- First, ask the pt if they know what is Asthma? If no, explain the disease:
- Definition:
- A chronic inflammatory disease of the lung’s airways which makes breathing difficult
- What happens in asthma?
- Inflammation: which thickens the airway walls and creates mucus which blocks the airways
- Constriction: muscle spasms constricting and narrowing the airways
- Symptoms?
- Wheezing: whistling sound
- Coughing esp at night
- SOB and chest tightness
- There are triggers which worsens the asthma symptoms?
- Dust, animal dander, cold air, cigarette smoke, respiratory infections
- Try to avoid your triggers
- Definition:
- Management:
- There is no cure for asthma, but by controlling it, you can have a normal healthy life
- There are 2 types of asthma medications:
- Quick-relief\rescue medications: (SABA)
- Fast-acting -> relieve asthma sx w\in 5-20 mins
- Used whenever needed based on symptoms
- If used > 2days\wk -> inform the doctor to adjust controller medications
- S\E: increased heartbeat, tremor, headache
- Drug used: albuterol (Ventolin)
- Quick-relief\rescue medications: (SABA)
- Controller medications: (ICS\LABA)
- Work slowly over wks or mos -> reduce inflammation + prevent asthma sx from occurring
- Don’t provide quick relief
- Should be taken daily, even when you’re not having sx
- S\E: hoarseness, mouth infection (oral candidiasis\thrush), easy bruising, wt gain
- To prevent S\E -> rinse your mouth after using the inhaler
- Drugs used: Budesonide (ICS), Salmetarol (LABA)
- How to use inhalers?
- Check expiration date
- Shake (3-4 times)
- Remove the cap
- Breath out all the way
- Hold inhaler 4 cm\width of 2 fingers in front of mouth
- Press down on the inhaler once to release 1 puff of medication
- Breath in slowly and deeply
- Hold in your breath for 10 secs\as long as comfortable and breath out fully
- If you need a second dose -> wait 1-2 mins, then repeat the process
- Rinse mouth afterwards to reduce S\E if ICS
- W\ spacer:
- “W\out using a spacer, most of the medication hits back of the throat and doesn’t go down the lungs. A spacer chamber makes it easier for the medication to reach the lungs + less medication gets deposited in mouth and throat preventing S\E”
- Check expiration date
- Shake (3-4 times)
- Remove the cap
- Attach inhaler to spacer
- Breath out all the way
- Bring the mouthpiece and place it between your teeth
- Close your mouth around the mouthpiece and form a good seal
- Press down on the inhaler once to release 1 puff of medication
- Breath in slowly and deeply
- Hold in your breath for 10 secs\as long as comfortable and breath out fully
- If you need a second dose -> wait 1-2 mins, then repeat the process
- Rinse mouth afterwards to reduce S\E if ICS
- Demonstrate it yourself then ask the pt to do it and observe
- Looking after a spacer:
- Wash every month and before first use w\ warm water and soap
- Leave to drip dry (don’t towel dry)
- Replace spacer every 6-12 mo
- What to do in an asthma attack?
- Take 2-6 puffs of rescue inhaler w\ 5 min interval
- If persists or signs of respiratory distress (turning blue, nasal flaring) -> go to the ER!