asthma pharm

[uclacrewdude]

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guys (and preferably ONE chick [1st come, 1st serve]),

is there any kind of prescribed order for chronic asthmatics? im thinking corticosteroids (beclomethasone/budesonide) are first line, but then what for prophylaxis? up the beta2-agonist dosage? cromolyn-type mast cell blockers? prostaglandins? 😕

 

[IDPHARM]

guys (and preferably ONE chick [1st come, 1st serve]),

is there any kind of prescribed order for chronic asthmatics? im thinking corticosteroids (beclomethasone/budesonide) are first line, but then what for prophylaxis? up the beta2-agonist dosage? cromolyn-type mast cell blockers? prostaglandins? 😕

Yes, first line therapy are inhaled steroids to prevent the inflammation but you can also add Serevent (long act beta agonist) and then a rescue inhaler for those breakthru attacks.

 

[Bobblehead]

http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

Open the pdf file. Page 20 classifies asthma. Page 83-85 gives a basic algorithm for treating each different type of asthma. So to answer your question, yes there's a general order although it has to be tailored to the patient and "it depends".

Uptodate has a nice selection of treatment guideline documents but I don't expect that everyone has access to it.

 

[Mossjoh]

You go by categories....

I- Mild Intermittent Asthma (symptoms <2days/week or <2nights/month)
II-Mild Persistent Asthma
III-Moderate Persistent Asthma
IV- Severe Persistent Asthma

Each has their symptoms associated, like above.

You start the class I asthmatics with just inhaled albuterol as needed. If they are mild persistent (II), you do an inhaled steroid + albuterol PRN.
Class III you do the Long Acting B-agonist (Salmeterol), Inhaled Corticosteroid, and albuterol INH PRN.
Class IV you may need to do oral steroids + the above methods plus add on other drugs if needed.

Mossjoh

 

[tupac_don]

guys (and preferably ONE chick [1st come, 1st serve]),

is there any kind of prescribed order for chronic asthmatics? im thinking corticosteroids (beclomethasone/budesonide) are first line, but then what for prophylaxis? up the beta2-agonist dosage? cromolyn-type mast cell blockers? prostaglandins? 😕

Yea leukotriene antagonists are for prophylactic use only, for long term asthmatics. Such as Montelukast and Zafirlukast. YOu wouldn't use prostaglandins?? (where is that coming from??) You typically use prostaglandins for GI induced ulcers (misoprostol), but definietly not asthma. YOu wouldn't up the B2 dosage at least of the short acting one. You might add a long acting B2 agonist such as Serrevent as someone mentioned. But typically the best deal is using steroids. And I am not sure about beclomethasone/budensoide only. WHat about triamcinolone, fluticasone propionate, prednisolone. Oh yea you can use cromolyn, but that is typically used in children. Like someone said, look up the Asthma guidelines, they will pop up if you type in google. THey will give you a great chart that says how to treat asthmatics.

Best of luck.