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Resp History
 
 

The Asthma History

 
 
 
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Overview

Patients with asthma are at risk of exacerbations, which may cause significant morbidity or mortality. By understanding the natural history of their airways disease it is possible to create a management plan that prevents complications in the future.
  • Ask About

  • Diagnosis - when asthma was diagnosed, risk factors, triggers
  • Severity - symptoms, FEV1, exacerbations
  • Management - lifestyle, pharmacologic, supportive
  • Complications
  • Risk Factors for Asthma

  • Family history of asthma
  • Atopy
  • Obesity
  • Potential Asthma Triggers

  • Environmental

  • Aeroallergens - pollens, dust mits, pet dander, mold
  • Cigarrette smoke
  • Air pollution
  • Other

  • Respiratory viral infections
  • Medications - beta blockers, NSAIDs
  • Exercise
  • Stress
  • Cold

Severity

  • Ask About

  • Frequency of puffer use
  • Spirometry results - FEV1, FVC
  • Exacerbations - frequency, ED visits, hospital admissions, ICU admissions

Complications

  • Complications of Asthma

  • Pneumonia
  • Atelectasis
  • Mucous plugging
  • Pneumothorax
  • Pneumomediastinum

Management

  • Management Strategies

  • Lifestyle Measures

  • Avoidance of triggers
  • Smoking cessation
  • Pharmacologic Measures

  • Short-acting beta agonists (SABAs) - salbutamol, terbutaline
  • Long-acting beta agonists (LABAs) - salmeterol, formoterol, indacaterol
  • Inhaled corticosteroids (ICS) - beclomethasone, budesonide, fluticasone, ciclesonide
  • ICS / LABA combinations - budesonide / formoterol, fluticasone / salmeterol, fluticasone / formoterol, fluticasone / vilanterol
  • Monoclonal antibodies - omalizumab, mepolizumab
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