Chapter 46. Asthma
AJ is a 5-year-old who has been experiencing daytime rhinorrhea, night-time cough that woke him two times this past week, enuresis two times in the past months, and has a history of reflux. Which symptom is most likely to warrant a work up for asthma?
Answer b is correct. Although wheezing is considered one of the classic symptoms of asthma, night-time cough has been shown to be a common symptom requiring further work up for asthma.
Answer a is incorrect. Rhinorrhea is upper airway symptoms and may contribute to poor asthma control, however, does not warrant a work up for asthma.
Answer c is incorrect. Reflux may play a role in asthma that does not respond to treatment, however, not a symptom that leads to the work up for asthma.
Answer d is incorrect. There has been no correlation between asthma and enuresis.
You are providing follow-up education for a 3-year-old child with asthma who in the past month is scheduling their AccuNeb 1.25 mg tid for symptoms. Parents indicate that he wakes up at least once a night due to cough. What is the best treatment option given the patient’s current asthma control? Select all that apply.
a. Continue current treatment.
Answer b is correct. Patient is using short-acting β-agonist (SABA) several times per day with night awakening greater than 1 time per week which is indicative of very poorly controlled asthma requiring step-up treatment.
Answer d is correct. An oral steroid burst will quickly suppress excessive lung inflammation due to very poorly controlled asthma.
Answer a is incorrect. Symptom presents and medication used not consistent with well control.
Answer c is incorrect. Symptom presents and medication used not consistent with well control.
AM is currently on fluticasone 220 mcg metered-dose inhaler (MDI) two puffs BID, Albuterol MDI two puffs q4 to 6-hour prn cough. The patient has been noticing white lesions on his tongue and inner cheeks. Which inhaler technique can a pharmacist recommend to prevent current symptoms? Select all that apply.
a. Rinse and spit with water after use.
b. Inhale medication quickly.