Wednesday, September 18, 2013

Asthma

if you got a patient with asthma,you are likey to be asked about the stepwise treatment:
Step1
Short acting beta agonist as required
e.g salbutamoul PRN


Step 2
Short acting beta agonist as required
+ Standard dose inhaled corticosteroids
e.g salbutamoul inh PRN
Beclomethasone inh regular


Step 3
Short acting beta agonist as required
+standard dose inhaled corticosteroids regular
+long acting beta agonist regular
e.g salbutamoul inh PRN
Beclomethasone inh regular
Salmetrol inhalers regular


If no response, consider increase the dose of regular inhaled corticosteroids to the upper limit of standard dose.


Step 4
Short acting beta agonist as required
+standard dose inhaled corticosteroids regular
+long acting beta agonist regular
+6 weeks trial of one or more of:
Leukotrienes receptors antagonists
Modified released thiophylline
Modified released oral beta agonist


Step 5
Add prednisolone tab


what are the features of acute svere asthma and how would you manage that?
what are the indications for mechanical ventilation?


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