A Word About Summer Breaks From Asthma Medicines
Asthma is a chronic yet variable disease everyones asthma is different. Asthma attacks or flare-ups are more common the spring and fall so children with asthma need to take their asthma medicines year round â even in the summer . Control or preventive medicines keep airways from swelling due to exposure to allergens, irritants or respiratory illnesses but they can take weeks to be fully effective again. Stopping controller medicines in the summer allows the airways to lose their protective armor against triggers. It can take weeks before the protection is gone but it also can take up to 3 months of daily use to get that protection back.
Because children returning to school are more likely to be exposed to the flu and colds, it creates a much greater risk that their asthma will flare up resulting in extra visits to a providers office or the ER and missed school days. Remember, summer break doesnt apply to asthma medicines.
2Biologics for Asthma: Attacking the Source of the disease, not the symptoms, American College of Allergy, Asthma & Immunology
Programs For Health Care Professionals
AAFA offers healthcare professionals continuing education opportunities online and onsite. We also offer programs and materials to help you educate professionals who work with patients and patients. These programs can be used in the classroom, in-home and at the worksite. Programs range from providing basic information about asthma and allergies to advanced disease management skills. In addition, we have posters, fact sheets and brochures in attractive, easy-to-read designs and formats. Some are also available in Spanish.
Institute For Clinical Systems Improvement
Institute for Clinical Systems Improvement â ICSIThe ICSI Diagnosis and Management of Asthma guideline work group endorsed 2016 Global Strategy for Asthma Management and Prevention Report with added qualifications/comments. The 2016 report addresses the diagnosis and management of asthma in the pediatric and adult population. The previous ICSI Diagnosis and Management of Asthma guideline from July 2012 has been retired.
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Types Of Severe Asthma
There are two main categories of severe asthma Type-2 inflammation and Non-Type-2 inflammation. These categories are based on a persons response to treatment. Type-2 inflammation includes allergic asthma and eosinophilic asthma and Non-Type-2 inflammation includes non-eosinophilic asthma. For example, allergic asthma and e-asthma respond to treatment with inhaled corticosteroids and IgE -directed therapy or other biologics listed in the above table. Patients with Non-Type-2 inflammation, including non-eosinophilic asthma, generally do not respond well to inhaled corticosteroids. Allergic asthma and e-asthma have distinct biomarkers and treatment options available today. Treatments for non-eosinophilic asthma are currently being development.
Allergic asthma is caused by exposure to allergens such as pollen, pet dander, molds, etc. Most people diagnosed with allergic asthma will also have a diagnosis of hay fever or rhinitis. For these patients, exposure to allergens causes the bodys immune system to produce immunoglobulin E, an antibody that attaches to certain cells and causes them to release chemicals creating an allergic reaction. When this happens, common symptoms are sneezing, itchy/watery eyes, severe allergic reactions , and increased airway sensitivity.
Non-eosinophilic asthma includes neutrophilic, smooth-muscle mediated and mixed cells. People in this subgroup have few to no eosinophils in test results, and do not respond well to inhaled corticosteroids.
A Stepwise Management Approach
There is no National Institute for Health and Care Excellence guidance for asthma management. However, a quality standard outlines 11 high-priority areas for quality improvement linked to British Thoracic Society and Scottish Intercollegiate Guidelines Network guidance on asthma management .
In most patients, asthma is effectively managed with inhaled corticosteroids and inhaled ß2-agonists according to steps 1-3 of the BTS/SIGN stepwise management plan . However, a minority of patients have poorly controlled asthma despite the prescription of optimal inhaled medication. These patients require additional maintenance therapies such as leukotriene receptor antagonists, sustained-release theophylline, oral ß2 agonists, or intermittent or regular oral corticosteroids . All patients at step 4 or 5 require referral to specialist asthma services for assessment and evaluation of their suitability for individualised therapy .
