Asthma Management: NICE Guidelines and Medication Recommendations

📋 Consider possible reasons for uncontrolled asthma before starting or adjusting medicines.

👥 Define uncontrolled asthma as three or more days a week with symptoms or three or more days a week with required use of a Saba or shorter Timber Agonist inhaler for symptomatic relief or one or more nights a week with Awakening due to asthma.

💊 Offer regular daily inhaled corticosteroids rather than intermittent therapy and adjust inhaler doses as needed.

🗺️ Provide pharmacological treatment for newly diagnosed asthma or uncontrolled asthma on current treatment.

⭐ The recommendations for asthma management in children aged 5-16 are similar to those for adults.

⭐ There are low, moderate, and high doses of inhaled corticosteroids for asthma treatment.

⭐ The pediatric doses of inhaled corticosteroids are half of the adult doses.

⭐ Asthma management follows a stepwise approach in adults and children aged 5 to 16.

👉 Short-acting beta 2 agonists are used as reliever therapy for infrequent short-lived symptoms of asthma.

💨 If asthma remains uncontrolled, additional medications such as long-acting beta 2 agonists and leukotriene receptor antagonists are offered.

💙 Maintenance and reliever therapy (MART) involves using a single inhaler containing both an inhaled corticosteroid and a fast-acting beta 2 agonist.

💡 Asthma management involves daily maintenance therapy and relief of symptoms as required.

🏥 For uncontrolled asthma, the inhaled corticosteroid dose can be increased to a moderate maintenance dose.

👶 In children under 5, the treatment pathway for asthma is slightly different, and diagnosis is challenging.

👉 Management of asthma using inhaled corticosteroids based on symptom resolution.

🔍 Consideration of alternative diagnosis if symptoms do not resolve after stopping treatment.

📝 Importance of a written asthma self-management action plan.

🌬️ Addressing the impact of pollution on asthma and providing strategies to minimize exposure.

⚠️ Increasing the dose of inhaled corticosteroid for seven days when asthma control deteriorates.

📚 The NICE guidance provides recommendations for managing asthma, including increasing inhaled corticosteroid dose.

🔍 The self-management plan should include regular use of inhaled corticosteroids to regain control of asthma.

⚠️ Identifying and optimizing care for asthma patients at increased risk of poor outcomes is important.

The ongoing management of asthma involves checking adherence, inhaler technique, and the need for treatment changes.

For monitoring symptoms in adults, a validated questionnaire and spirometry or Peak flow variability testing can be used.

Routine use of fractional exhaled nitric oxide or challenge testing for monitoring purposes is not recommended.

Inhaler technique should be checked at every asthma consultation and when there is deterioration or a change in the device.