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W9 Respiratory Disease - COPD & Asthma (Asthma pharmaceutical mngmnt…
W9 Respiratory Disease - COPD & Asthma
Asthma
Prevalence
over 2.5mil Aus have asthma- 1 in 10 adults & 1 in 9 or 10 children
Pops @ risk
linked w/ allergies: in fams w/ allergies
adults of any age can develop it
indoor & outdoor pollution (moulds, gases, chemicals, particles & cigarette smoke)- can ⇈ risk of developing asthma
Athletes can develop asthma after v intensive training over sev years, esp while breathing air tht is polluted, cold or dry
Asthma pharmaceutical mngmnt
Main grps of meds
SABA: work within 5 mins to relieve symptoms
ICS preventers: most effective & powerful, reduce inflammation in lungs
LEBE: reduce swelling for atleast 12 hours, long relief, prevent night time syptoms
Preventer
preventers should be taken every day and continued long term to reduce the risk of flare-ups.
ICS-based preventers
steroid medicine inhaled corticosteroid
Relievers
containing a rapid-onset inhaled beta2 agonist,
use it when they experience difficulty breathing.
1) Asthma & airflow obstruction
Airflow
obstruction
diseases & airflow
restricting
disease
-
Definition of asthma
chronic lung disease, which can be controlled but not cured.
3 factors occur in pathology of asthma to cause obstructive airflow limitation
bronchoconstriction,
congestion or
oedema of bronchial mucosa and mucus.
Signs & symptoms
Causes of occupational asthma
animal subs: prots found in dander, hair, scales, fur, saliva & body waste
chemicals
ezms used in detergent & flour conditioners
metals: Pt
plant subs
respiratory irritants: Cl2 gas, sulfur dioxide & smoke
Stepping up treatment graphic
All patients > most patients > some patients > few patients > referral
consider stepping up if good control is not achieved
when asthma is stable & well controlled for 2-3 months: consider stepping down (reduce ICS dose, or stopping long acting beta2 agonist if ICS dose is already low)
Incorrect use of inhalers
Improving inhaler technique will improve a person with asthma’s:
quality of life,
lung function and
asthma control.
It will also decrease the risk of side effects like hoarseness and mouth infections (oral thrush)
Up to 90 per cent of Australians use their life-saving inhalers incorrectly, increasing their risk of hospitalisation by 50 per cent for asthma and chronic obstructive pulmonary disease (COPD
Asthma action plan
purpose: reduce or prevent flare-ups and emergency department visits.
Following a written asthma action plan can help your child do normal everyday activities without having asthma symptoms.
Emergency
severity assessed as life-threatening acute asthma
give salbutamol via continuous nebulisation (piped oxygen or oxygen cylinder fitted w/ high-flow regulator)
arrange immediate transfer to higher-level care area - notify senior staff
reassess etc
COPD
Diffs & Sims of COPD and Asthma
Sims: inability to get enough air into lungs
COPD: ppl who have chronic bronchitis &/or emphysema
hard to breathe bc swollen airways filled w/ mucus
shortness of breath w/o triggers but when exposed to triggers: symptoms worsen
Asthma: hard to breathe bc trigger or environment
triggers: cigarette smoke, pet dander, dust
COPD bc of emphysema
damaged air sacs in lungs
lead to hyperinflation or inability of lungs to return to their normal shape after expelling air
Causes of COPD
Smoking
exposure to air pollutions, chemicals & 2nd hand smoke
rare: genetic defect AAT
4 Main aims of COPD management
Assess & monitor disease
Reduce risk factors
Manage stable COPD
Manage exacerbations