Your Name/Credentials Asthma 101 Your Name/Credentials Job Title Organization
What is Asthma? Reversible narrowing of the airways in the lung Inflammation A long term disease of the airways Not contagious (you can’t catch it) Inherited (tends to run in families)
Normal lungs
Normal airway
Bronchoconstriction (muscles tighten)
Inflammation (swelling and mucus)
What happens in an asthma attack? Muscles tighten around the pipes in the lungs Swelling occurs inside the pipes Lots of mucus is produced inside the pipes.
How do you know if you have it? Diagnosing Asthma How do you know if you have it?
Diagnosis of Asthma Based on a history of coughing or wheezing or shortness of breath Symptoms can vary based on age Cough can be the only symptom No other causes for the cough or wheezing are found
Diagnosing Asthma Your doctor will ask a lot of questions about the type of problems you or your child are having The doctor will examine you or your child Older children and adults can be tested using ‘spirometry’
Asthma Warning Signs
Warning signs of an upcoming asthma attack Drop in peak flow meter scores Dry cough Feeling tired, not wanting to play Feeling sad, angry, moody or restless Trouble sleeping, night cough Stuffy nose, runny nose, watery eyes
More Warning Signs Sneezing, itchy or tickly throat Stomach ache, headache Fast heartbeat Tight chest Fast breathing Wheezing Ear pain
Retractions in the chest More severe symptoms Vomiting Becoming lethargic Retractions in the chest Looking pale
Classification of Asthma
Mild Intermittent Asthma Daytime symptoms no more than twice a week Nighttime symptoms no more than twice a month Brief episodes of problems No problems in between times This is the only class of asthma that does not require preventive medicines
Mild Persistent Asthma Symptoms more than twice a week but less than once a day Attacks may affect activity Nighttime symptoms more than twice a month
Moderate Persistent Asthma Daily Symptoms Daily Use of Albuterol (or equivalent) Attacks affect activity Attacks at least twice a week; may last for days Nighttime symptoms more than once a week
Severe Persistent Asthma Continual Symptoms during the day Limited physical activity Frequent Daily episodes Frequent nighttime symptoms
How can asthma attacks be prevented?
Prevention You can’t prevent every trigger, but there are a lot of things you can do to help your child Pay attention to what causes your child to have problems-write it down so you don’t forget Talk to your doctor about possible triggers; get testing done, if possible
Preventing Infections Wash your hands frequently. Teach your child to do the same Sneeze or cough into a tissue, if possible (At LEAST into the ‘crook’ of the elbow Get your child a Flu Shot every year!
Prevent Exposure to Triggers! Triggers: Things, acts or events that cause asthma episodes Can be allergies, weather, irritants, viral infections, strong emotions, stress, exercise, medical conditions, and medicines Preventing exposure to triggers lowers frequency and severity of asthma symptoms with less need for medicine Use diary to analyze exposure and reaction
Top Five Asthma Triggers Tobacco Smoke and Tobacco Odor Pet Dander Outdoor and Indoor Mold Dust and Dust Mites Cockroaches
Avoiding cigarette smoke is critical! Don’t smoke around your child or in any house or car where your child will be. Request visitors to refrain from smoking in your house or car Don’t take your child to places where other people are smoking
Asthma Action Plans
Asthma Action Plans A step by step approach to treating asthma symptoms Based on peak flow meter readings or a scale of symptoms in children too young for peak flow monitoring Developed by your doctor with your input, and personalized based on your best peak flow
When to see an asthma specialist
General Guidelines When the diagnosis isn’t clear When you need more information about what is triggering your asthma When you aren’t reaching the goals set with the treatment you are on When you have had a life-threatening attack
Goals for kids with asthma
Activity Children with Asthma should be able to play regularly and vigorously with no restrictions!
Symptoms Kids with asthma who are well controlled Should not be waking up at night coughing Should not be using their rescue medicine more than twice a week Should not miss school for asthma Should not need to go to the emergency room or be admitted to the hospital for their asthma Should not consider themselves sicker or weaker than other children
Treatments for asthma
Types of asthma medicines Controller medicines are used to prevent the inflammation in the lungs. They are used every day, even if your child seems well Rescue medicines are used when your child is having problems
Know Your Medications! HOW WHEN to use them to use them!!! Name: (Generic & Brand names) Dose: WHEN to use them!!! HOW your medications work to use them
Quick Reliever (Rescue)Medications (Bronchodilators) Relax tight, twitchy muscles around airways Work in 1-3 minutes and last for 4 hours Take immediately to get episode under control If use > 2 times a week - asthma is out of control ! Proair albuterol sulfate Generic albuterol sulfate inhalation solution Proventil HFA albuterol sulfate Generic albuterol sulfate Ventolin HFA albuterol sulfate Combivent Respimat ipatroprium bromide & albuterol sulfate Xopenex HFA levalbuterol Xopenex levalbuterol inhalation solution Atrovent HFA ipratropium bromide
Long Acting Bronchodilators Controllers Keep airways open by relaxing tight, twitchy muscles Work very slowly and last up to 12 hours Prevent night time symptoms and exercise-induced asthma DOES NOT GIVE QUICK RELIEF! Serevent Diskus salmeterol xinafoate inhalation powder Foradil Aerolizer formoterol fumarate inhalation powder
Inhaled Corticosteroids Controllers Prevent episodes by controlling airway inflammation and decreasing overly-sensitive airways Reduce inflammation that already exists Should take daily if have day symptoms >2 times per week or night symptoms > 2 times per month Always use holding chamber Brush teeth or gargle, rinse, spit after use to prevent thrush Asmanex Twisthaler (mometasone furoate) AeroBid and AeroBid -M flunisolide Azmacort triamcinolone acetonide QVAR 40 mcg and QVAR 80 mcg beclomethasone dipropionate HFA Flovent HFA 44 mcg; Flovent HFA 110 mcg; Flovent HFA 220 mcg; fluticasone propionate Pulmicort Turbuhaler and Pulmicort Respules budesonide inhalation powder and budesonide inhalation solution
Combination Medication Controllers FLOVENT: inhaled steroid - reduces airway inflammation SEREVENT: long-acting bronchodilator keeps airways open Take 1 inhalation AM and PM Built-in dose counter Brush teeth or gargle, rinse, spit after use to prevent thrush DOES NOT GIVE QUICK RELIEF! Advair 100/50 Flovent 100 mcg and Serevent 50 mcg Advair 250/50 Flovent 250 mcg and Serevent 50 mcg Advair 500/50 Flovent 500 mcg and Serevent 50 mcg
Non Steroid Anti Inflammatory Prevent episodes by blocking release of chemicals that cause airway inflammation and muscle tightening Prevent symptoms when exposed to triggers that cannot be avoided: exercise, cold air, animals, etc. Taken year round or only during seasonal allergies DOES NOT GIVE QUICK RELIEF! Cromolyn Sodium Inhalation Solution Intal Inhaler (cromolyn sodium)
Leukotriene Modifiers Prevent episodes by interfering with actions that trigger inflammation and muscle tightening Used for mild asthma or in combination with other meds Must take daily DOES NOT GIVE QUICK RELIEF!
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