Pain Relievers and Asthma – Pharmacy Guide
The National Asthma Council Australia has launched an up-to-date resource for pharmacists and pharmacy assistants to aid in recommending and dispensing analgesics to people with asthma and reduce the confusion associated with aspirin/nonsteroidal anti-inflammatory drugs (NSAIDs) and asthma.
Dr Jenny Gowan, pharmacist and Associate Professor Frank Thien, respiratory physician and allergist, co-authored the ‘Pain relievers and asthma: quick reference guide'. Aspirin and non-steroidal anti-inflammatory drugs, can trigger asthma or rhinitis symptoms in a small percentage of people with asthma and these people need to be offered a suitable alternative analgesic.
"Many others, however, may be avoiding aspirin/NSAIDs unnecessarily because they mistakenly believe that asthma and aspirin/NSAIDs don't mix, " according to Dr Gowan. "The fact is almost 90 per cent of people with asthma can take aspirin/NSAIDs safely and this new A4 sized guide can be used by pharmacists and pharmacy assistants to quickly identify those people at risk."
"And, it can help reassure other people with asthma that there should be minimal risk, as long as other cardiovascular and gastrointestinal risk factors are also addressed," she advised.
The ‘Pain relievers and asthma: quick reference guide' has been developed as an adjunct to normal quality care protocols and should be used as part of a pharmacy's usual best-practice care approach.
It features an easy to follow flowchart of the essential questions to ask every person requesting pain reliever medication, clearly identifying those people most likely to tolerate aspirin or other NSAIDs and those who need to be referred to the pharmacist or their doctor for advice.
"Choosing a pain reliever can be challenging for people with asthma, especially those with aspirin/NSAID-intolerant asthma (AIA) and it is important that pharmacy assistants in particular, are aware of the many issues that need to be considered," Dr Gowan advised.
"For example, while paracetamol may be a suitable alternative for many people with AIA, higher doses have been found to prompt a reaction in some patients. This new guide addresses these complexities and will assist pharmacy assistants and pharmacists to help people with asthma find an appropriate pain reliever."
The reverse side of the new ‘Pain relievers and asthma: quick reference guide' summarises current supporting evidence and the facts about aspirin/NSAID-intolerant asthma and includes key practice points for community pharmacy.
The new guide is supported by an unrestricted educational grant from Reckitt Benckiser. Editorial control has been maintained by the National Asthma Council Australia.
Copies of the ‘Pain relievers and asthma: quick reference guide' are being direct mailed to pharmacies around Australia and can also be obtained from the National Asthma Council Australia.
Resource
Pain relievers and asthma: quick reference guide
'Kids With Asthma' spring update
 The NAC's interactive, kid-friendly website 'Kids With Asthma' (http://www.kidswithasthma.com.au/) has seasonal information posted on the site quarterly to ensure it remains relevant and up to date.
The current seasonal topic focusses on spring allergies and is available now.
Useful information in the seasonal area incudes:
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When pollen counts are highest
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When allergies may be worse
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Why treating allergies is important in managing asthma
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How to keep asthma and allergies under control
Detailed clinical information on this topic is also being made available to health professionals via a seasonal email update. Associate Professor Peter Smith, who is an allergist from Southport in Queensland, discusses allergic rhinitis in children in the latest update.
Health professionals can register to receive Kids With Asthma seasonal update emails at: http://www.msd4gps.com.au/
Paediatric Asthma and Allergic Rhinitis
Melbourne GPCE 13-15 November 2009
 Dr Simon Young, GP, will present a seminar on Paediatric Asthma and Allergic Rhinitis at Melbourne GPCE on Friday 13 November, on behalf of National Asthma Council Australia with support from Schering-Plough.
The interactive session will cover the latest in immunotherapy and prevention, as well as differential diagnosis and practical management for children with concurrent asthma and allergic rhinitis.
For all the details and registration for the Melbourne GPCE go to http://www.gpce.com.au/
RACGP and NAC Asthma Research Award 2009
The winner of the 2009 RACGP and NAC Asthma Research Award was Dr James Turton from the Australian National University.
The NAC congratulates Dr Turton on winning this award, which is given to the best presenter of an asthma-related abstract or poster at the RACGP Annual Scientific Convention. It is one of four annual awards funded by the NAC to encourage research into asthma.
Dr Turton's winning presentation was: Can the inhaled mannitol challenge test be successfully used to improve asthma management in the general practice setting? James Turton, John Brannan, Nicholas Glasgow and Marjan Kljakovic.
 Turton 2009 Abstract RACGP 114.24 Kb
Resources
NAC Asthma Research Awards
RACGP (http://www.racgp.org.au)
H1N1 ('Swine Flu') Vaccination Information
Free pandemic influenza ('Swine Flu' ) vaccine became available for all Australians from September 30, 2009.
All States and Territories are offering vaccine to adults and children 10 years and over. Once the vaccine is registered for younger children by the Therapeutic Goods Administration, children will also be eligible to be vaccinated.
Initially a total of 5.5 million doses of the vaccine have been delivered around Australia for the start of this program. The government has placed an order for a total 21 million doses of the newly developed vaccine.
Impact of 'Swine Flu'
While the H1N1 09 influenza has remained a mild illness in most people, it is important that we don't lose sight of the more devastating hard edge of this disease.
