By John Rees
The recent version of this top promoting ABC has been up to date to incorporate the recent British Thoracic Society instructions released in 2003 at the administration of bronchial asthma.
Concise and hugely illustrated, the e-book contains chapters on leukotriene antagonists and lengthy performing beta agonists.
The major themes incorporated within the textual content conceal the organization of bronchial asthma care, analysis, administration of youngsters and little one bronchial asthma.
An crucial textual content for GPs, clinical scholars, nurses and somebody facing the remedy of bronchial asthma in either adults and youngsters.
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Additional resources for ABC of Asthma
Html). The guidelines suggest that control of asthma should be assessed against the following standards: ● Minimal symptoms during day and night ● Minimal need for reliever medication ● No exacerbations ● Normal lung function (in practice FEV and/or PEF Ͼ80% 1 predicted or best) This degree of control would be the aim for the first three steps in the guideline. At steps four to five such freedom from symptoms may not be achievable without side effects, and the objectives are: ● Fewest possible symptoms ● Least possible need for relief bronchodilators ● Least possible limitation of activity ● Least possible PEF variation ● Best PEF ● Fewest adverse effects of treatment Uncontrolled inflammation Inflammation reduced by treatment Airway remodelling Reverse or limit damage?
It is helpful for general practitioners to have nebulisers available for acute asthmatic attacks. In acute asthma, ␤2 agonists are best given by nebulisers driven by oxygen as they may even worsen hypoxia slightly through an effect on the pulmonary vasculature. In general practice the use of oxygen as the driving gas is not usually practical. Domiciliary oxygen sets do not produce a flow rate adequate to drive most nebulisers, but, if available, they can be used with nasal cannulae during the nebulisation for a patient having an acute attack.
Guidelines are most likely to influence behaviour when they are adapted to local needs in hospital or practice and endorsed by a local respected enthusiast. They should be accompanied by regular audit against the agreed parts of the guidelines. Most of the published guidelines are in broad agreement on the strategy for managing chronic asthma. In the UK the general practitioner contract allows practices to earn points related to organisation of asthma management. The BTS/SIGN guidelines are an excellent resource General features As a preliminary step in all patients with asthma, obvious precipitating factors should be sought and avoided when practicable.
ABC of Asthma by John Rees