Podcast
Questions and Answers
What percentage of bad asthma exacerbations are due to respiratory infections?
What percentage of bad asthma exacerbations are due to respiratory infections?
What type of cells are the main drivers of inflammation in asthma?
What type of cells are the main drivers of inflammation in asthma?
What is the primary function of immature dendritic cells in asthma?
What is the primary function of immature dendritic cells in asthma?
What is the goal of counselling patients with asthma?
What is the goal of counselling patients with asthma?
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What is the main characteristic of asthma?
What is the main characteristic of asthma?
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What is a common symptom of asthma?
What is a common symptom of asthma?
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What is the process that allows gas exchange?
What is the process that allows gas exchange?
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What is an example of an asthma trigger?
What is an example of an asthma trigger?
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What is the term for the respiratory system's ability to respond to stimuli?
What is the term for the respiratory system's ability to respond to stimuli?
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What is the purpose of spirometry in asthma diagnosis?
What is the purpose of spirometry in asthma diagnosis?
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What is believed to contribute to the development of asthma?
What is believed to contribute to the development of asthma?
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What is a risk factor for asthma exacerbations?
What is a risk factor for asthma exacerbations?
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What is the name of the system that manages respiration?
What is the name of the system that manages respiration?
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What happens during inspiration?
What happens during inspiration?
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What is the result of the diaphragm relaxing?
What is the result of the diaphragm relaxing?
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What are the two main characteristics of asthma?
What are the two main characteristics of asthma?
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How can a patient's adherence to preventers be checked?
How can a patient's adherence to preventers be checked?
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What is an indicator of poorly controlled asthma?
What is an indicator of poorly controlled asthma?
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What is the purpose of providing a Symptom diary for a GP visit?
What is the purpose of providing a Symptom diary for a GP visit?
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What is an important aspect of asthma management that patients should be aware of?
What is an important aspect of asthma management that patients should be aware of?
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Why is it important to check if a patient knows the appropriate technique for using their SABA inhaler?
Why is it important to check if a patient knows the appropriate technique for using their SABA inhaler?
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What resource can be provided to patients for asthma management information?
What resource can be provided to patients for asthma management information?
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What is the formulation strength of Terbutaline dry powder inhaler?
What is the formulation strength of Terbutaline dry powder inhaler?
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What is the duration of action of Terbutaline?
What is the duration of action of Terbutaline?
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What is the recommended dose of Terbutaline?
What is the recommended dose of Terbutaline?
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What is the importance of proper inhaler use with Terbutaline?
What is the importance of proper inhaler use with Terbutaline?
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Why is Terbutaline no longer subsidised by PBS for S4 versions?
Why is Terbutaline no longer subsidised by PBS for S4 versions?
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What is a key point to discuss with patients using as needed SABAs?
What is a key point to discuss with patients using as needed SABAs?
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What is an advantage of Dry Powder Inhalers (DPIs)?
What is an advantage of Dry Powder Inhalers (DPIs)?
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What is a key role for pharmacists in dispensing S3 Relievers?
What is a key role for pharmacists in dispensing S3 Relievers?
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What is the primary function of bronchodilators in asthma treatment?
What is the primary function of bronchodilators in asthma treatment?
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What is the purpose of adding inhaled corticosteroids (ICS) to asthma treatment?
What is the purpose of adding inhaled corticosteroids (ICS) to asthma treatment?
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What is the recommended medication for most children with asthma?
What is the recommended medication for most children with asthma?
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What is the recommended combination of medications for children aged 1-5 years?
What is the recommended combination of medications for children aged 1-5 years?
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What is the name of the medication that can precipitate acute angle-closure glaucoma?
What is the name of the medication that can precipitate acute angle-closure glaucoma?
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What is the time to action of Salbutamol?
What is the time to action of Salbutamol?
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What is the formulation strength of Salbutamol in a pressurised metered dose inhaler?
What is the formulation strength of Salbutamol in a pressurised metered dose inhaler?
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What is a common side effect of Salbutamol?
