
3. Click on the Week 3 Assignment link, where you can also “View Rubric” for grading criteria.
4. Attach your saved file under “Attach File” by clicking the “Browse My Computer” button.
5. If applicable, agree to submit your paper to the Global Reference Database in the Plagiarism Tools section.
6. Click “Submit” to complete the process. Please note that SafeAssign cannot accept files larger than 10MB. Keep your file size within this limit.

Assignment: Asthma and Stepwise Management ppt Essay

Long-term asthma management

• ICS – anti-inflammatory, blocks late reaction to allergen, reduce airway sensitivity.
• Inhibit cytokine production, adhesion protein activation, inflammatory cell migration and activation at cellular level.
• Reverse beta2-receptor down-regulation. Inhibit microvascular leakage.
• Side effects- oropharyngeal candidiasis, delayed growth in children (Heffle, et al., 2018).
• Oral corticosteroids- works the same as inhaled corticosteroids.
• Short-term use- reversible abnormalities in sugar metabolism, mood changes, hypertension, rare aseptic necrosis of femur.
• Long-term use- systemic effects

Inhaled and oral corticosteroids have the same mechanism of action. They are both anti-inflammatory medications which act by inhibiting cytokine production, activation of adhesion protein, inflammatory cell migration and activation at the cellular level. They also reverse beta2-receptor down-regulation and inhibit microvascular leakage. Oral corticosteroids may cause short-term and long term side effects. The long-term effects are systemic and may include growth suppression, dermal thinning, hypertension, muscle weakness, and impaired immune function.

• Long-term Treatment
• LABAs- work slowly and lasts longer than SABAs (Boulet, et al., 2019).
• Cause bronchodilation by relaxing bronchial smooth muscle, increases cyclic AMP producing functional antagonism of bronchoconstriction (Lenney, et al., 2018).
• LABAS can increase heart rate, tremors, hypokalaemia.
• A reduced Broncho protective effect may occur 1 week after chronic therapy (Ramsahai, et al., 2018).
• Leukotriene modifiers – LTRAs and 5-lipoxygenase inhibitor. Block synthesis of all leukotrienes at the cellular level.
• May elevate liver enzymes, thus monitoring is recommended (Zahran, et al., 2017).
• LRTAs +ICSs – used as adjunctive therapy for >12 years .
• Immunomodulators – adjunctive therapy for >12 years.

The long-term medications for asthma control are taken on daily basis to achieve and maintain control of persistent asthma. Leukotriene receptor antagonists (LTRAs) is for patients aged more than one while 5-lipoxygenase pathway inhibitors are used for more than 12 years. Long-acting beta-agonists such as salmeterol and formoterol act as bronchodilators for at least 12 hours after a single-dose. LABAS cannot be used as monotherapy due to short duration of acting.

Short-Term management – Assignment: Asthma and Stepwise Management ppt Essay

• Quick-relieve inhalers – fast acting bronchodilators e.g albuterol.
• Provide short-term relieve of symptoms –rescue inhalers
• Act by opening inflamed airways and relieving asthma symptoms.
• Short-acting Beta-agonists- most common quick relieve drugs for asthma attacks.
• Oral steroids – for frequent attacks, not quick-relief medications.

Asthma quick-relief drugs are used for fast control of asthma attacks. Also called rescue drugs. They can be used before exercise to dilate and relax muscles of the airways. Short-acting Beta-agonists are the most common quick relievers for asthma attacks. They include albuterol, levalbuterol, metaproterenol, and terutaline.  Oral steroids can also be administered although not for quick relieve. They are given 7 to 14 days during symptom flare-ups.

 

Quick-relievers –Assignment: Asthma and Stepwise Management ppt Essay

• Short-acting beta-agonists act as bronchodilators – relax airway muscles within 5 minutes.
• Increase airflow and make breathing easier.
• Relieve symptoms within 3-6 hours.
• Pharmacologically predictable dose-related and potency related adverse effects.
• Cause tachycardia and tremors.
• The potential for arrhythmia increases with comorbidity and hypoxemia (Lenney, et al., 2018).
• Non-pharmacologic predictable side effects – non-specific and specific stimuli.
• Increased airway inflammation.

SABAs are bronchodilators which relax the airway muscles within 5 minutes and relieve asthma symptoms within 3 to 6 hours. Research shows pharmacologically predictable dose-related and potency related adverse effects of SABAs including tachycardia, tremors, and effects on potassium and glucose levels. However, the effects resolve with increased exposure to the medications. Also, there is potential for arrhythmia in comorbidity and hypoxemia. Non-pharmacologically predictable effects include nonspecific and specific stimuli including allergen and exercise, and increased airway inflammation.

 

Importance of Step-wise management – Assignment: Asthma and Stepwise Management ppt Essay

• Prevent recurrent asthma exacerbations.
• Prevent progressive loss of lung function.
• Provide optimal pharmacotherapy with minimal or no adverse effects.
• Reduce ED visits and hospitalization (Bernstein & Mansfield, 2019).
• Providers and patients gain and maintain control of asthma.
• Providers use the approach to complement decision making in meeting patient needs.
• Alternative treatment in unresponsive cases available.
• Effective control and management of asthma for both patients and providers.

The step-wise approach to asthma management helps patients and providers to gain and maintain asthma control. It helps prevent recurrent asthma exacerbation , improve lung function, and improve the quality of life. The approach does not replace decision-making in asthma management but is used by providers as an alternative in decision-making regarding meeting patient’s individual needs. Alternative treatment are used in unresponsive cases . Alternatives therapies can be discontinued and the preferred treatment used before stepping up. The step-wise approach helps providers and patients control and manage asthma effectively.

Step-wise management of ASTHMA

• Step 1: ICS- formoterol+ SABA
• Step 2: Low –dose ICS- formoterol or daily low-dose ICS + SABA
• Step 3: Low-dose ICS long-acting agonist +SABA
• Step 4: Medium dose ICS-LABA +SABA
• Step 5: Higher dose ICS-LABA or refer to a pulmonologists.

References

• Boulet, L. P., Reddel, H. K., Bateman, E., Pedersen, S., FitzGerald, J. M., & O’Byrne, P. M. (2019). The global initiative for asthma (GINA): 25 years later. European Respiratory Journal, 54(2).
• Bernstein, J. A., & Mansfield, L. (2019). Step-up and step-down treatments for optimal asthma control in children and adolescents. Journal of Asthma, 56(7), 758-770.
• Heffler, E., Madeira, L. N. G., Ferrando, M., Puggioni, F., Racca, F., Malvezzi, L., … &Canonica, G. W. (2018). Inhaled corticosteroids safety and adverse effects in patients with asthma. The Journal of Allergy and Clinical Immunology: In Practice, 6(3), 776-781.
• Lenney, W., Bush, A., Fitzgerald, D. A., Fletcher, M., Ostrem, A., Pedersen, S., … & Zar, H. J. (2018). Improving the global diagnosis and management of asthma in children. Thorax, 73(7), 662-669.
• Ramsahai, J. M., Hansbro, P. M., & Wark, P. A. (2019). Mechanisms and management of asthma exacerbations. American journal of respiratory and critical care medicine, 199(4), 423-432.
• Zahran, H. S., Bailey, C. M., Qin, X., & Johnson, C. (2017). Long-term control medication use and asthma control status among children and adults with asthma. Journal of asthma, 54(10), 1065-10.

Assignment: Asthma and Stepwise Management

To Prepare

By Day 7 of Week 3

Submission and Grading Information