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Unproved Alternate Therapy In Status Asthmaticus
Although the application of noninvasive ventilation has proved to be safe and effective in COPD, the use of NIV in severe asthma is not clearly defined. A systematic review found 5 studies with > 200 subjects with severe asthma randomized to NIV or placebo. Two of the studies found no difference in the number of subjects who required intubation and mechanical ventilation , whereas one study demonstrated fewer admissions in the NIV group. NIV should not be attempted in patients who are agitated or uncooperative, and patients should be monitored closely if NIV is attempted. Although retrospective studies are encouraging about the potential benefits of NIV, in our experience, many patients with acute, severe asthma are unable to tolerate NIV.,
Although intravenous aminophylline is not likely to result in any additional bronchodilation when compared with standard care with inhaled bronchodilators and corticosteroids, some patients with near-fatal asthma may gain benefit with intravenous aminophylline. The usual loading dose of 5 mg/kg is given intravenously over 20 min and then infused at a rate of 0.50.7 mg/kg/h. Such patients are rare, and the potential adverse effects are not uncommon . Blood levels should be checked daily for all patients receiving aminophylline infusions.
How Can Allergy And Asthma Specialists Help
Your primary care doctor can diagnose and treat a large variety of illnesses, but your regular doctor is likely a general practitioner. Although your doctor may understand many types of diseases, he or she does not specialize in lung diseases, such as asthma or allergies. Thats when an allergy and asthma specialist can come in.
An allergy and asthma specialist can help you in several ways. There are different types of asthma and various types of allergies. Symptoms and treatment plans may differ depending on the subtype. Your specialist will perform various diagnostic tests to make an accurate diagnosis. They can also help you determine allergens and symptom triggers.
The specialist will also develop a treatment plan that might include reducing triggers and prescribing medications, along with other treatments. Education is also a big part of managing allergies and asthma. Learning as much as possible about your condition helps you develop effective ways to manage the disease. Your allergy and asthma doctor is a great source of information.
Your specialist may also provide referrals such as asthma education classes, smoking cessation programs, or pulmonary rehabilitation.
Resources For Parents Caregivers And Kids
Find tips on keeping a smoke-free home and car on EPA’s Smoke-Free Homes website.
It’s hard to see a child sick. The good news is you can help a child gain control over asthma. That means fewer days out of school and fewer attacks that can be scary for you and the child.
Along with the doctor, you have an important role in helping a child control asthma.
Assessment And Diagnostic Findings
To determine the diagnosis of asthma, the clinician must determine that episodic symptoms of airway obstruction are present.
- Positive family history. Asthma is a hereditary disease, and can be possibly acquired by any member of the family who has asthma within their clan.
- Environmental factors. Seasonal changes, high pollen counts, mold, pet dander, climate changes, and air pollution are primarily associated with asthma.
- Comorbid conditions. Comorbid conditions that may accompany asthma may include gastroeasophageal reflux, drug-induced asthma, and allergic broncopulmonary aspergillosis.
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What Types Of Asthma Are There
Healthcare providers identify asthma as intermittent or persistent . Persistent asthma can be mild, moderate or severe. Healthcare providers base asthma severity on how often you have attacks. They also consider how well you can do things during an attack.
Asthma can be:
- Allergic: Some peoples allergies can cause an asthma attack. Molds, pollens and other allergens can cause an attack.
- Non-allergic: Outside factors can cause asthma to flare up. Exercise, stress, illness and weather may cause a flare.
Pharmacology Practice Questions For The Tmc Exam
In this post, weve listed out some of our premium Pharmacology Practice Questions for the TMC Exam. So if thats what youre looking for then youre definitely in the right place.
Pharmacology is definitely one of the most important sections of the TMC Exam. That is why we put so much emphasis on that topic here on this website, in our products, and on our YouTube channel as well.
And that is also why were providing these TMC Practice Questions for you because practicing with real-life practice questions is one of the most effective strategies for preparing for the exam.
We didnt include the correct answers, however. That way, you can quiz yourself and really test your knowledge to see where you stand. But, if you need the correct answers and rationales, you can download them using the links below.
So if youre ready, lets go ahead and dive right in!
Below, weve provided 35 Pharmacology Practice Questions to help you prepare for the TMC Exam. If you need the correct answers as well, you can download them now by .
