A IS FOR ASTHMA

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					Asthma Basics
CHILDREN
           • 8.6 million U.S. children under
             age 18 diagnosed w/asthma

           • 3.8 million of them have had
             an asthma attack (episode) in
             the last 12 months.

           • Asthma is the leading cause of
             school absenteeism

           • Asthma is the leading, serious
             chronic illness among children
       What is Asthma?
• Asthma is the leading, serious
  chronic illness among children.

• The airways of a
  person with asthma
  are inflamed.

• Asthma causes episodes of
  wheezing, breathlessness, chest
  tightness and coughing.
   An Asthma Episode
An asthma episode usually happens after
one or several exposures to an
irritant/allergen (trigger) to which they are
sensitive.

The response is narrowing of the airways.
The airway becomes narrower from:

   Increased
    inflammation
   The muscles
    surrounding the
    airways tighten
   The lungs produce a
    thick mucus
Normal Lungs   Inflamed Lungs
Signs of an Asthma Episode
     •   Shortness of Breath
     •   Wheeze
     •   Cough
     •   Chest Tightness
Asthma Warning Signals
     •   Itchy, watery/glassy eyes
     •   Cough/Congestion (night cough)
     •   Wheezing
     •   Fatigue not related to activity
     •   Unusual paleness; undereye circles
     •   Medicine not helping
     •   Hunched position / squatting
     •   Difficult Breathing
     •   Retractions
     •   Flared nostrils
     •   Scared look
     •   Vomiting (from coughing/stress)
            Triggers
•   Smoke
•   Nighttime
•   Dust Mites
•   Pollen/Molds
•   Weather & Air
    Pollution
•   Animal Dander
•   Pests (Cockroaches)
•   Strong Scents/Odors
•   Exercise
•   Respiratory Infections
•   Emotions
 What Actions Can You Take to Reduce Potential
            Episodes in the Home?
Home Modifications
• Change forced air heating
  filters (every 2/3 months)
• Avoid strong odors:
 Art/craft supplies,chemical
 fumes,cleaning fluids
• Vacuum/dust regularly
• Restrict application of
  pesticides for non-use
  hours
• Use dust-proof bedding
  covers
              Medications
    Rescuers:
•   Relax tightened muscles
•   Short-Acting
•   Nebulizer or Puffer
•   Treat acute episodes and symptoms

    Controllers:
    Reduce inflammation in airways
    Reduce # of times children need to take rescuers
    Long-Acting
    Take on a regular basis
         “Rules of Two”

When do you need more
than a bronchodilator?

•Quick relief > 2X/week
•Nighttime waking > 2X/month
•Refill quick relief inhaler > 2X/year
    Asthma Medications and Supplies
         Meter Dose               Dry Powder
         Inhalers - MDI           Inhaler - DPI




Spacers (use
                      Nebulizer / Compressor
 with MDIs)



                                                  Peak
                                                  Flow
                                                  Meter
  Bronchodilator Inhalers - Short Acting
                                  albuterol




Generic albuterol    Proventil HFA albuterol   Ventolin albuterol


                Combivent
                ipratropium                       Ventolin
                bromide and                       Rotahaler
                albuterol                         albuterol
                (Recalled, 6-6)
   Bronchodilator Inhalers - Short Acting




Alupent        Brethaire       Maxair            Maxair
metaproteranol terbutaline     Inhaler           Autohaler
                               pirbuterol        pirbuterol
                               (recalled, 5-8)


               Atrovent                               recalled
  Xopenex      ipratropium bromide -
levalbuterol   used w/ one of the
               other bronchodilators
   Inhaled Corticosteroids ("Steroids")




Vanceril            Vanceril
beclomethasone   Double Strength   QVAR40 QVAR80
                  84 mcg/puff       beclomethasone
        Beclovent
        beclomethasone



            Aerobid        Pulmicort     Azmacort
            flunisolide    budesonide    triamcinolone
   Inhaled Corticosteroids ("Steroids")
                       fluticasone




Flovent 44 -       Flovent 110 -     Flovent 220 -
fluticasone 44     fluticasone 110   fluticasone 220
mcg/puff           mcg/puff          mcg/ puff


       Flovent
       Rotahaler
                   Flovent          100mcg   250mcg
                   Rotadisks 50
                   fluticasone,50mcg
     Cromolyn Sodium and Nedocromil

           Tilade                 Intal
           nedocromil             cromolyn sodium
           sodium                 inhalation aerosol

  Metered dose          Metered dose
  1.75 mg/actuation     800 mcg/inhalation

• Inhaled medications that work to
  prevent bronchial tube swelling as part
  of a regular maintenance plan
• Also taken before exercise
• Not for sudden symptoms
  Bronchodilator Inhalers - Long Acting
reduce the narrowing of lung passages by relaxing
airway muscles

Serevent - salmeterol
Serevent Discus




             Foradil Aerolizer -formoterol
 Inhaled Corticosteroids with
 Long-acting Bronchodilator


Flovent       Serevent          Advair

          +              =


     (fluticasone and salmeterol)

     Inflammation & muscle tightness
              Oral Corticosteroids
Drug Class        Generic Name   Trade Name

                                 Cortan
Oral              Prednisone     Deltasone
Corticosteroids                  Prednicen-M
                                 Sterepred
                                 Prelone
Oral                             Pediapred
                  Prednisolone
Corticosteroids                  Delta-cortef

Oral              Methyl-        Medrol
Corticosteroids   prednisolone   SoluMedrol
           Leukotriene modifiers

For long-term control/prevention of asthma
symptoms, especially inflammation.

   Pediatric patients 2 to 5 years of age          4mg
   One 4-mg cherry chewable tablet daily in the evening

   Pediatric patients 6 to 14 years of age         5 mg
   One 5-mg cherry chewable tablet daily in the evening

   Adults and adolescents 15 years and older      10 mg
   One 10-mg tablet daily in the evening

               Also Accolate ; Zyflo
How Should a Child Use an Inhaler?
How Should a Child Use an Inhaler –
         with a Spacer?

                 1.   Ask child to breathe out
                 2.   Have child place spacer in mouth
                 3.   Press down on inhaler
                 4.   Ask child to take a slow deep
                      breath
                 5.   Encourage child to hold breath
                      for five (5) seconds
                 6.   Remove spacer for exhalation
                 7.   Wait one minute before repeating
                      the process if there is a second
                      puff ordered
        Communication
Good
communication
with
physician
          Communication – Asthma
          Medicine/Management Plan




• Fill out an Asthma
  Medicine/Management
  Plan for your child
• Review form with
  physicians
• Keep form accessible
           Helpful Hints
Ways to Help Child Calm Down/Relax

Belly Breathing
   •   Sit up straight on a chair
   •   Place both hands on your belly
   •   Breathe slowly through your nose
   •   Blow the air slowly out of your mouth
           Summary
Remember:
 Asthma can’t be cured, but it can be controlled
 with

     • Medication
     • Avoiding triggers
     • Knowing what to do in case
       of an attack
 Most children with asthma can do anything they
 want; it’s just a matter of controlling and managing
 the disease.
What you can do:
• Listen to what the child says and watch the
  child for telling signs.
• Initiate environmental changes at home.
• Increase early detection of asthma
  episodes.
• Increase communication between
  yourselves and your
  physicians.
WHEN YOU CAN’T BREATHE, NOTHING ELSE MATTERS



                             This program is
                             sponsored by a grant
                             from the New York
                             State Department of
                             Health, through the
                             Asthma Coalition of
                             Western New York.

                             Contact our office at
                             (716) 699-4042

				
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