Pharmacological Treatment Protocol for Asthma

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Template for a Pharmacological Treatment Protocol for Asthma

The therapeutic stepSuggested Drug Alternative Drug Inhaler Device Dosage Routine FrequencyParticular Guidelines
Step 1: Albuterol and other short-acting beta-agonists (SABA)MDI, or Levalbuterol Metered-Dose Inhaler90 mcg per puffBreathing inAs needed, take 1-2 puffs every 4-6 hours.For instant relief, use as a rescue inhaler.
Step 2: Low-Dose Inhaled Corticosteroids (ICS), such as Propionate FluticasoneDry Powder Inhaler for Beclometasone (DPI)44–110 mcg dailyBreathing inTwice a dayCheck for oral thrush and wash your mouth after using it.
Step 3: ICS plus long-acting beta-agonists (LABA), such as salmeterol or fluticasoneFormoterol/Budesonide MDI/DPI 250/50 mcg or 200/50 mcgBreathing inTwice a dayUse SABA only when necessary; never for immediate relief.
Step 4: High-Dose ICS + LABA (such as salmeterol/fluticasone)Budesonide + Formoterol MDI/DPIAs directedBreathing twice a dayThink of including theophylline or leukotriene modifiers.
Global Initiative for Asthma (GINA) 2022 is cited.

Disparities in Adult and Child Treatment
7a. Adults’ First Pharmacologic Line of Treatment (Track 1, Step 1)
Albuterol is one example of a short-acting beta-agonist (SABA).
90 mcg per puff
Method: MDI inhalation
As needed, take one or two puffs every four to six hours.
Special Instructions: SABA relieves symptoms right away. Overuse should be avoided as it may result in tremors and tachycardia.
Precautions: Don’t take more medication than is recommended; keep an eye out for cardiovascular side effects.
Drug Cost: $30 to $50 for a generic 200-dose inhaler
Patient education: Stress the importance of always having the inhaler on hand in case of emergency. Talk about the negative effects of excessive use, like headaches, palpitations, and jitters.
Citation: 2022 Global Initiative for Asthma (GINA).

7b. Children’s (ages 6–11) First Line of Initial Pharmacologic Treatment (Step 1 of Track 1)
Albuterol is one example of a short-acting beta-agonist (SABA).
90 mcg per puff
Route: MDI or Spacer inhalation
As needed, take one or two puffs every four to six hours.
Special Instructions: To improve lung delivery, lessen oral side effects, and guarantee correct inhaling technique, use with a spacer.
Precautions: Consistent usage of SABA may be a sign of inadequate asthma management; if excessive, get additional assessment from a healthcare professional.
The cost of a generic 200-dose inhaler ranges from $15 to $40.
Patient Education: To prevent a recurrent need for SABAs, teach correct inhaler technique and the value of taking maintenance medication as directed.
Citation: 2021 American Academy of Pediatrics (AAP).

Monitoring of Treatment
Physical Examinations of Adults Receiving First-Line Drugs
At every visit, measure the effort and respiration rate.
To make sure there is enough ventilation, check oxygen saturation (SpO2).
Look for symptoms of oral thrush or other inhaled corticosteroid (ICS) side effects, particularly if you’re taking ICS and LABA together.
If taking large dosages of corticosteroids, keep an eye out for systemic adverse effects.
Tests of Pulmonary Function
Spirometry Calculate the forced vital capacity (FVC) and forced expiratory volume (FEV1). Check against the baseline values.
Peak Flow Tracking: In order to evaluate control over time, monitor the peak expiratory flow rate (PEFR).
Exhaled Nitric Oxide Testing: This test can be used to measure corticosteroid response and airway inflammation.
Tests in the Lab
Complete Blood Count (CBC): To keep an eye out for systemic corticosteroid side effects or indications of infection.
Serum Potassium: Use beta-agonists to check for possible hypokalemia.
To identify oral thrush from ICS use, utilize an oral candidiasis screen.
Citation: 2020 National Asthma Education and Prevention Program (NAEPP).

