2011 Pre-Reg Pharmacy Asthma

8/13/2019 2011 Pre-Reg Pharmacy Asthma

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Paediatric Asthma

Maria Tracey

Paediatric Pharmacist

Jane Davis

Paediatric Clinical Nurse Specialist

CF/Respiratory

Royal Alexandra Hospital Paisley


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Objectives

Explain the stepwise approach to thetreatment of chronic asthma in children

Demonstrate the choice of inhaler devices

used in children

Demonstrate multidosing


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Definition of asthmaDefinition of asthma

Diagnosis and natural history. Thorax 2003; 58 (Suppl I): i1-i92

A chronic inflammatory disorder of the airways

in susceptible individuals, inflammatory symptoms

are usually associated with widespread but variable

airflow obstruction and an increase in airway

response to a variety of stimuli. Obstruction is often

reversible, either spontaneously or with treatment.


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Statistics

5.2 million people in UK

1.1 million children


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What is Asthma?

Or a combination of all three

SwellingInflammation Excess

mucus

Asthma is a condition of the airways where

there is difficulty in breathing due to


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Asthma Triggers

Infections (eg colds and

viruses)

House-dust mite Pets (furred / feathered)

Second hand smoke

Exercise

Pollens/moulds


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TheImpact of Asthma

Night cough, disturbed nights

Restriction in activity / exercise

Increased school absences

Ongoing symptoms may have a detrimentaleffect on physical, psychological and social

well-being


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Children age 5-12 yrs


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Key Points

Dose equivalence of corticosteroids

CFC free corticosteroid inhalers

Accurate medication history


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Relievers

Preventers

AdditionalTreatments

Asthma Medications


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Easyhaler


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Overview: Inhaler devices

Inhaler devices. Thorax 2003; 58 (Suppl I): i1-i92

pMDI + spacer is preferred deliverymethod in children aged 0-5 years

pMDI + spacer is as effective as

other delivery methods for other

age groups

Choice of inhaler should be basedon patient preference and ability to

use


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Multidosing

Multiple puffs(up to 10) of a short-acting 2agonist via a spacer device is as effectiveas nebulised

Children(and adults) with mild andmoderate exacerbation of asthma should be

treated by bronchodilator given from a pMDI+ spacer with doses titrated according toclinical response


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Summary: Paediatric asthma

Inhaled steroids are the recommended preventerdrug

In children >5 years, add inhaled long acting 2agonists rather than increasing the dose ofinhaled steroids above 400mcg/day

pMDI + spacer is preferred delivery method inchildren aged0-5 years, and as effective as other deliverymethods for other age groups


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References

www.Asthma.Org.Uk Tel 02077865000

British Thoracic Society, Scottish

Intercollegiate guidelines Network (2008)British Guideline on the Management ofAsthma Thorax (63) Supplement 1V
http://www.asthma.org.uk/http://www.asthma.org.uk/

Documents

2011 Pre-Reg Pharmacy Asthma