What is a common side effect of Salbutamol?
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Study Notes
Asthma Control
- Check patient's asthma control by assessing symptoms, medication use, and lung function
- Check if patient has been prescribed preventers and is adherent to medication
- Check level of SABA usage and patient's technique for using SABA inhaler
- Check for comorbid conditions (AR, OSA, GORD) and refer if needed
- Check if patient has an asthma action plan
Asthma Management
- Provide Reliver PuEer and demonstrate proper technique
- Provide Bisolvon Dry Cough Liquid if necessary
- Educate patient on preventer use and asthma management
- Raise awareness about serious asthma flare-ups and asthma first aid
- Suggest keeping a symptom diary for GP visits
- Provide information on asthma management (Asthma Australia) and record key counseling
Asthma Trajectories
- Variable pathways: early onset (atopic), post-puberty resolution/new development, adult onset (late onset asthma)
- Importance of understanding trajectories to answer patient questions about growing out of asthma
Respiratory Tract
- Inspiration: contraction of diaphragm and external intercostal muscles increase thoracic cavity space and decrease intra-pleural pressure
- Expiration: relaxation of diaphragm and increase in intra-pleural pressure
- Inspiration-expiration cycle allows for gas exchange
Respiration Control
- Managed by CNS respiratory control system
- Central neural respiratory generator
- Sensory input system (thoracic neural receptors, peripheral and central medullary chemoreceptors)
- Muscular effector system
Asthma Pathogenesis and Pathophysiology
- Asthma is a chronic obstructive lung disease that can be controlled but not cured
- Characterized by respiratory symptoms (cough, wheeze, dyspnoea, or chest tightness) and excessive variation in expiratory airflow function
- Associated with airway inflammation and airway hyper-responsiveness
Risk Factors for Asthma
- House dust mites
- Mould
- Pets
- Pollen
- Cigarette smoke
- Exercise
- Smoke
- Chemicals
- Stress
- Emotions
- Hormonal changes (women)
- Respiratory infections (common cold = 80% of bad asthma exacerbations)
- Weather (e.g. thunderstorms)
- Medications
- Occupational exposures
Asthma Pathophysiology
- Repeated infections/exposures disrupt airway epithelial barrier leading to danger signaling and chemokine secretion
- Immature dendritic cells (DC) act as antigen-presenting cells (APCs)
- Allergen-linked APCs stimulate naïve T helper cells to differentiate to Th2 cells
- Cytokines linked to Th2 cell response drive inflammation (majority of asthma cases) - eosinophils are the main driver
Counselling on Controlling Asthma
- Educate patients on controlling asthma to reduce lung remodeling
- Importance of preventers in asthma management
Asthma Diagnosis
- History (family, symptoms, pattern)
- Physical examination (wheeze)
- Consideration of other diagnoses
- Documenting variable airflow limitation (spirometry)
Assessing Asthma Control
- Risk factors for asthma flare-ups
Asthma Treatment Principles
- Bronchodilators (relievers): SABAs, LABAs, SAMAs/LAMAs
- Anti-inflammatory agents (preventers): ICS, LTRAs, targeted biologic agents
- Need for preventers if symptoms occur more than twice a month
- Most children can be treated with SABA alone or with ICS or montelukast additions
- No ICS+LABA combination allowed for 1-5 years children
Reliever Medications - Schedule 3
- Short-acting beta agonists (SABAs): salbutamol and terbutaline
- Salbutamol: formulation type, strength, time to action, elimination half-life, dose, precautions, side effects
- Terbutaline: formulation type, strength, time to action, elimination half-life, dose, precautions, side effects
Dry Powder Inhalers - Turbuhalers
- Teach back method: key steps
Key Roles for Pharmacists
- Educate patients on proper inhaler use
- Counsel patients on asthma management and control
- Monitor patient adherence to medication and asthma control
- Identify and address SABA use issues
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Description
Assess your knowledge on evaluating asthma control in patients, including symptom assessment, medication adherence, and comorbidity checks. Learn about asthma management techniques and best practices.