| What is asthma? |
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Asthma is an inflammatory disease |
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The underlying condition or tendency remains even when symptoms are absent |
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In people with asthma, the airways narrow and don't function normally when exposed to a trigger factor |
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Triggers are sometimes difficult to identify |
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During an asthma episode, a combination of factors causes airway narrowing:
- Smooth muscle spasm
- Airway swelling, due to:
- oedema - fluid and proteins deposited across the airway wall
- mucus hypersecretion
- muscle and mucous gland enlargement.
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| How asthma is treated |
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Action and role of each of the classes of asthma medications: |
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Reliever medication (bronchodilators) |
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Preventer medication (anti-inflammatory agents) |
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Symptom controllers (long-acting beta2 agonists) |
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Combination medications (preventer plus symptom controller) |
| Emphasise the important role of preventers in those who need them. |
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The difference between preventers and relievers |
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Preventers must be taken regularly, irrespective of symptoms |
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Common side-effects and how to cope with these |
| Delivery devices |
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Care of the device |
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Correct inhaler technique (demonstrate and practice until patient can perform correctly) |
| Key facts about childhood asthma |
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Childhood asthma is common: 30% of children will have a form of asthma at some stage |
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Infrequent virus-induced wheezing in infancy improves by age 6 years in most children. |
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Allergy is an important cause of asthma in children and can trigger acute attacks of asthma. Continuing asthma is more likely if eczema and hay fever are also present and there is ongoing allergen exposure. |
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More than half the children with mild asthma will be free of symptoms or have only mild intermittent wheezing in later life. |
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Moderate or severe asthma rarely goes away by itself, even in adolescents. |
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Stopping treatment results in a return of symptoms, usually within days to weeks. |
| Negotiate a plan of care and review and monitor the plan |
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Reinforce the need for long-term adherence to preventive therapy. |
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What to expect about the duration of treatment: |
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Asthma treatment is usually long-term |
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Beginning treatment with asthma medications does not necessarily mean that life-long treatment will be necessary. |
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Discourage the notion that treatment can be discontinued as soon as the symptoms resolve |
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Emphasise the importance of attending for regular review of the current management plan. |
| Monitor and manage the symptoms and signs of asthma |
| Develop a written asthma action plan: |
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How to recognise of deteriorating asthma (peak expiratory flow monitoring or symptoms) |
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Steps to take if asthma control deteriorates, including: |
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when to increase medication and by how much |
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when and how to seek medical treatment |
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If using peak expiratory flow measurement to monitor asthma: |
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Instruct in correct technique and maintenance |
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Tailor the monitoring schedule to the person's daily program |
| How to avoid asthma exacerbations |
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Recognising and avoiding triggers |
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Smoking cessation and avoiding other people's smoke |
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Managing exercise-induced asthma |
| Minimising the effects of asthma on everyday life |
| Identify aspects of daily life (work, school, social activities) that are affected by asthma and develop strategies for minimising effects: |
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Effects of asthma on physical function |
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Effects on emotions |
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Effects on interpersonal relationships. |
Principles of drug therapy 
