Asthma Pharmacology: Medications and Devices

Asthma Pharmacology: Medications and Devices

Christine W.Wagner,APRN, CPNP, FNP-BC,AE-C, QOE

Objectives

Upon completion of this workshop participants will be able to:

Classify the different medications used to treat asthma

Describe the correct technique for the devices used to deliver those medications

List the correct priming and cleaning instructions for each type of device

2007 NIH Asthma Guidelines Step Therapy

Intermittent Asthma

Step 1

Preferred:

SABA PRN

Persistent Asthma: Daily Medication for Ages 5?11

Consult with asthma specialist if step 4 care or higher is required. Consider consultation at step 3.

Step 2

Preferred:

Low-dose ICS

Alternative:L

TRA, cromolyn, nedocromil, or

theophylline

Step 3

Preferred: Either

Low-dose ICS + either LABA,

LTRA, or theophylline

OR

Medium-dose ICS

Step 4

Preferred:

Medium-dose ICS + LABA

Alternative:M

edium-dose ICS + either

LTRA or theophylline

Step 5

Preferred:

High-dose ICS + LABA

Alternative:

High-dose ICS + either LTRA or

theophylline

Step 6

Preferred:

High-dose ICS + LABA + oral systemic corticosteroid

Alternative:

High-dose ICS + either LTRA or theophylline + oral systemic corticosteroid

Assess control

Step up therapy if needed (first,

check adherence,

inhaler technique, environmental control, and comorbid conditions)

Step down if possible (and asthma is well controlled at

least 3 months)

Patient education at EVERY encounter

LOOKING AHEAD TO EPR-4

EPR-4 Update in 2018

NHLBI Advisory Council

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