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Paediatric Asthma

Paediatric Asthma. Maria Tracey Paediatric Pharmacist Jane Davis Paediatric Clinical Nurse Specialist CF/Respiratory Royal Alexandra Hospital Paisley. Objectives. Explain the stepwise approach to the treatment of chronic asthma in children

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Paediatric Asthma

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  1. Paediatric Asthma Maria Tracey Paediatric Pharmacist Jane Davis Paediatric Clinical Nurse Specialist CF/Respiratory Royal Alexandra Hospital Paisley

  2. Objectives • Explain the stepwise approach to the treatment of chronic asthma in children • Demonstrate the choice of inhaler devices used in children • Demonstrate multidosing

  3. Statistics • 5.2 million people in UK • 1.1 million children

  4. What is Asthma? Asthma is a condition of the airways wherethere is difficulty in breathing due to Inflammation Swelling Excess mucus • Or a combination of all three

  5. Asthma Triggers • Infections (eg colds and viruses) • House-dust mite • Pets (furred / feathered) • Second hand smoke • Exercise • Pollens/moulds

  6. Night cough, disturbed nights Restriction in activity / exercise Increased school absences Ongoing symptoms may have a detrimental effect on physical, psychological and social well-being The Impact of Asthma

  7. Children age 5-12 yrs

  8. Children age 5-12 yrs

  9. Children age 5-12 yrs

  10. Children age 5-12 yrs

  11. Children age 5-12 yrs

  12. Children age 5-12 yrs

  13. Combination Inhalers • Steroid/LABA • Can improve compliance • Useful when asthma stable • Lack of flexibility to  or  dose

  14. Key Points • Dose equivalence of corticosteroids • CFC free corticosteroid inhalers • Accurate medication history

  15. Asthma Medications • Relievers • Preventers • Additional Treatments

  16. Easyhaler

  17. Overview: Inhaler devices • pMDI + spacer is preferred delivery method in children aged 0-5 years • pMDI + spacer is as effective as other delivery methods for other age groups • Choice of inhaler should be based on patient preference and ability to use Inhaler devices. Thorax 2003; 58 (Suppl I): i1-i92

  18. Multidosing • Multiple puffs(up to 10) of a short-acting ß2 agonist via a spacer device is as effective as nebulised • Children(and adults) with mild and moderate exacerbation of asthma should be treated by bronchodilator given from a pMDI + spacer with doses titrated according to clinical response

  19. Summary: Paediatric asthma • Inhaled steroids are the recommended preventer drug • In children >5 years, add inhaled long acting ß2 agonists rather than increasing the dose of inhaled steroids above 400mcg/day • pMDI + spacer is preferred delivery method in children aged0-5 years, and as effective as other delivery methods for other age groups

  20. References • www.Asthma.Org.Uk Tel 02077865000 • British Thoracic Society, Scottish Intercollegiate guidelines Network (2008) British Guideline on the Management of Asthma Thorax (63) Supplement 1V

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