Questions and Answers
What are key pathophysiologic features and contributing factors to asthma severity and control?
What are the key assessment components when collecting asthma-specific history and physical exam?
What are common diagnostic and monitoring methods for asthma?
How can the NAEPP EPR3 Guidelines classification system be applied to assess asthma severity and control?
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What does it mean to practice applying treatment guidelines for stepwise approach to asthma pharmacotherapy?
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How can pharmacotherapeutic management be individualized to a patient's specific needs and comorbidities?
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What are the appropriate delivery techniques for common asthma devices including metered-dose inhalers and nebulizer therapy?
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What are the key elements of asthma education and how can common myths be addressed?
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What does NAEPP stand for?
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What does EPR-3 stand for?
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What does FEV1 represent?
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What does FVC signify?
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What does MDI stand for?
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What does VHC mean?
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What does ICS stand for?
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What does SABA represent?
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What does LABA mean?
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What does LTRA signify?
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What does CFC stand for?
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What does HFA represent?
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What does DPI stand for?
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What is the burden of asthma?
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What was the purpose of the National Asthma Education & Prevention Program (NAEPP)?
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What summarization does the EPR-3 provide?
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Asthma is ____
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What are the characteristics of chronic airway inflammation in asthma?
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What are the risk factors for developing asthma?
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Study Notes
Asthma Overview
- Asthma affects approximately 300 million individuals globally, making it one of the most prevalent chronic diseases.
- Increasing asthma prevalence, particularly in children, is noted in many countries.
- Asthma leads to significant absenteeism from school and work, with high healthcare expenditures—1-2% of healthcare spending in developed nations, rising demand in developing economies.
- Poorly controlled asthma can be costly; investing in preventive medication can reduce emergency care costs.
National Asthma Education & Prevention Program (NAEPP)
- Established by the NHLBI in 1989 to combat the increasing asthma problem.
- Initial Expert Panel Report (EPR) was published in 1991, with revisions in subsequent years (EPR-2 in 1997, updates in 2002, and EPR-3 in August 2007).
- EPR-3 outlines significant evidence-based guidelines aimed at reducing asthma symptoms and improving quality of life.
Asthma Medical Management
- Asthma is characterized as a chronic inflammatory disease of the airways with recurring symptoms, airflow obstruction, and bronchial hyper-responsiveness.
- Management involves recognizing pathophysiological features, assessing severity through NAEPP EPR-3 guidelines, and tailoring treatments based on individual patient needs and comorbidities.
- Six treatment steps within the EPR-3 guidelines facilitate a stepwise approach to asthma pharmacotherapy, promoting step-up or step-down strategies as needed.
Common Asthma Devices
- Metered-Dose Inhalers (MDI) are essential for delivering short-acting and long-acting bronchodilators.
- Valved-Holding Chambers (VHC) enhance MDI medication delivery and efficacy.
- Dry Powder Inhalers (DPI) provide a convenient alternative for patients, ensuring proper technique is crucial for effectiveness.
- Nebulizer therapy is an option for extensive delivery of medications, especially in severe cases.
Risk Factors for Asthma
- Genetic predisposition significantly increases the likelihood of developing asthma, particularly with a family history of the condition.
- Other contributing factors include socioeconomic status, race/ethnicity, gender variations, prematurity or low birth weight, and environmental influences such as maternal smoking and dietary habits lacking fruits and vegetables.
Asthma Inflammation Characteristics
- The chronic airway inflammation associated with asthma involves activation of mast cells and infiltration by various inflammatory cells (eosinophils, macrophages, neutrophils, lymphocytes).
- Features include airway edema, goblet cell hyperplasia resulting in excessive mucus production, and smooth muscle thickening, which can lead to irreversible airway remodeling.
Key Terms
- FEV1: Forced Expiratory Volume in 1st second; an important measure of lung function.
- FVC: Forced Vital Capacity; total volume of air forcibly exhaled after a deep breath.
- ICS: Inhaled Corticosteroid; anti-inflammatory medication used in asthma control.
- SABA: Short-acting Beta2-agonist; typically used as a rescue inhaler for immediate relief.
- LABA: Long-acting Beta2-agonist; used for ongoing asthma management.
- LTRA: Leukotriene Receptor Antagonist; another class of medication to help manage asthma symptoms.
Education and Myths
- Essential elements include education on asthma management, recognizing and dispelling common myths, especially when communicating with children and families.
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Description
Explore the global impact of asthma, its increasing prevalence, and the efforts undertaken by the National Asthma Education & Prevention Program. Understand the significance of medical management and the importance of preventive care in controlling this chronic disease.