This influenza has led to more than 4700 people being hospitalised in Australia, with around 13% of these being admitted to ICU. Almost 1500 of those hospitalisations have been in children and teenagers. Sadly, since the pandemic began, there have been 180 associated deaths.
Unlike seasonal influenza which mainly impacts the elderly, the current pandemic influenza strain has affected younger people.
Need for vaccination
Australia's Chief Medical Officer, Professor Jim Bishop, has expressed concern that while the normal winter influenza season is on the wane, pandemic influenza may continue into summer as it has done in the northern hemisphere. There is also a chance of the pandemic flu returning as a more virulent disease.
Therefore, it is important that people take this disease seriously and protect themselves and their families by getting vaccinated.
Australia will be one of the first countries in the world to offer the vaccine to the general population and all people aged over ten are immediately eligible to receive the free vaccination.
Who is most vulnerable?
The people most vulnerable to 'Swine Flu' are those with chronic respiratory disease such as asthma or COPD, diabetes, cancer, severe obesity and conditions that suppress the immune system, as well as pregnant women and Indigenous Australians. These people are encouraged to talk to their doctor about having this flu shot as soon as it is available in their local area.
How to access the vaccine
State and Territory health authorities have a range of strategies in place to provide the vaccine to their populations including through GPs, influenza clinics, Aboriginal Medical Services and local government.
Resources
For information about how people can access the free vaccine, ring the National Pandemic Hotline on 180 2007 or visit http://www.healthemergency.gov.au/
Breastfeeding and asthma
 Findings from a two-year study on asthma and wheezing illness in one year olds and kindergarten children, released this month by the Australian Institute of Health and Welfare, show that within the first three years of life, almost 17% of Australian infants experienced asthma or wheezing illness.
However breastfeeding within the first 12 months of life may offer a protective effect against asthma or wheezing in infancy, which increases with increasing breastfeeding duration.
Report author Professor Guy Marks, of the Australian Centre for Asthma Monitoring said, ‘Asthma or wheeze in infants was more common in those whose mothers had asthma, were relatively young or smoked during pregnancy.’
The report, Asthma in Australian Children: Findings from Growing up in Australia, the Longitudinal Study of Australian Children, also found that asthma or wheeze during the first three years of life was more common among boys, those who had older siblings, those who were born at an earlier gestational age, or who were admitted to a Neonatal Intensive Care Unit after birth.
‘There are important differences between wheezing illness in infancy and kindergarten-aged children, both in the nature of the disease and in its risk factors,’ said Professor Marks.
’By the age of 5, 21% of Australian children have been diagnosed with asthma and among those who did not have asthma by age five, 4% per year were diagnosed over the next two years,’ he said.
Boys were more likely than girls to first develop asthma or wheezing illness in infancy but, from age five years, new cases occurred equally in boys and girls.
The report also showed that among kindergarten-aged children, living in remote areas and having food or other allergies were risk factors for the onset of asthma-like symptoms.
Children who had asthma or wheeze in their fifth year were more likely than other children to be hospitalised, to attend an emergency department, and to visit a general practitioner more frequently over the next two years, and were also more likely to be overweight or obese two years later.
Parents of children with wheeze or asthma were more likely to report that their child had poorer health or disturbed sleeping patterns.
Resources
Australian Centre for Asthma Monitoring 2009. Asthma in Australian children: findings from Growing Up in Australia, the Longitudinal Study of Australian Children. Cat. no. ACM 17. Canberra: AIHW.
AIHW Media release 14 Oct 2009
Optimised inhaler mouthpiece design
Researchers in the United States have developed an optimised mouthpiece design to aid efficient drug delivery to the lungs by reducing the amount of medication wasted as it passes through the mouthpiece of an aerosol inhaler. With current inhaler designs, only approximately 10 to 20 percent of asthma medications are delivered to the lungs. And, because the lungs provide a direct and effective route of entry for medications into the bloodstream, an optimised mouthpiece design will reduce medication waste and may provide reproducible delivery of future inhaled medications.
"Through a process of computational and experimental analysis and design for a new inhaler, we were able to optimise a prototype mouthpiece that allowed for more medication to pass through the mouthpiece and be available to reach the lungs," said Michael Hindle, PhD, research associate professor at Virginia Commonwealth University (VCU) School of Pharmacy. "By optimising the design, it will help ensure delivery efficiency so less medication will be wasted and more will be effectively delivered to the lungs for relief from symptoms."
Dr Hindle adds that this rational computational inhaler analysis and design approach, which was developed with Worth Longest, PhD from the School of Engineering at VCU, may be applicable for other inhalers and medications that require reproducible delivery. "Insulin is an example of a drug that requires a reproducible delivery strategy that can be administered painlessly and as effectively through aerosol inhalers."
Resource
This research will be presented during the American Association of Pharmaceutical Scientists Annual Meeting in Los Angeles USA in November 2009.
www.aapspharmaceutica.com/meetings/annualmeet/am09/index.asp
Research Funding Opportunities
| The National Asthma Council Australia would be pleased to list funding opportunities that may be available for asthma research. Submit brief details for consideration by email to
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Conference Diary
Submit brief conference/meeting details to the National Asthma Council Australia for possible posting in our Conference Diary by email to
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