Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.
One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.
To Prepare:
Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
Be sure to address the following:
Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
Explain the stepwise approach to asthma treatment and management for your patient.
Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.
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In my practice, I often encounter asthma patients who require long-term control and quick relief treatment options. For long-term control, I commonly prescribe inhaled corticosteroids such as fluticasone or budesonide. These medications work by reducing inflammation in the airways, thus preventing asthma attacks. In addition to inhaled corticosteroids, I may also consider prescribing long-acting beta-agonists (LABAs) like salmeterol or formoterol for patients who require additional bronchodilation.
Quick relief treatment options include short-acting beta-agonists (SABAs) such as albuterol or levalbuterol. These medications provide rapid bronchodilation and are used during acute asthma attacks or for immediate symptom relief. I must be cautious in prescribing SABAs to patients with certain comorbidities, such as cardiovascular disease, as these medications can increase heart rate and blood pressure.
The impact of long-term control medications is to reduce airway inflammation, decrease the frequency and severity of asthma exacerbations, and improve lung function. These medications are taken daily, even when the patient is asymptomatic, to maintain control and prevent asthma attacks. Quick relief medications provide immediate relief of symptoms during acute episodes and help to relax and open the airways.
The stepwise approach to asthma treatment and management involves the gradual progression and adjustment of medication therapy based on the patient's level of control. The National Institutes of Health (NIH) guidelines recommend starting with low-dose inhaled corticosteroids as the foundation of long-term control therapy for most patients. If asthma control is not achieved with low-dose inhaled corticosteroids, step up to medium-dose inhaled corticosteroids or consider adding a LABA. If control is still not achieved, step up to high-dose inhaled corticosteroids or consider adding other medications such as a leukotriene modifier or a biologic therapy.
The stepwise approach allows healthcare providers to individualize treatment plans based on the patient's specific needs and level of asthma control. By starting with the lowest effective dose and adjusting treatment as needed, we can achieve and maintain control of the disease while minimizing the risk of side effects from higher doses of medications. This approach also emphasizes regular assessment of asthma control and encourages patients to actively participate in their own care.
In summary, the stepwise approach to asthma treatment and management involves the gradual progression of medication therapy based on the patient's level of control. Long-term control options like inhaled corticosteroids and LABAs aim to reduce inflammation and prevent asthma attacks, while quick relief options like SABAs offer immediate symptom relief during acute episodes. This approach helps healthcare providers and patients work together to achieve and maintain control of asthma while minimizing drug-related side effects.
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