Asthma and Stepwise Management

Student`s Name
Tutor`s Name
Institution
Course
Date of Submission
Asthma and Stepwise Management
Introduction
 The ailment is develops from environmental factors such as
smoking, allergies, pollution, cold air and physical activity.
 Asthma causes the tissue damage in the bronchial mucosa,
instigating copious thick secretions and narrowing of the airway
(McCance, & Huether, 2019)
 The National Institutes of Health reported that asthma affects over
300 million individuals
 In the United States, Asthma affects more than 6.3 million children
and 18 million adults. (CDC, 2019)
 Quick Relief Treatment Options
 Quick relief/rescue medication for Asthma are required for rapid short term symptoms
 These medications include
Short-acting beat agonists
 This class of drug is inhaled quick-relief bronchodilators and acts within minutes
 They include albuterol, levalbuterol and Ventolin
Anticholinergic agents
 They include ipratropium Atrovent (HFA) and tiotropium (Spiriva, Spiriva Respimat).
 The medications reacts by relaxing victims airways
 Even though anticholinergic agents are used for emphysema and chronic bronchitis, they are also used to treat
asthma.
Oral and intravenous corticosteroids
 They include prednisone (Prednisone Intensol, Rayos) and methylprednisolone (Medrol, Depo-Medrol, Solu-
Medrol).
 Oral and intravenous corticosteroids combats short-term asthma by relieving airway inflammation.
 Long-Term Medications
Leukotriene Combination
Inhaled corticosteroids. Theophylline
modifiers inhalers
• These medicines are • The class of • They contain a • These are daily
used several days to asthma medication long term,-acting pills for combating
weeks is taken orally beta agonist along Asthma
• fluticasone • They include with • They include
propionate (Flovent montelukast corticosteroid. Theo-24,
HFA, Flovent Diskus, (Singulair), • Common types of Elixophyllin,
Xhance), budesonide zafirlukast combination of Theochron.
(Pulmicort Flexhaler, (Accolate) and inhalers include • They act by
Pulmicort Respules, zileuton (Zyflo) fluticasone- relaxing the
Rhinocort), salmeterol (Advair muscles around
ciclesonide (Alvesco HFA, Airduo the airways
Digihaler, others),
budesonide-
formoterol
(Symbicort),
formoterol-
mometasone
(Dulera)

(Patel et al., 2020).

Impacts of Long and Short-term Drugs
 Leukotriene modifiers are linked to psychological reactions such as hallucinations, depression,
suicidal thoughts and agitation (Blakey et al., 2018).
 Oral corticosteroids cause negative effects such as disturbed sleep, hyperactivity and increased
appetite
 Overuse of albuterol are associated with increased days with asthma symptoms.
 Beta-agonist medications are associated with increased tremor increased nervousness and
insomnia
 Among children, beta-agonist is known cause of nausea, fever, bronchospasm, vomiting and
dyspepsia.
 In response to the negative impacts, clinicians use various medications such as long-acting beta-
agonists (LABAs) and Zileuton.
 Stepwise Approach
Step 1  Identify asthma risk factors  Stage one Asthma known as intermittent.
Assessment and  Ascertain diagnosis of asthma  Physicians uses SABA`s as primary medications
diagnoses  SABAs are bronchodilators that contains Pirbuterol, albuterol and
Levalbuterol
 Albuterol is a beta adrenergic drugs and relieves asthma in 5 minutes,.
 Levalbuterol is a beta 2 agonist while Pirbuterol is a short acting beta 2
adrenoreceptor
 Agonist (Rosenthal, & Burchum, 2018)

Step 2  Employ objective measures to asses patient`s  Asthma in this stage is termed as mild-persistent.
Define asthma current asthma symptoms  Low doses of inhaled corticosteroid ((ICS) and leukotriene are employed to
severity  Classify asthma in accordance to its severity combat the Ailment.
(intermittent, mild, moderate and severe.
Step 3  Initiate Asthma treatment following the results  Doctors use medium dosage of ICS and longa acting beta agonist (LABA)
achieved in step two
Step 4/5  Step four entails monitoring asthma control while  Recommended Asthma dosage in this stage is ICS, LABA or Montelukast
Dosage for step 4 step five entails taking the right action to combat
and 5 are similar the ailment.

Step 6  Entails laying down long-term management of the  The most recommended dosage for this step are oral and inhaled
ailment. corticosteroids.
 Omalizumab is also a preferred medication in this stage.

(Rosenthal& Burchum, 2021).

 Stepwise Management and Maintenance
 Stepwise management helps physicians and patients to manage Asthma through

 Informing clinician's decision making to address individual patient needs

Stepwise aims to achieve Asthma control and mitigate the ailment's symptoms until quality outcomes are realized,.

This occurs as a result of stepwise ability to enable clinicians to make sound decisions regarding individualized patient`s needs

 Regulating medication therapy to reduce the long-term impacts of medications

By studying the effects of short-term and long term drugs on patients, stepwise informs physicians on the right dosage a fact that eradicates the

negative effects of drugs on patients,

 The stepwise approach starts with accurate diagnosis, evaluation of patient`s medical history and physical examinations

This ensures appropriate treatment for specific condition (National Heart Lung and Blood Institute, 2007).

Additionally, the approach eradicates the misguided diagnosis a fact that in turn leads to quality patient outcomes
 Summary

The presentation highlights the contribution of step wise algorithm in combating Asthma. The

approach is a six-step approach physicians apply to decide the right medication for Asthma patient. The

power point has also designated long and short terms medication plans that aligns with within an

asthmatic patient ailment stage. The stepwise algorithm is therefore an evidence-based intervention that

helps healthcare practitioners to realize quality outcomes in addressing asthmatic symptoms arising from

various risk factors. The major asthma risk factors include exercise, allergies and exposure to

chemicals, fumes , smoking and stress. Health practitioners must adhere to stepwise approach while

handling asthma patients because it aids them select a medication plan that suits patient`s needs.
 References
Blakey, J., Slater, M. G., Gayle, A., & Baldwin, M., (2018). Primary care prescribing habits for asthma in England
2007–15: are we following the guidelines? European Respiratory Journal, 52(suppl62) PA4204: DOI:
10.1183/13993003.congress-2018.PA4204.
Centers for Disease Control and Prevention: [CDC]. (2018, January 30). Asthma Management and tretment.
Retrieved from https://www.cdc.gov/asthma/management.html.
McCance, K., & Huether, S. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th
ed.). St. Louis, MO: Elsevier.
National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and
management of asthmaLinks to an external site.. Retrieved from
http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm
Patel, R., Naqvi, S. A., Griffiths, C., & Bloom, C. I. (2020). Systemic adverse effects from inhaled corticosteroid
use in asthma: a systematic review. BMJ open respiratory research, 7(1), e000756.
https://doi.org/10.1136/bmjresp-2020-000756
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and
physician assistants (2nd ed.) St. Louis, MO: Elsevier.