Laura Case study.

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Presentation transcript:

Laura Case study

23-year old woman with history of childhood asthma Part 1: the story so far… 23-year old woman with history of childhood asthma Started fitness campaign but suffers from breathlessness on exertion At clinic, PEF normal

Part 1: questions What advice would you give Laura? What therapy would you recommend if a peak flow diary showed a stable baseline but short lived dips after running?

Remember to make an assessment of the probability of asthma. Part 1: key points Remember to make an assessment of the probability of asthma. Diagnose before treating – try to confirm diagnosis with objective tests before long term therapy is started.

Part 2: the story continues… Increasing symptoms Interested in complementary therapy Becomes pregnant.

Part 2: questions What would you advise Laura about complementary treatments for asthma?

Part 2: questions What would you do now Laura is pregnant if she was: (a) not distressed, slightly wheezy with respiratory rate of 20 breaths/minute, pulse 100 beats/minute and PEF of 390 L/minute? (b) looks dreadful, cannot complete sentences, with very quiet breath sounds on auscultation, respiratory rate 30 breaths/minute, pulse 120 beats/minute and PEF of 120 L/minute?

Continue usual asthma therapy in pregnancy Part 2: key points No consistent evidence to support use of complementary or alternative treatments in asthma Continue usual asthma therapy in pregnancy Monitor pregnant women with asthma closely to ensure therapy is appropriate for symptoms.