Asthma education

In the USA, LTRAs have largely replaced theophylline as the incremental drug for the treatment of moderate and severe asthma, where LABA plus ICS alone do not provide adequate control. For patients with mild persistent asthma, LTRAs have been designated as a suitable substitute for low dose ICS by the National Asthma Education Panel Program (NAEPP) of the National Heart and Lung Institute (National Institutes of Health). However, inhaled ICS are more efficacious. 

Educate patients on the use of inhaled drug delivery devices, peak flow monitors, and asthma education plans. 

Adapted from National Institutes of Health, National Heart Lung and Blood Institute. National Asthma Education and Prevention Program. 

NAEPP National Asthma Education and Prevention Program... 

National Asthma Education Program. Guidelines for the diagnosis and treatment of asthma II. Bethesda National Institutes of Health, 1997. 

The National Asthma Education and Prevention Program (NAEPP) defines asthma as a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. In susceptible individuals, inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. These episodes are usually associated with airflow obstruction that is often reversible either spontaneously or with treatment. The inflammation also causes an increase in bronchial hyperresponsiveness (BHR) to a variety of stimuli. 

FIGURE 80-2. Home management of acute asthma exacerbation. Patients at risk of asthma-related death should receive immediate clinical attention after initial treatment. Additional therapy may be required. (MDI, metered-dose inhaler PEF, peak expiratory flow.) (Adapted from NHLBI, National Asthma Education and Prevention Program, Expert Panel Report 2. Guidelines for the Diagnosis and Management of Asthma. NIH Publication No. 97-4051. Bethesda, MD U.S. Department of Health and Human Services, 1997.)... 

National Asthma Education and Prevention Program. (2002) Executive summary of the NAREPP expert panel report. Guidelines for the diagnosis and management of asthma. Update on selected topics 2002. Bethesda, MD National Institutes of Health. NIH publication 02-5075. 

Sympathomimetics Accor6 ng to the National Asthma Education and Prevention Program s Expert Panel Report II, long-acting 2-agonists (eg, salmeterol) are used... 

How would you adapt Dr. Brouchard s strategies for compensation for a different type of service, such as asthma education and monitoring, weight-loss, or osteoporosis counseling ... 

Table 17.3 National Asthma Education Program Guidelines for Pharmacist...

National Heart, Lung and Blood Institute (NHLBI). National Asthma Education and Prevention Program Program Description. NHLBI, NIH, 2002 1-5. Available at www.nhlbi.nih.gov/about/naepp/naep pd.htm. 

National Asthma Educator Certification Pharmacy (NABP)... 

National Asthma Educator Certification Board, http //naecb.org, accessed June 19, 2003. 

Some certification programs are available to professionals from many health disciplines, including pharmacists. Areas in which such certification programs are available include diabetes education, anticoagulation therapy, pain management, and asthma education. Some of these programs are still in the early stages of development. Several of these providers are listed in Appendix B however, the information is not intended to be exhaustive. 

National Asthma Education and Prevention Program Expert Panel Report 2 Guidelines for the Diagnosis and Management of Asthma, National Heart, Lung, and Blood Institute Bethesda, Maryland, 1997, NIH Publication No. 97-4051. 

The National Asthma Education and Prevention Program recommends inhaled SAB As be used as needed for acute asthma exacerbation. The usual dose is 360 to 720 pg per four to eight puffs every 20 minutes up to 4 hours for albuterol metered-dose inhaler (MDI). This recommendation contrasts with previous ones for regular use of 180 pg per two puffs for albuterol MDI three to four times daily. Regular use of SABAs has been a standard approach without the scientific basis since 1970s [12]. Current guidelines indicate that inhaled LABAs (usual dose, 84 pg per two puffs for salmeterol MDI twice daily) should be combined with ICSs for asthma control, rather than used as a stand-alone therapy. 

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