Case Study: Asthma
Short and Long Term Treatment Options
Mrs. Carson’s son is a case of newly diagnosed asthma. The child is visibly stable and without signs of acute exacerbations. However, he has had longstanding respiratory distress and has an audible wheeze.
The initial management of the patient will revolve around the alleviation of symptoms and relief of the suffering due to the distress. White et al. (2018) recommends provision of short-acting beta-adrenergic agonist (SABA), more commonly salbutamol inhalation via a nebulizer, to enhance bronchodilation and provide relief to the patient.
After that, the performance of spirometry is recommended once the patient has stabilized as subsequent management relies on the knowledge of the lung functionality (Mendes & Palmer, 2018; Horak et al., 2016). Mrs. Carson’s son will, therefore, be put after that on maintenance therapy with low dose pediatric inhaled corticosteroids. Provision of corticosteroids follows on the same guidelines, GINA (2015), which recommends provision of the same to children with SABA unresponsive asthma or those with asthma-related symptoms for more than three times a week. The latter provision fits the patient in this case.
As regards the long term therapy, the patient will be put on long-acting inhaled corticosteroids to modify the course of the disease (Ballas, 2018). However, reviews should be done monthly to assess the improvement in lung function as well as look out for the adverse effects of prolonged steroid use (Ballas, 2018).
Involves the following:
- Informing the child and the mother that the condition warrants long term therapy.
- Explaining to them the correct use and disposing of the nebulizers to maximize therapeutic benefits.
- Describing to them the mechanism of control and measures to do so when the condition deteriorates.
- Talking to them about the importance of avoiding allergens.
Ballas, Z. K. (2018). Asthma clinical practice guidelines: Time for an update. Journal of Allergy and Clinical Immunology, 142(3), 787.
Horak, F., Doberer, D., Eber, E., Horak, E., Pohl, W., Riedler, J., … & Studnicka, M. (2016). Diagnosis and management of asthma–Statement on the 2015 GINA Guidelines. Wiener klinische Wochenschrift, 128(15-16), 541-554.
Mendes, A., & Palmer, S. J. (2018). NICE overhauls asthma management and treatment recommendations.
White, J., Paton, J. Y., Niven, R., & Pinnock, H. (2018). Guidelines for the diagnosis and management of asthma: a look at the key differences between BTS/SIGN and NICE. Thorax, 73(3), 293-297.