Failure of Treatment
Signs of Treatment Ineffectiveness
Symptoms getting worse: increased frequency of nocturnal awakenings, chest tightness, and wheezing even when taking prescription drugs on a regular basis.
Increased use of SABA: Frequently requiring rescue inhalers, a sign that asthma is not being adequately controlled.
Low peak flow measurements: Peak flow readings are regularly less than 80% of one’s own best.
Reduced capacity to tolerate exercise: respiratory problems that prevent them from engaging in active activities.
What to Do If Treatment Doesn’t Work
Increased therapy: Increase the ICS dosage for adults or, if not already given, add a LABA. A combination therapy (ICS + LABA) might be taken into consideration for kids.
Think about complementary and alternative medicine: Add biologics (such omalizumab) or leukotriene modifiers for asthma that is hard to manage.
Measures Higher Level of Care Needed
Exacerbation of severe asthma: symptoms of respiratory distress that call for hospitalization or urgent care.
Inadequate management of asthma in spite of therapy modifications: Needs referral to a specialist for additional assessment (e.g., pulmonologist or allergist).
Overuse of systemic corticosteroids: This suggests poorly managed asthma, requiring additional research and potentially a modification in treatment.
Citation: 2021 National Institute for Health and Care Excellence (NICE).

In conclusion
The treatment of asthma necessitates a customized strategy depending on the patient’s age, symptom intensity, and reaction to early treatments. Healthcare professionals can help patients of all ages manage their asthma by prescribing drugs, tracking treatment outcomes, and addressing treatment failures using evidence-based guidelines. Achieving long-term asthma control and enhancing the patient’s quality of life requires consistent monitoring, patient education, and suitable medication modifications.

Citations
GINA, the Global Initiative for Asthma, 2022. worldwide approach to managing and preventing asthma. taken from the website https://ginasthma.org.
AAP stands for American Academy of Pediatrics. (2021). control of asthma in kids aged six and up. 148(4), e2021052542, Pediatrics. 2021-052542 https://doi.org/10.1542/peds
NICE stands for the National Institute for Health and Care Excellence. (2021). Asthma: Identification, tracking, and treatment of chronic asthma. From https://www.nice.org.uk/guidance/ng80, retrieved
(2020) The National Asthma Education and Prevention Program (NAEPP). Report 3 from the expert panel: Guidelines for diagnosing and treating asthma. From https://www.nhlbi.nih.gov/health-topics/asthma to the source

 

 

QUESTION

Preparing the Assignment

Follow these guidelinesLinks to an external site. when completing each component of the assignment. Contact your course faculty if you have questions.

General Instructions  

Explore current literature and clinical practice guidelines to complete the clinical treatment protocol template.

  1. Complete the protocol outline templateLinks to an external site. to develop a protocol for asthma treatment. Use of the template is required. A 10% deduction will be applied if the template is not used. See the rubric.
  2. Provide references for your protocol at the bottom of the form where indicated. References should come from the following sources:
    1. Asthma Clinical Practice Guideline
    2. Course Textbook (for individual medication information)
    3. Journal Articles from within the last five years as defined by program expectationsLinks to an external site..
  3. Follow APA grammar, spelling, word usage, and punctuation rules consistent with formal, scholarly writing.
  4. No more than one short direct quote (15 words or less) may be used in this assignment.
  5. First person should not be used within this assignment.
  6. At least three scholarly references must be used for this assignment.
  7. Abide by Chamberlain University’s academic integrity policy.

Include the following sections (detailed criteria listed below and in the grading rubric).

Pharmacological Treatment 

  1. Correctly complete all blanks for the preferred and alternative medication for each step of therapy noted in the CPG.
  2. List medications in order according to the CPG.
  3. List generic medication names for each category.
  4. Provide an in-text citation under the completed table.

Treatment Differences in Adults and Children 

  1. Correctly list the first line of initial pharmacologic treatment in step one; track one for asthmatic adults.  (7a on the form)
  2. Correctly list the first line of initial pharmacologic treatment in step one, track one for asthmatic children ages 6-11. (7b on the form)
  3. Correctly list drug dose, route, frequency, instructions, precautions, drug cost, and education for adult and pediatric clients.
  4. Provide in-text citations under the information for adults and pediatric clients.

Treatment Monitoring 

  1. List the physical assessments required for monitoring the first-line medications prescribed to adults for track one, step one.
  2. List the pulmonary function tests required for monitoring the first-line medications prescribed to adults for track one, step one.
  3. List the laboratory tests required for monitoring the first-line medications prescribed to adults for track one, step one.
  4. Provide an in-text citation under the treatment monitoring section.

Treatment Failure 

  1. Describe how you will know that treatment is not working or needs to progress.
  2. Describe the next step if treatment is not working or needs to progress.
  3. Describe the indicators that would demonstrate that the client requires a higher level of care.
  4. Provide an in-text citation under the treatment failure section
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