British Guideline on the Management of Asthma - PowerPoint PPT Presentation

1 / 12
About This Presentation
Title:

British Guideline on the Management of Asthma

Description:

Inhaler devices. Management of acute asthma. Special situations ... Check inhaler technique. Eliminate trigger factors ... a single inhaler (Symbicort SMART ... – PowerPoint PPT presentation

Number of Views:3226
Avg rating:5.0/5.0
Slides: 13
Provided by: wrig79
Category:

less

Transcript and Presenter's Notes

Title: British Guideline on the Management of Asthma


1
  • British Guideline on the Management of Asthma
  • BTS/SIGN British Guideline on the Management of
    Asthma, May 2008
  • Introduction
  • Diagnosis
  • Non-pharmacological management
  • Pharmacological management
  • Inhaler devices
  • Management of acute asthma
  • Special situations
  • Organisation and delivery of care, and audit
  • Patient education and self-management
  • Development of the guideline

2
Asthma controlBTS/SIGN British Guideline on the
Management of Asthma, May 2008
  • Aim is for asthma control
  • no daytime symptoms
  • no night time awakening due to asthma
  • no need for rescue medication
  • no exacerbations
  • no limitations on activity including exercise
  • normal lung function
  • Before moving up to the next step
  • Check compliance
  • Check inhaler technique
  • Eliminate trigger factors
  • At any stage, step down therapy once asthma is
    controlled

3
Measuring clinical outcomesBTS/SIGN British
Guideline on the Management of Asthma, May 2008
  • Ask the patient three key questions
  • In the last week (or month)
  • have you had difficulty sleeping because of your
    asthma symptoms (including cough)?
  • have you had your usual asthma symptoms during
    the day (cough, wheeze, chest tightness or
    breathlessness)?
  • has your asthma interfered with your usual
    activities (e.g. housework, work/school etc.)?

4
Stepwise management of asthma in adultsBTS/SIGN
British Guideline on the Management of Asthma,
May 2008
5
Stepwise management of asthma in adultsBTS/SIGN
British Guideline on the Management of Asthma,
May 2008
6
Step 2 Regular preventer therapy BTS/SIGN
British Guideline on the Management of Asthma,
May 2008
Inhaled steroids are the most effective preventer
drug for adults and children for achieving
overall treatment goals
7
Stepwise management of asthma in adults BTS/SIGN
British Guideline on the Management of Asthma,
May 2008
8
Current advice from the CHMwww.mhra.gov.uk
December 2006, updated February 2007
  • In the management of chronic asthma, formoterol
    and salmeterol should
  • be added only if regular use of standard-dose ICS
    has failed to control asthma adequately
  • not be initiated in patients with rapidly
    deteriorating asthma
  • be introduced at a low dose and the effect
    properly monitored before considering dose
    increase
  • be discontinued in the absence of benefit
  • be reviewed as appropriate stepping down therapy
    should be considered when good long-term asthma
    control has been achieved
  • Patients should report any deterioration in
    symptoms following initiation of treatment with a
    LABA

9
So where does Symbicort SMART fit in the
management of asthma? BTS/SIGN British Guideline
on the Management of Asthma, May 2008
  • In adult patients at step 3, who are poorly
    controlled
  • The use of budesonide/formoterol in a single
    inhaler (Symbicort SMART) as rescue medication
    instead of a short-acting ß2 agonist, in addition
    to its regular use as a controller treatment, has
    been shown to be an effective treatment option
  • Before instituting this management, careful
    patient education is required

10
Stepwise management of asthma in adultsBTS/SIGN
British Guideline on the Management of Asthma,
May 2008
11
Stepwise management of asthma in adultsBTS/SIGN
British Guideline on the Management of Asthma,
May 2008
12
Asthma treatment summary
  • BTS/SIGN guidance is the basis for treatment
  • Use the RCP three questions to help assess
    control, not (just) PEFR and FEV1
  • Start at step appropriate for patients asthma,
    and step down when control achieved and patient
    is stable
  • Safety issues and concerns regarding high-dose
    inhaled steroids and long-acting beta2-agonists
Write a Comment
User Comments (0)
About PowerShow.com