FCAAIA Notes: The first national guidelines for the diagnosis and treatment of asthma were published in 1993, with updates and revisions more recently. Guidelines are just that-they are not rules or laws. But, they are evidence based recommendations to help physicians maintain control of asthma, use as little medication necessary to do so, and to decrease the risk of complications of asthma.
It is important for our patients to understand the basis and rationale for our treatment recommendations. They should ask any questions they have, but realize that “empowerment” is not just knowledge; it is in essence consent and agreement that comes from understanding. Continue reading “WHAT PATIENTS REALLY THINK ABOUT ASTHMA GUIDELINES”
FCAAIA Notes: This study tells us that the best predictor of having a moderate or severe asthma exacerbation is a history of a previous such flare. Incorrect inhaler technique was also predictive. Of course, correct inhaler technique is a subset of using medications in the prescribed doses. If you do not use them, they will not work.
Inhaler technique is difficult to master; Continue reading “PREDICTIVE FACTORS FOR MODERATE OR SEVERE EXACERBATIONS IN ASTHMA PATIENTS RECEIVING OUTPATIENT CARE”
FCAAIA Notes: In pregnancy, about 1/3 of mothers with asthma get worse, 1/3 get better, and 1/3 remain the same. The pattern tends to be the same from one pregnancy to the next. The control often improves in the last trimester. The health of the mother is paramount during pregnancy. Guidelines for the treatment of asthma in pregnancy have been around for a long time and are reviewed and updated regularly.
Poorly controlled asthma is more of a risk to the fetus than the medications used to treat it. Continue reading “ASTHMA DURING PREGNANCY: EXACERBATIONS, MANAGEMENT, AND HEALTH OUTCOMES FOR MOTHER AND INFANT”
FCAAIA Notes: As I’ve written before, “The nose bone’s connected to the lung bone.” Asthma is part of “allergic airway disease” and control of the lower airway (lungs) always requires that we consider the upper air way (nose) as well. So, we treat nasal allergies even if the symptoms are relatively mild and not bothersome.
Here it also becomes clear that patients with asthma who also have sleep apnea (do you snore loudly, a lot, and sometimes startle awake gasping for a breath?) should address the apnea Continue reading “OBSTRUCTIVE SLEEP APNEA ACCELERATES FEV1 DECLINE IN ASTHMATIC PATIENTS”