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Programs For Patients And Caregivers
AAFA offers a variety of educational materials and tools for patients of all ages. Several are also available in Spanish. Browse our asthma or allergy sections for important information about managing your condition. If you still have questions, use our Ask the Allergist service to get your question answered. Also, dont forget to follow our and so you can stay up-to-date on the latest news on asthma and allergies. We offer all of these resources to help you manage your asthma and allergies.
For more information or to place an order for hardcopy materials, please contact AAFA at:
1.800.7.ASTHMA Call this toll-free hotline to order programs, materials or tools Monday – Friday between 10 AM and 3 PM EST.
Use An Asthma Action Plan
How do you keep track of your medicines, when to take them and what to do when your symptoms are flaring up? Your provider should work with you to develop an asthma action plan , also called an asthma management plan . An AAP is a written document that is developed with your provider and individualized for each patient. Some AAPs use a green, yellow and red zone format. Each zone tells a patient when their asthma is green – doing well, yellow – getting worse and needs to be treated with rescue medicines or red â emergency and you need to call 911 or get to an emergency room right away.
An AAP will include:
- What daily control medicines to take, when to take them and how often.
- What symptoms indicate your asthma is flaring up, how severe that symptom might be and what to do when having symptoms.
- What rescue inhalers or nebulized medicine you should use, how much and when.
- What typically triggers your asthma.
- When your asthma is out of control and you need to call 911 or get to an emergency room.
- Some AAPs will also include Peak Flow Meter readings which measures how well/poorly your lungs are working. A very low peak flow reading is an emergency.
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Develop A Comprehensive Asthma Home Visit Program
Home-based, multi-trigger, multi-component interventions with an environmental focus for children with asthma are proven to reduce exposure to multiple indoor asthma triggers .
Use our free publications for healthcare providers to begin or improve a home visit program for your asthma patients. These interventions involve home visits by trained personnel to conduct two or more activities, including:
- Assessment the home environment
- Changing the indoor home environment to reduce exposure to asthma triggers and
- Education about the home environment.
EPA provides resources and information for physicians and healthcare plan administrators to create home visit programs. Home visit programs are proven to be effective to improve overall quality of life and productivity, improving asthma symptoms and reducing the number of school days missed due to asthma.
The 2019 Gina Guidelines For Asthma Treatment In Adults
Emily L. Fedor, BS Pharmacy Studies, PharmD Candidate 2021Western New England University College of Pharmacy & Health SciencesWestern New England University College of Pharmacy & Health SciencesVictoria L. Freniere, BS Pharmacy Studies, PharmD Candidate 2021Western New England University College of Pharmacy & Health SciencesJared Ostroff, PharmD, BCACP, BCGPAmbulatory Pharmacy Anticoagulation CoordinatorClinical Associate ProfessorWestern New England University College of Pharmacy & Health SciencesSpringfield, Massachusetts
US Pharm. 2020 45:18-24.
ABSTRACT: Establishing asthma symptom control using pharmacologic and nonpharmacologic interventions improves quality of life and prevents exacerbations in patients with asthma. The Global Initiative for Asthma 2019 guidelines provide recommendations for asthma treatment organized into five steps that correlate with disease severity. Medication options include inhaled corticosteroids , long-acting beta2 agonists, short-acting beta2 agonists , leukotriene receptor antagonists, and oral corticosteroids. Recent data show unfavorable outcomes for SABAs used alone for as-needed treatment of symptoms of mild asthma. Guideline changes include the use of a low-dose ICS with formoterol for as-needed treatment in adults with mild asthma, or for use whenever a SABA would be used. Appropriate, effective medication regimens combined with counseling on proper inhaler technique will help patients achieve asthma-management goals.
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What Are Common Asthma Attack Triggers
An asthma attack happens when someone comes in contact with substances that irritate them. Healthcare providers call these substances triggers. Knowing what triggers your asthma makes it easier to avoid asthma attacks.
For some people, a trigger can bring on an attack right away. Sometimes, an attack may start hours or days later.
