How Stepwise Management Assists Health Care Providers And Patients in Gaining And Maintaining Control of Asthma

How Stepwise Management Assists Health Care Providers And Patients in Gaining And Maintaining Control of Asthma

A Sample Answer For the Assignment: How Stepwise Management Assists Health Care Providers And Patients in Gaining And Maintaining Control of Asthma

Long-term control drugs

•There are several stated models of treatment of asthma. However, the major ones include bronchodilators and anti-inflammatory drugs. Bronchodilators include: beta 2 selective agonists, muscarinic antagonists, xanthine derivatives, leukotriene receptor blockers and anticholinergics. Anti- inflammatory drugs include: corticosteroids and mast cell stabilizers.
•These Long-term control drugs : Long acting beta-2 agonists (LABA), Methylxanthines, Inhaled corticosteroids, Leukotriene receptor antagonists and Cromolyn.
1.  Long- acting beta-2 agonists (LABA) mode of action is by activating the pre-junctional β2-adrenoceptors and reduce acetylcholine release thereby prevent any   functional competition by acetylcholine .
•They include drugs such as: Salmeterol, formoterol and olodaterol
•The therapeutic effects include: improving lung function, increase number of  asthma symptom free days, reduce the asthma symptoms and reduce number of asthma attacks.
•However they include contraindications and adverse effects whereby in a drug such as salmeterol caution should be taken in use by African Americans and for (LABA) should be used with an oral glucocorticoid to minimize various risks and shouldn’t be used alone for prophylaxis as it can lead to increased risk of severe asthma attacks and asthma related deaths.
2.   Methylxanthines mode of action is through non-competitive inhibition of the phosphodiesterase enzyme, methylxanthines cause an intracellular increase in levels   of cyclic adenosine monophosphate and cyclic guanosine monophosphate.
•Here the most common drug used is theophylline.
•The therapeutic effects involve it preventing and treating wheezing, shortness of breath, and chest tightness caused by asthma.
•However it also has contraindications and adverse effects whereby caution should be taken in patients with heart disease, seizure disorders and liver dysfunction and its adverse effects involve toxicity, severe dysrhythmias and even death
Inhaled corticosteroids mode of action is by suppressing inflammation through decreasing inflammatory mediators, decreasing activity of inflammatory   cells and decreasing edema of airway mucosa.
•The inhaled corticosteroids include drugs such as budesonide, fluticasone propionate, ciclesonide and beclomethasone.
•The therapeutic effects involve reducing inflammation, reducing production of mucus, improve response to bronchodilators and reduce potential of dyspnea.
•However there are contraindications and adverse effects involved such as caution should be observed  in patients tested positive with candida albicans and its adverse effects involve it could lead to candidiasis development and decreased growth.
4.   Leukotriene receptor antagonists mode of action is by preventing leukotriene release from mast cells and eosinophils or by blocking the specific   leukotriene receptors on bronchial tissues it also reduces the influx of eosinophils, thus limiting inflammatory damage in the airway.
•The main drugs prescribed here are montelukast and zafirlukast.

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•The therapeutic effects involve it prevents bronchoconstriction, mucus secretion and edema thus having open airways.

•However there are contraindications and adverse effects involved such as it shouldn’t be used in patients with a hypersensitivity to it or with hepatic impairment and its adverse effects involve it could lead to fever, headache, cough, sore throat and risk of upper respiratory infections.

