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Clinical Management of Asthma
Expert Panel Report 3
National Asthma Education and Prevention Program
National Heart, Lung and Blood Institute, 2007
Source: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf
2007 NAEPP EPR-3
Treatment recommendations based on:Severity ControlResponsiveness
Provide patient self-management education at multiple points of care
Reduce exposure to inhaled indoor allergens to control asthma-multifaceted approach
Source: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf
What is GIP?
Guidelines Implementation Panel Report for Expert Panel Report 3
Recommendations and strategies to implement EPR-3
Six key messages
Source: http://www.nhlbi.nih.gov/guidelines/asthma/gip_rpt.pdf
GIP’s Six Key Messages
Inhaled Corticosteroids
Asthma Action Plan
Asthma Severity
Asthma Control
Follow-up Visits
Allergen and Irritant Exposure Control
Source: http://www.nhlbi.nih.gov/guidelines/asthma/gip_rpt.pdf
Diagnosing Asthma: Medical History
SymptomsCoughingWheezingShortness of breathChest tightness
Symptom Patterns SeverityFamily History
Diagnosing Asthma
Troublesome cough, particularly at nightAwakened by coughingCoughing or wheezing after physical
activityBreathing problems during particular
seasonsCoughing, wheezing, or chest tightness
after allergen exposure Colds that last more than 10 daysRelief when medication is used
Diagnosing Asthma
Wheezing sounds during normal breathing
Hyperexpansion of the thorax
Increased nasal secretions or nasal polyps
Atopic dermatitis, eczema, or other allergic skin conditions
Medications to Treat Asthma
Medications come in several forms.
Two major categories of medications are:Long-term controlQuick relief
Medications to Treat Asthma:Long-Term Control
Taken daily over a long period of time
Used to reduce inflammation, relax airway muscles, and improve symptoms and lung functionInhaled corticosteroidsLong-acting beta2-agonists
Leukotriene modifiers
Medications to Treat Asthma: Quick-Relief
Used in acute episodes
Generally short-acting beta2agonists
Medications to Treat Asthma: How to Use a Spray Inhaler
The health-care provider should evaluate inhaler technique at each visit.
Source: “What You and Your Family Can Do About Asthma” by the Global Initiative for Asthma Created and funded by NIH/NHLBI
Medications to Treat Asthma: Inhalers and Spacers
Spacers can help patients who have difficulty with inhaler use and can reduce potential for adverse effects from medication.