Triggers can be different for each person. But some common triggers include:
- Air pollution: Many things outside can cause an asthma attack. Air pollution includes factory emissions, car exhaust, wildfire smoke and more.
- Dust mites: You cant see these bugs, but they are in many homes. If you have a dust mite allergy, they can cause an asthma attack.
- Exercise: For some people, exercising can cause an attack.
- Mold: Damp places can spawn mold. It can cause problems for people with asthma. You dont even have to be allergic to mold to have an attack.
- Pests: Cockroaches, mice and other household pests can cause asthma attacks.
- Pets: Your pets can cause asthma attacks. If youre allergic to pet dander , breathing in the dander can irritate your airways.
- Tobacco smoke: If you or someone in your home smokes, you have a higher risk of developing asthma. The best solution is to quit smoking.
- Strong chemicals or smells.
With asthma, you may not have all of these symptoms. You may have different signs at different times. And symptoms can change between asthma attacks.
Asthma What It Is And How To Help If Someone Is Having An Asthma Attack
We all know people who have asthma. However, very few of us would know what to do if someone close by started to have a serious asthma attack and was struggling to breathe. Read on to find out what asthma is, what may trigger it and how to help someone having an asthma attack.
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National Heart Lung And Blood Institute National Asthma Education & Prevention Program
Expert Panel Report Guidelines for the Diagnosis and Management of AsthmaThe NAEPP Guidelines are the nations gold standard for asthma care and management. These guidelines offer evidence and expert opinion-based recommendations defining how to manage asthma through comprehensive assessment, diagnosis, treatment and monitoring individual patients asthma. These guidelines detail the use of control medications like inhaled corticosteroids, the important components of a written action plan that guide patient asthma self-management, the importance of scheduling regular follow-up visits with a health care provider, and the impact and control of environmental triggers that can worsen the patients asthma. There are two versions available for download â the full guidelines and a 2007 summary report.
Management Of Patients Admitted To The Hospital: Wards And Icu Care
Careful consideration must be given to the level of care required when a patient with an exacerbation of asthma is admitted to the hospital. In general, guidelines suggest that patients should be admitted for observation and further treatment if the pretreatment FEV1 or PEF is < 25% of predicted or of personal best or if the post-treatment values are < 40% after emergency department treatment. Typically, patients who demonstrate a poor response to therapy , persistent or unresponsive hypercapnia, altered mental status, hypotension, or have significant comorbid conditions should be admitted to the ICU.
Although many patients maintain good oxygen saturations despite severe airway obstruction, some patients develop small airway mucus plugging even after the PEF/FEV1 normalize. Guidelines suggest that oxygen should be administered via nasal cannula or oronasal mask to maintain an arterial oxygen saturation of 9395% in adults and 9498% in children. In severe exacerbations, low-flow oxygen therapy by titrating the saturation to 9395% was associated with better physiological outcomes than with high-flow 100% oxygen therapy.
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How To Work Effectively With Your Allergy And Asthma Specialist
People who have a good relationship with their doctor often have better health outcomes. Developing an effective working relationship with your doctor is essential. Consider the following suggestions:
Consider It a Partnership
Keep in mind: you are part of the treatment team. After all, it is your life, and you should have a say in your treatment. Learning about your condition and treatment options helps empower you to take an active role in your treatment.
Its vital to tell your doctor the truth. Being untruthful about your health habits or compliance with treatment will not help you. Be honest about symptoms and your side effects to medications. Your doctor needs to have an accurate picture of what is going on.
Write Down Your Concerns or Questions
It might seem like doctors have less and less time these days to talk with patients. But your allergy and asthma specialist should spend some time talking with you. To maximize the time, its helpful to write down questions and concerns you have. Its easy to forget what you want to ask. Writing things that you want to cover down before your appointment helps you stay on track.
Dont be Afraid to be an Advocate for Yourself
Learn How to Use an Online Patient Portal
Many medical practices have patient portals where you can make appointments, message your doctor, and get test results. Make sure you learn how to access the website to get information easily and quickly.