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Laura

Laura. Case study. Part 1: the story so far…. 23-year old woman with history of childhood asthma Started fitness campaign but suffers from breathlessness on exertion At clinic, PEF normal. Part 1: q uestions. What advice would you give Laura?.

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Laura

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  1. Laura Case study

  2. Part 1: the story so far… • 23-year old woman with history of childhood asthma • Started fitness campaign but suffers from breathlessness on exertion • At clinic, PEF normal

  3. Part 1: questions What advice would you give Laura? What therapy would you recommend if a peak flow diary showed a stable baseline but short lived dips after running?

  4. Part 1: key points Remember to make an assessment of the probability of asthma. Diagnose before treating – try to confirm diagnosis with objective tests before long term therapy is started.

  5. Part 2: the story continues… • Increasing symptoms • Interested in complementary therapy • Becomes pregnant.

  6. Part 2: questions What would you advise Laura about complementary treatments for asthma?

  7. Part 2: questions What would you do now Laura is pregnant if she was: (a) not distressed, slightly wheezy with respiratory rate of 20 breaths/minute, pulse 100 beats/minute and PEF of 390 L/minute? (b) looks dreadful, cannot complete sentences, with very quiet breath sounds on auscultation, respiratory rate 30 breaths/minute, pulse 120 beats/minute and PEF of 120 L/minute?

  8. Part 2: key points • No consistent evidence to support use of complementary or alternative treatments in asthma • Continue usual asthma therapy in pregnancy • Monitor pregnant women with asthma closely to ensure therapy is appropriate for symptoms.

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