Asthma Case Study

I have made no changes to Ms. Dahlberg's bronchodilator and inhaled corticosteroid use. She does have a prescription of prednisone at home, as she is well aware of her asthma exacerbation equivalents. She does have a history of steroid use psychosis and I advised her to initiate treatment at 40 mg per day. She should then seek further medical attention after initiating systemic steroids. She should also continue use of her current bronchodilators and inhaled corticosteroids.

A quite common, yet still horrible disease that people suffer from is asthma, which my uncle suffers from. It’s a terrible thing when you see them pull out that inhaler. You see the pain in their eyes. Also, how they have suffered with this horrendous condition of simply not being able to breath. Asthma is a non-communicable disease that plagues many people around the globe.

Task analysis is the process of obtaining information about a job by determining the duties, tasks, and activities involved and the knowledge, skills, and abilities required in performing each task. There can be broken down into six

In an emergency situation, why is a drug most commonly delivered via injection versus an oral route?

R.J. is a 15-year-old boy with a history of asthma diagnosed at age 8. His asthma episodes are triggered by exposure to cats and various plant pollens. He has been using his albuterol inhaler 10 to 12 times per day over the last 3 days and is continuing to wheeze. He normally needs his inhaler only occasionally (2 or 3 times per week). He takes no other medications and has no other known medical conditions. Physical examination reveals moderate respiratory distress with a respiratory rate of 32, oximetry 90%, peak expiratory flow rate (PEFR) 60% of predicted, and expiratory wheezing.

Eight-year-old B.J. has had asthma for 2 years since he had acute bronchitis. He was tested for allergies and demonstrated marked responses to a number of animals, pollens, and molds. B.J. also has a history of asthma related to exposure to very cold weather.

If combined with adrenergic stimulating drugs used for treating asthma, ex. albuterol the adrenergic blocking effects of labetalol may counteract the effects of the stimulating drugs and reduce their effectiveness for treating asthmatic attacks. More of the adrenergic drug may be needed.

Asthma control varies over time due to severity and changes in the environment, for example, home, school and or work environments. There are several medications and combinations used to control asthma attacks. The first line of medication are inhaled corticosteroids used to prevent and reduce airway swelling and inhaled long-acting beta agonist used to keep the airways open and relaxed (AAFA, 2015). Examples of long-acting corticosteroids are fluticasone, budesonide, mometasone, beclomethasone, ciclesonide, flunisolide. Examples of LABA medications are salmeterol and formoterol; it is important to remind patients that these medications are not to be used in emergency situations. At times, both medications are used together in a single medication to treat asthma and prevent attacks. Some caution that patients should be aware that when using combination medication, the risk for severe asthma attacks increase (Mayo Clinic, 2015). Examples of combination medications are Advair (fluticasone and salmeterol), Symbicort (budesonide and formoterol), Dulera (mometasone and formoterol) and Breo (fluticasone and

It is important because many people do not know that asthma can potentially get worse from certain treatment options. Since asthma is a very common disease I believe that people should be aware of anything that can affect them and cause them harm. In the article The Local Side Effects of Inhaled Corticosteroids by Nicholas J. Roland, Rajiv K. Bhalla, and John Earis it states” Inhaled corticosteroids can lead to osteoporosis, bruising and thinning of the skin, subscapular cataracts, and even glaucoma.” (214). These side effects are things that people should be fully aware of and know that there is a chance that they might have to deal with side effects that could add other problems to them on top of asthma. In the article Current Treatment of Severe Asthma by S. Hashimoto and E. H. Bel states “Unfortunately the chronic use of oral corticosteroids is associated with serious side effects such as osteoporosis, diabetes, hypertension, and cataract formation” (697). Asthma treatments can have varying and concerning side effects that can drastically change a person’s life if they had these side

In this article Dr. Foaud explains the inflammatory response that occurs in the airways of asthma patients and how the different types of cells and respiratory epithelial interact in the process. Respiratory epithelium, mast cells, eosinophils, basophils, and leukocytes all play an critical part in not only the inflammatory response but also in the way that they may be utilized to inhibit the response to help treat asthma. The article also explains how chemokines recruit inflammatory cells to the airways. The inflammatory response seen in asthma

It is available in elixir and pill/capsule form. Immunomodulators decrease asthma symptoms and are not for acute relief. The use of these decreases the need for systemic corticosteroids. Immunomodulators impact different parts of the pathophysiology of asthma. They can be of use in decreasing inflammation and stopping airway remodeling. They bind to IgE preventing it from binding to basophils and mast cells. They also decrease the number of circulating basophils as well as prevent mast cells from releasing things that will worsen asthmatic symptoms. Xolair is a monoclonal antibody and is the only currently approved immunomodulator therapy available for asthma. It is mainly used with positive skin test to known asthma triggers but can also be used for symptoms that are inadequately controlled by inhaled corticosteroids. There are many newer drugs that are in development. Some of these include: Daclizumab which affects multiple places in the asthma cascade; Lebrikizumab which binds and blocks interleukin-13 activity; Reslizumab that targets

Miss Brightman’s asthma is currently not controlled, and there are several viable courses of action to consider that could reverse this. One option would be to progress Miss Brightman onto step 3; a long-acting beta2 agonist would be introduced, such as Salmeterol or Formoterol, in the form of a combination inhaler with the corticosteroid to aid compliance. However, when looking at the recommended doses for Beclometosone in the BNF, it is apparent that Miss Brightman has been extremely underdosed. The BNF states that the recommended dose of inhaled corticosteroid for an adult is 200-400μg twice daily, meaning that the

They have been shown to play a role in the body’s stress response system and reduces inflammation. Corticosteroids are produced in the body by in adrenal gland near the kidneys. Some corticosteroids are currently used to treat inflammation of the airway passages for asthma patients. Some of the common drugs are Prednisone, Plumicort and Advair. These drugs are inhale by the patient. Corticosteroids can also be applied topologically to treat inflammation of rashes like poison ivy, arthritis, and inflammatory bowel disease. While the side effects of Corticosteroids are not as severe as Anabolic steroids, there are serious side effects associated with taking them. Patients may experience rapid weight gain (especially in the face or neck), fever, depression, vision changes, dry mouth, muscle pain/weakness or

I would like to include that Proventil is prescribed as needed. It is a bronchodilator that stimulate beta 2 to cause relaxation of bronchial smooth muscles and also a short acting relief inhaler used to rescue attack. Rita should use Proventil inhaler before she uses any other inhaler. If used frequently, it will trigger beta 1 reaction which will increase Rita’s heart rate, force of contraction and could cause nervousness. Corticosteroids (prednisone) is given by mouth. Since the doctor ordered prednisone 60mg taper dose, the nurse will teach Rita how to taper (decrease) dose every 2-3 days to avoid systemic effects when the medication is used for long period of time. Do not increase dosage or frequency of taking medication. Overuse

Fluticasone Propionate/Salmeterol Xinafoate (Advair Diskus 250 mcg/50 mcg) is an example of a combination long acting inhaled corticosteroid and a long acting bronchodilator. Turkoski, Lance, and Bonfiglio (2010), state the corticosteroid Fluticasone Propionate promotes “vasoconstrictive and anti-inflammatory activity [in the lungs]” ( p.799) These authors also explain Salmeterol Xinafoate “relaxes bronchial smooth muscle by acting on beta2receptors” [in the lungs] (p. 1618). Davis et al. (2017) found that patients in their study who did not adhere to long acting inhaled corticosteroid and a long acting bronchodilator therapy had significantly higher rates of COPD exacerbations; and subsequently much higher healthcare