Need ONE Response Per Each Discussion Total 6 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion
butterflyl
WEEK13.docxDiscussion 13: Manuel M Cabrera
Top of Form
Discussion 13
1. It would be appropriate to adopt a stepwise pharmacological approach in this situation to reduce the overall impact of side effects and prevent complications. Moreover, one may argue that additional information is necessary to verify the severity of the patient’s condition, and it is necessary to focus on symptoms like nighttime awakenings, lung function, and interference with daily activities (Tietze, 2016). Nonetheless, a short-acting beta2-agonist (SABA) like albuterol should be recommended as the Step 1 and Step 2 treatment when the objective is to relieve the symptoms, and the appropriate dosage is 90-180 mcg orally as needed (Tesse, Borrelli, Mongelli, Mastrorilli, & Cardinale, 2018). Its onset of action is close to 10 minutes, and it stays effective during a period of 3 to 4 hours (Tietze, 2016). It may be appropriate to combine a SABA with a 100-200 mcg inhaled corticosteroid (ICS) like fluticasone propionate because it would help to control asthma and does not increase the risks associated with adverse events. It may also be necessary to increase the dosage of an ICS or consider a long-acting beta2-agonist like salmeterol to control the condition if control is not achieved within 3 months while utilizing low dosages.
2. It is important to ensure that the patient and the parents understand the need to adhere to the treatment plan because a stepwise approach may be ineffective if recommendations are not followed. It is also necessary to consider environmental factors that may affect adherence to the regimen and consider lifestyle changes that could reduce the overall impact of asthma. Healthcare professionals should also make sure that the patient and the parents have an understanding of the side effects associated with medications (Tietze, 2016). It is important to keep track of cardiovascular issues, diabetes, and hyperthyroidism when taking SABAs or LABAs because of drug-disease interactions.
References
Tesse, R., Borrelli, G., Mongelli, G., Mastrorilli, V., & Cardinale, F. (2018). Treating pediatric asthma according guidelines. Frontiers in Pediatrics, 6, 234. doi:10.3389/fped.2018.00234
Tietze, K. J. (2016). Asthma. In V. P. Arcangelo, A. M. Peterson, W. F. Wilbur, & J. A. Reinhold (Eds.), Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer Health.
Bottom of Form
Alvarez Lizandra Week 13
Top of Form
After being diagnosed with asthma this 10-year-old boy must be started on both short- and long-term treatment options. Short acting bronchodilators are used to relieve symptoms and last four to six hours. Albuterol an inhaled beta2 adrenergic agonists is the most commonly used bronchodilator (Grupta, Bhat, & Pianosi, 2018). Long term medications or maintenance medications are to be taken every day to control persistent asthma. They include inhaled corticosteroids, leukotriene modifiers, combination inhalers, theophylline, and biologics.
It is important to include in the teaching plan that even though the short acting bronchodilators act quickly, they can’t prevent the symptoms from coming back. It is important that the family receives teaching in avoiding triggers (Aalderen, 2012). Also, they must learn to monitor symptoms and lung function. Lastly the education plan must be very specific as to how and when to use medications.
References:
Gupta, A., Bhat, G., & Pianosi, P. (2018). What is New in the Management of Childhood Asthma?. Indian journal of pediatrics, 85(9), 773–781. https://doi.org/10.1007/s12098-018-2705-1
van Aalderen W. M. (2012). Childhood asthma: diagnosis and treatment. Scientifica, 2012, 674204. https://doi.org/10.6064/2012/674204
Laura Saldivar
Advanced Pharmacology
Discussion
4/8/2020
Most children with asthma will show symptoms at a young age, such as before primary school or before the age of five years old (Asthma in Children 2018). The bronchial tubes in infants, toddlers and preschoolers are small and narrow, and asthma causes them to become even more narrow making the symptoms of shortness of breath very prominent (Asthma in Children 2018). Children present with symptoms such as c oughing and wheezing, especially upon expiration, labored breathing, tachypnea and dyspnea. Treatment for mild intermittent asthma symptoms consists of using short-acting inhaled beta2 agonists as needed for asthma attacks, only when exposed to their asthma triggers, viral respiratory illness, chemical inhalants, people who have only exercise-induced asthma, and infants and children who wheeze with viral upper respiratory infections (Woo, T. M., & Robinson, M. V. 2020).
