Clinical Management of Asthma

Expert Panel Report 3

National Asthma Education and Prevention Program

National Heart, Lung and Blood Institute, 2007

Source: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf

2007 NAEPP EPR-3

Treatment recommendations based on:Severity ControlResponsiveness

Provide patient self-management education at multiple points of care

Reduce exposure to inhaled indoor allergens to control asthma-multifaceted approach

Source: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf

What is GIP?

Guidelines Implementation Panel Report for Expert Panel Report 3

Recommendations and strategies to implement EPR-3

Six key messages

Source: http://www.nhlbi.nih.gov/guidelines/asthma/gip_rpt.pdf

GIP’s Six Key Messages

Inhaled Corticosteroids

Asthma Action Plan

Asthma Severity

Asthma Control

Follow-up Visits

Allergen and Irritant Exposure Control

Source: http://www.nhlbi.nih.gov/guidelines/asthma/gip_rpt.pdf

Diagnosing Asthma: Medical History

SymptomsCoughingWheezingShortness of breathChest tightness

Symptom Patterns SeverityFamily History

Diagnosing Asthma

Troublesome cough, particularly at nightAwakened by coughingCoughing or wheezing after physical

activityBreathing problems during particular

seasonsCoughing, wheezing, or chest tightness

after allergen exposure Colds that last more than 10 daysRelief when medication is used

Diagnosing Asthma

Wheezing sounds during normal breathing

Hyperexpansion of the thorax

Increased nasal secretions or nasal polyps

Atopic dermatitis, eczema, or other allergic skin conditions

Diagnosing Asthma:Spirometry

Test lung function when diagnosing asthma

Medications to Treat Asthma

Medications come in several forms.

Two major categories of medications are:Long-term controlQuick relief

Medications to Treat Asthma:Long-Term Control

Taken daily over a long period of time

Used to reduce inflammation, relax airway muscles, and improve symptoms and lung functionInhaled corticosteroidsLong-acting beta2-agonists

Leukotriene modifiers

Medications to Treat Asthma: Quick-Relief

Used in acute episodes

Generally short-acting beta2agonists

Medications to Treat Asthma: How to Use a Spray Inhaler

The health-care provider should evaluate inhaler technique at each visit.

Source: “What You and Your Family Can Do About Asthma” by the Global Initiative for Asthma Created and funded by NIH/NHLBI

Medications to Treat Asthma: Inhalers and Spacers

Spacers can help patients who have difficulty with inhaler use and can reduce potential for adverse effects from medication.

Medications to Treat Asthma:Nebulizer

Machine produces a mist of the medication

Used for small children or for severe asthma episodes

No evidence that it is more effective than an inhaler used with a spacer