Download - 2011 Pre-Reg Pharmacy Asthma
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Paediatric Asthma
Maria Tracey
Paediatric Pharmacist
Jane Davis
Paediatric Clinical Nurse Specialist
CF/Respiratory
Royal Alexandra Hospital Paisley
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Objectives
Explain the stepwise approach to thetreatment of chronic asthma in children
Demonstrate the choice of inhaler devices
used in children
Demonstrate multidosing
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Definition of asthmaDefinition of asthma
Diagnosis and natural history. Thorax 2003; 58 (Suppl I): i1-i92
A chronic inflammatory disorder of the airways
in susceptible individuals, inflammatory symptoms
are usually associated with widespread but variable
airflow obstruction and an increase in airway
response to a variety of stimuli. Obstruction is often
reversible, either spontaneously or with treatment.
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Statistics
5.2 million people in UK
1.1 million children
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What is Asthma?
Or a combination of all three
SwellingInflammation Excess
mucus
Asthma is a condition of the airways where
there is difficulty in breathing due to
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Asthma Triggers
Infections (eg colds and
viruses)
House-dust mite Pets (furred / feathered)
Second hand smoke
Exercise
Pollens/moulds
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TheImpact of Asthma
Night cough, disturbed nights
Restriction in activity / exercise
Increased school absences
Ongoing symptoms may have a detrimentaleffect on physical, psychological and social
well-being
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Children age 5-12 yrs
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Children age 5-12 yrs
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Children age 5-12 yrs
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Children age 5-12 yrs
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Children age 5-12 yrs
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Children age 5-12 yrs
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Key Points
Dose equivalence of corticosteroids
CFC free corticosteroid inhalers
Accurate medication history
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Relievers
Preventers
AdditionalTreatments
Asthma Medications
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Easyhaler
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Overview: Inhaler devices
Inhaler devices. Thorax 2003; 58 (Suppl I): i1-i92
pMDI + spacer is preferred deliverymethod in children aged 0-5 years
pMDI + spacer is as effective as
other delivery methods for other
age groups
Choice of inhaler should be basedon patient preference and ability to
use
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Multidosing
Multiple puffs(up to 10) of a short-acting 2agonist via a spacer device is as effectiveas nebulised
Children(and adults) with mild andmoderate exacerbation of asthma should be
treated by bronchodilator given from a pMDI+ spacer with doses titrated according toclinical response
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Summary: Paediatric asthma
Inhaled steroids are the recommended preventerdrug
In children >5 years, add inhaled long acting 2agonists rather than increasing the dose ofinhaled steroids above 400mcg/day
pMDI + spacer is preferred delivery method inchildren aged0-5 years, and as effective as other deliverymethods for other age groups
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References
www.Asthma.Org.Uk Tel 02077865000
British Thoracic Society, Scottish
Intercollegiate guidelines Network (2008)British Guideline on the Management ofAsthma Thorax (63) Supplement 1V
http://www.asthma.org.uk/http://www.asthma.org.uk/