Short-term control drugs

•These involves drugs such as: Short acting beta-2 agonists (SABA), Anticholinergics and Oral  corticosteroids.
1.   Short acting beta-2 agonists mode of action is through activates the beta-2 receptor, and this helps relax the bronchial tubes within   five minutes.
•Drugs involved her include albuterol, levalbuterol, isoproterenol and terbutaline sulphate.
•The therapeutic effects include: relieving of symptoms of asthma attack such as dyspnea, wheezing and coughing.
•Contraindications and adverse effects are also involved in these drugs such as caution should be taken in patients with heart disease, diabetes and hypertension then on the adverse effects there are usually no adverse effects as long as patient is compliant with the practitioner’s instruction though one may experience mild effects such as headaches, trembling and nervousness.
2. Anticholinergics mode of action is through activates the beta-2 receptor, and this helps relax the bronchial tubes within five minutes.
•Drugs involved her include alcidinium and ipratropium bromide.
•The therapeutic effects include: reducing inflammation, decrease mucus production in the airways and prevent bronchospasms.
•Contraindications and adverse effects are also involved in these drugs such as caution should be taken in patients with heart disease, hypertension and myasthenia the adverse effects include dry mouth, constipation, urinary retention, bowel obstruction, dilated pupils, blurred vision, increased heart rate, and decreased sweating.
•These involves drugs such as: Short acting beta-2 agonists (SABA), Anticholinergics and Oral  corticosteroids.
3. Oral Corticosteroids mode of action is through binding to intracellular receptors which then act to modulate gene transcription in target tissues .
•Drugs involved her include: prednisone, prednisolone, methylprednisolone and dexamethasone.
•The therapeutic effects include: reduce inflammation and swelling in the airways they also relieve asthma related symptoms, such as body pain, swelling, and stiffness.Contraindications and adverse effects are also involved in these drugs such as caution should be taken in patients with

Stepwise-approach to asthma treatment and management

•It involves six steps whereby in the first step a short acting beta-2 agonists (SABA) is used when necessary such as albuterol.
•In the second step when the asthma is persistent a low dose inhaled corticosteroid is used or alternatively a methylxanthine such as theophylline is used.
•In the third step preferably a low dose inhaled corticosteroid is used together with a long acting beta- 2 agonist or alternatively a low dose inhaled corticosteroid and either theophylline or leukotriene receptor antagonists .
•In the fourth step preferably a medium dose inhaled corticosteroid and a long acting beta-2 agonist or alternatively medium dose inhaled corticosteroid with theophylline.
•In the fifth step a high dose inhaled corticosteroid is used together with a long acting beta- 2 agonist is preferred and omalizumab can be considered for patients with allergies.
•In the sixth step a high dose inhaled corticosteroid  with a long acting beta- 2 agonist and an oral corticosteroid is preferred  and the same omalizumab should be considered for patients with allergies.
•The drugs used change depending on the category asthma condition they are in whether it is intermittent, mild persistent, moderate persistent or severe.

Stepwise management use in controlling the disease

•The six steps involved are used to benefit the patient in the phase of the patient’s asthma whether it is intermittent, mild persistent, moderate persistent or severe.
•One is able to step up or step down in the steps involved if relief is found and vice-versa and throughout one should have a short acting beta-2 agonist. The effectiveness of it should be assesses by the heard breath sounds.
•If relief is not heard one steps up. The stepwise approach helps to not the category of the condition of the patient and the effectivity of the medication. If the medication is not working it helps the practitioner determine what the next course of treatment is as it is indicated in the steps depending on the ,medication listed on that step.
•Then in the case of relief the drugs the patient to use as they are stepping down.
•It also aids healthcare providers in identifying alternatives that can be used if the preferred one can’t be used such as a low dose inhaled corticosteroid and either theophylline or leukotriene receptor antagonists in the third step.
•It also aids the patient in knowing the level of symptoms and which category they are in whether it is intermittent, mild persistent, moderate persistent or severe.
•The patient is also able self- examine themselves and identify if symptoms are worsening to prevent from reaching that stage and use the medication in the step they  are situated in such as if they are still in intermittent asthma they use medication as directed in the first step and don’t let it get to persistent asthma that requires another regimen that is daily medication. Having exercise induced bronchospasm is an indicator for inadequate asthma control.
•The patient benefits also by gaining relevant information on how to use the various drugs, the potential side effects and their management together with other significant health education such as chronic use of high dose inhaled corticosteroids could lead to osteoporosis.
how stepwise management assists health care providers and patients in gaining and maintaining

control of asthma: Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening symptoms.
Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To prepare:

Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients including adults and children.
Review Chapter 25 of the Arcangelo and Peterson text. Reflect on using the stepwise approach to asthma treatment and management.
Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

By Day 7 OF how stepwise management assists health care providers and patients in gaining and maintaining control of asthma

Write a 2- to 3- page paper that addresses the following:
Describe long-term control and quick relief treatment options for asthma patients, as well as the impact these drugs might have on patients.
Explain the stepwise approach to asthma treatment and management.
Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.