Advanced Pharmacology Asthma Discussion Paper

Advanced Pharmacology Asthma Discussion Paper

Advanced Pharmacology: Asthma

Among the appropriate pharmacological therapies to be prescribed for Johnathan is STEP therapy as recommended by EPR3, which places him in step three, due to his known use of Albuterol that is in step 1. Further, with a viral asthmatic attack, an inhaled corticosteroid (ICS) is recommended, which could be administered via a nebulizer machine (Lizzo & Cortes, 2020). The above, in combination with a leukotrine receptor antagonist (LTRA) would increase the efficacy of ICS.

Asthma exacerbation presents as medical emergency, which necessitates prompt treatment. Jonathan and his mother will therefore need to understand the need for an ICS inhaler even while in school. She also needs to know the need to involve the teacher in the management of Johnathan’s condition, in case of an exacerbation in school. Spirometric indices such as forced exhalation volume are integral in the assessment of asthma especially among children. EPR3 recommends this test among children above 5 years to measure the lung functionality through breath volumes using a spirometer (Dinakar & Chipps, 2017).

Asthma is classified on frequency of exacerbations and severity (Oksel et al., 2018). Mild intermittent asthma presents mildly for less than 2 days a week, resolving spontaneously. This type does not hinder performance of daily activities and includes exercise-induced asthma. Mild persistent asthma presents symptomatically more than twice a week, with symptoms persisting more than a day. Moderately persistent asthma presents symptomatically in most days of the week and at least one night each week. Severe persistent asthma, the most chronic, presents almost every day and severally at night. This type does not respond well to medications.

Johnathan’s mother needs education on the need to change the inhaler to an ICS inhaler. She also should be made aware of benefits of including Johnathan’s teacher in care for Johnathan. This will ease the use and storage of the inhaler in school setup. She also should be educated on the need to prevent Johnathan from contracting URTI from family and friends due to his sensitivity and vulnerability. The plan of care for Jonathan will include pharmacological management and health education. Pharmacological therapy will address the attack as an emergency, as well as prevention of future occurrences.

References

• Dinakar, C. & Chipps, B. (2017). Clinical Tools to Assess Asthma Control in Children. Pediatrics. 139 (1) e20163438; DOI: https://doi.org/10.1542/peds.2016-3438
• Lizzo, J. M. & Cortes, S. (2020). Pediatric Asthma. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551631/
• Oksel, C., Haider, S., Fontanella, S., Frainay, C., & Custovic, A. (2018). Classification of Pediatric Asthma: From Phenotype Discovery to Clinical Practice. Frontiers in Pediatrics, 6(258), 258–. doi:10.3389/fped.2018.00258