Asthma Patient Assessment Quiz

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

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.