The recommended treatment for patients with mild persistent asthma is one long-term control medication daily. The primary treatment is inhaled anti-inflammatory medication. Treatment is started with inhaled low-dose corticosteroids (ICS) for all age groups. (Woo, T. M., & Robinson, M. V. 2020). The child should be educated to avoid any allergens, or triggers that cause asthmatic episodes. The child should be educated to not sleep with the fan blowing directly on his face to avoid blowing dust and allergens in his direction. If asthmatic symptoms occur use inhaler as needed.
Discussion 13 Gretell Alfonso
Top of Form
Gretell Alfonso
Advanced Pharmacology
Discussion 13 Asthma
March 9, 2020
For Mrs. Cason son we need to first identify treatment according to which state or level her son is in by the guidelines. First off, I would give her son a nebulizer treatment to help with opening the airway in order for her son to be able to breath. As a short acting treatment, I would prescribe 2 puffs of Proventil due to the fact that is not only cheap but also is a safe treatment for asthma in children. Proventil is a short acting beta 2 agonist which will help with opening the airways by affecting the smooth muscle on the bronchial tree making it easier for breathing through increased airflow (Woo, T. M., & Robinson, M. V. 2016). I would also prescribe a low to medium dose inhaler of Advair Diskus 100/50 as a daily inhaled long acting corticosteroid to help control the asthma and bronchospasm along with an anti- inflammatory agent Cromolyn 20mg/2mL (Woo, T. M., & Robinson, M. V. 2016). Cromolyn is an anti-inflammatory agent that according to the asthma treatment guidelines should be prescribed with a long acting inhaled beta 2 agonist. Cromolyn is also very safe to use in children, supply should be for 4 weeks. Since Mrs. Cason’s son has been going through respiratory issues for one year, I believe that her son can really benefit from an anti-inflammatory which will also help with better respiratory airflow (Guilbert, T. W., Bacharier, L. B., & Fitzpatrick, A. M. 2015, September).
My educational plan for the child is to explain to him first why is it so important to take his medications every day and be consistent with the treatment overall in order to improve his asthma and avoid any complications such as severe asthma (Guilbert, T. W., Bacharier, L. B., & Fitzpatrick, A. M. 2015, September). I would also educate the patient in how to properly use the inhalers he will be using. For example, I would explain to him and his mother that when he is ready to take a puff from his inhalers there are several steps to be taken. Step one would be to take a normal breath, step two would be to place the inhaler spacer in the mouth and finally to inhale slowly and hold breath for about 10 seconds in order to make sure the medication is absorbed (Woo, T. M., & Robinson, M. V. 2016). In addition, he will need to wait 1 minute between puffs and also rinse his mouth after inhaler use. I would also tell Mrs. Cason and her son that the Proventil inhaler needs to be used when an asthma attack is about to happen or while it is happening. The other inhaler and the corticosteroid need to be taken every day. There are a few things I would ask Mrs. Cason to make sure that her son avoids which is irritants such as second hand smoke or anything that she has noticed makes her sons asthma worse. When using treatment for asthma the patient needs to understand that the treatment needs to be consistent in order for it to work and be fully effective. Furthermore, the patient should also be aware of the side effect that come with the medications. For example, tachycardia is a very common side effect with albuterol (Woo, T. M., & Robinson, M. V. 2016). Finally, I would let Mrs. Cason know that it is important for them to come back for a follow up appointment in order to make sure that the child is responding to medication treatment given and that within 4 weeks the patient might need to be seen again in order to adjust medication regimen once the asthma is under control (Guilbert, T. W., Bacharier, L. B., & Fitzpatrick, A. M. 2015, September).
Reference:
Guilbert, T. W., Bacharier, L. B., & Fitzpatrick, A. M. (2015, September). Severe asthma in
children. Retrieved April 9, 2020, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589165/
Woo, T. M., & Robinson, M. V. (2016). Pharmacotherapeutics for advanced practice nurse
prescribers(4th ed.). Retrieved from
https://ereader.chegg.com/#/books/9780803645813/cfi/402!/4/[email protected]:0.00
Bottom of Form
Robert Alonso
Mrs. Cason’s son was diagnosed of asthma
Although research investigations have documented a somewhat favorable safety history of inhaled beta2-adrenergic agonists, above all, for Mrs. Cason's son, it is obvious that the reports might have indicated adverse asthma. As such, the kid could have had this obstructive airway disease for quite a long time, and this might have paused some critical dangers. However, with this case, inhaled beta2-adrenergic agonists or Inhaled corticosteroids (ICSs) could be applied as long term controls (Reddel et al., 2019). This case becomes severe, and even though short term courses regarding oral systematic corticosteroids could be utilized or recommended, the prompt control approach would be the initiation of long-term therapy. Such long term oral systematic corticosteroids can be very successful in this case because the condition has somehow transitioned into much severity.
Also, for this instance, we have to acknowledge that Long-acting beta-agonists (LABAs) like Salmeterol and formoterol can be used as bronchodilators with a period of bronchodilation of at least 12 hours after one dose. However, they are not to be used singly or as monotherapy to control this condition in the long-term range. This is 10-year old; therefore, a combination of LABAs with ICSs is the perfect one for the long-term control and prevention of his condition.
In reference to the above, the rationale for these recommendations is that there are always many benefits and positive effects of LABAs when applied in combination therapy for several demographics of patients that might need more therapy like this kid. However, some short term low-dose like ICS alone might not prove useful in this case (Bush & Griffiths, 2017). The education plan for this kid can be quite elaborate. However, in a simple approach, the child must now be incorporated into most of the physical activities with proper precautions. Also, the classroom allergens that could facilitate his allergies like chalk dust, animals, perfumes must be eliminated. To do this, the kid must also be served with some anti-allergic drugs to help him survive the short-term scenarios that might arise in school.
References
Bush, A., & Griffiths, C. (2017). Improving treatment of asthma attacks in children.
Reddel, H. K., FitzGerald, J. M., Bateman, E. D., Bacharier, L. B., Becker, A., Brusselle, G., ... & Wai-san Ko, F. (2019). GINA 2019: a fundamental change in asthma management: treatment of asthma with short-acting bronchodilators alone is no longer recommended for adults and adolescents.
Ariel Lopez
Asthma is a respiratory illness affecting the lungs. Some of the symptoms associated with asthma are wheezing, tightness of muscles in the chest, weakness and recurrent coughing. When a child is suffering from severe asthma, it becomes hard for him to talk or play. Common asthma triggers are infections like colds, allergic substances such as pollens, air pollution, exercise, and cold air. There exist numerous asthma therapies available to alleviate asthma symptoms. This essay will discuss short and long term asthma treatment options and educational plan for a child with asthma.
Inhaled beta2-adrenergic agonists are used in treating asthma symptoms because they are known to open up the airways of the lungs. They trigger beta cells, which slacken the smooth muscles of the lungs. The tightening of these muscles is mostly linked to environmental smoking (Brandao, 2017). Some asthma therapy options are permanent while others are temporary. The brief beta-agonists are employed for the severe temporary alleviation of asthma symptoms. When the child’s peak flow falls below a determined value or if he develops wheezing or shortness of breath, his asthma action plan should instruct Mrs. Cason on how his son is supposed to use his rescue inhaler.
On the other hand, the son should take long term beta-agonists daily as part of his prevention plan. However, long term beta-agonists are not routinely used as monotherapy in asthma treatment. They are normally part of a blend of asthma products like Advair. These medicines integrate a sniffed steroid and a long-lived beta-agonist into one inhaler. When utilized in a synergy product, the long-lived beta agonists will normally be used by the child daily.
My educational plan for this child will include creating the time to; first, help Mrs. Cason comprehend any doubts around diagnosis. Secondly, address the apprehensions of the child and Mrs. Cason. Thirdly, evaluate the effects of asthma on everyday activities. Fourthly, control asthma symptoms by decreasing subjection to asthma triggers (Zahran et al., 2018). And lastly, help Mrs. Cason to comprehend the role of each therapy and how it works.
In conclusion, the essay has discussed short and long term asthma treatment options and educational plans for a child with asthma. Asthma in children can distort play and other child pursuits. Inhaled beta2-adrenergic agonists work by alleviating rapid cough, wheezing and difficult breathing by increasing airflow through the air passages. The educational plan for children should aim at leading to the comprehension of good control of asthma and the capacity of drugs in attaining this.
References
Brandao, H. V., & Cruz, C. S. (2017). Asthma and Cesarean Section. Austin J Asthma Open Access, 1(1), 1001.
Zahran, H. S., Bailey, C. M., Damon, S. A., Garbe, P. L., & Breysse, P. N. (2018). Vital signs: asthma in children—United States, 2001–2016. Morbidity and Mortality Weekly Report, 67(5), 149.
Bottom of Form
