National Asthma Education and Prevention Program (NAEPP).

Posted: January 18th, 2023

National Asthma Education and Prevention Program (NAEPP).

Julia’s asthma is moderate persistent asthma. Julia had daily symptoms of cough, shortness of breath, wheezing, nasal congestion, sneezing, and itchy eyes, which limited her ability to perform activities of daily life. Apart from reporting an increase in nocturnal awakenings, Julia’s FEV₁ was 65%. These symptoms met the diagnostic criteria of moderate persistent asthma. Current guidelines suggest that, for a diagnosis of moderate-severe asthma, a patient’s FEV₁ should exceed 60% but be below 80%. A patient should also have daily symptoms of wheezing, difficulty breathing, cough and wheezing which affect daily activity levels (White et al., 2018).National Asthma Education and Prevention Program (NAEPP).

ORDER NOW.                      

The guidelines suggest that, moderate persistent asthma should be treated with a medium-dose ICS or a LABA (long-acting beta-agonist) such as theophylline plus a low dose ICS. As stated by Becker & Abrams (2017), the goals of therapy, in this case, would be to attain control of asthma symptoms, preserve pulmonary function, help the patient to maintain normal activity levels, to prevent exacerbations and frequent emergency visits to the hospital.National Asthma Education and Prevention Program (NAEPP).

The most likely adverse drug events that could arise after the initiation of therapy is oral candidiasis. Oral candidiasis occurs from the use of Inhaled corticosteroids. During follow-up visits, oral candidiasis can best be detected through a candida throat culture or examining the tongue for oral thrush (White et al., 2018). This effect increases with dosage increase and vice versa.

According to Bonham, Patterson & Strek (2018), pregnancy tends to worsen asthma and can result in complications such as pre-eclampsia, premature births, and intrauterine growth retardation if not adequately managed. Although there are no current studies on pregnant women that explain whether one treatment option is more recommended than another. As recommended by Bonham, Patterson & Strek (2018), if Julia were to be pregnant again, the most preferred treatment option will be increasing the dosage of ICS to medium dose range or administering a LABA plus a low-dose inhaled corticosteroid. This choice is guided by the recommendations provided by the FDA on the categories that define the potential for adverse effects in pregnancy based on human data, animal studies and if a medication’s benefit outweighs potential risks.National Asthma Education and Prevention Program (NAEPP).

Although there is limited data that explains the safety/effectiveness of combined therapy in pregnancy evidence from RCTs (randomized controlled trials) on adult non-pregnant women that illustrates adding a LABA to a low dose inhaled corticosteroid offers a great control of asthma as compared to increasing the dosage of corticosteroids (Bonham, Patterson & Strek, 2018). Besides, the safety profiles of short and long-acting inhaled beta2-agonists are the same. According to the FDA, they both fall under category C. Inhaled corticosteroids also fall under category C.

In this category, studies on animal reproduction have demonstrated to have adverse effects on the fetus although there are insufficient well-controlled human studies to demonstrate the same. However, the drugs have potential benefits, which outweigh the risks, and this warrants the use of the drug in pregnancy. A perfect example of a long-acting inhaled beta2 agonist that has demonstrated to have an excellent safety profile is salmeterol and formoterol (Bonham, Patterson & Strek, 2018). The best-inhaled corticosteroids are budesonide and fluticasone.National Asthma Education and Prevention Program (NAEPP).

Julia’s asthma is moderate persistent asthma. Julia had daily symptoms of cough, shortness of breath, wheezing, nasal congestion, sneezing, and itchy eyes, which limited her ability to perform activities of daily life. Apart from reporting an increase in nocturnal awakenings, Julia’s FEV₁ was 65%. These symptoms met the diagnostic criteria of moderate persistent asthma based the National Asthma Education and Prevention Program (NAEPP) guidelines. These guidelines suggest that, for a diagnosis of moderate-severe asthma, a patient’s FEV₁ should exceed 60% but be below 80%. A patient should also have daily symptoms of wheezing, difficulty breathing, cough and wheezing which affect daily activity levels (National Institutes of Health, 2017).

The guidelines suggest that, moderate persistent asthma should be treated with a medium-dose ICS or a LABA (long-acting beta-agonist) such as theophylline plus a low dose ICS. As stated by Becker & Abrams (2017), the goals of therapy, in this case, would be to attain control of asthma symptoms, preserve pulmonary function, help the patient to maintain normal activity levels, to prevent exacerbations and frequent emergency visits to the hospital.National Asthma Education and Prevention Program (NAEPP).

The most likely adverse drug events that could arise after the initiation of therapy is oral candidiasis. Oral candidiasis occurs from the use of Inhaled corticosteroids. During follow-up visits, oral candidiasis can best be detected through a candida throat culture or examining the tongue for oral thrush (White et al., 2018). This effect increases with dosage increase and vice versa.

Pregnancy tends to worsen asthma and can result in complications such as pre-eclampsia, premature births, and intrauterine growth retardation if not adequately managed. Although there are no current studies on pregnant women that explain whether one treatment option is more recommended than another, if Julia were to be pregnant again, the most preferred treatment option will be increasing the dosage of ICS to medium dose range or administering a LABA plus a low-dose inhaled corticosteroid (Schatz, Krishnan & Chambers, 2018). This choice is guided by the recommendations provided by the FDA on the categories that define the potential for adverse effects in pregnancy based on human data, animal studies and if a medication’s benefit outweighs potential risks.National Asthma Education and Prevention Program (NAEPP).

Although there is limited data that explains the safety/effectiveness of combined therapy in pregnancy evidence from RCTs (randomized controlled trials) on adult non-pregnant women that illustrates adding a LABA to a low dose inhaled corticosteroid offers a great control of asthma as compared to increasing the dosage of corticosteroids (Schatz, Krishnan & Chambers, 2018). Besides, the safety profiles of short and long-acting inhaled beta2-agonists are the same. According to the FDA, they both fall under category C. Inhaled corticosteroids also fall under category C.

In this category, studies on animal reproduction have demonstrated to have adverse effects on the fetus although there are insufficient well-controlled human studies to demonstrate the same. However, the drugs have potential benefits, which outweigh the risks, and this warrants the use of the drug in pregnancy (Schatz, Krishnan & Chambers, 2018). A perfect example of a long-acting inhaled beta2 agonist that has demonstrated to have an excellent safety profile is salmeterol and formoterol. The best-inhaled corticosteroids are budesonide and fluticasone.National Asthma Education and Prevention Program (NAEPP).

Julia’s asthma is moderate persistent asthma. Julia had daily symptoms of cough, shortness of breath, wheezing,, nasal congestion, sneezing, and itchy eyes, which limited her ability to perform activities of daily life. Apart from reporting an increase in nocturnal awakenings, Julia’s FEV₁ was 65%. These symptoms met the diagnostic criteria of moderate persistent asthma based on the guidelines provided by the National Asthma Education and Prevention Program (NAEPP). These guidelines suggest that, for a diagnosis of moderate severe asthma, a patient’s FEV₁ should exceed 60% but be below 80%. A patient should also have daily symptoms of wheezing, difficulty breathing, cough and wheezing which affect daily activity levels (National Institutes of Health, 2017).

Based on the guidelines for managing moderate persistent asthma, the most preferred treatment for Julia would be a medium-dose ICS or a long acting beta-agonist (LABA) such as theophylline or LTRA plus a low dose ICS. As stated by Becker & Abrams (2017), the goals of therapy in this case would be to attain control of asthma symptoms, preserve pulmonary function, help the patient to maintain normal activity levels to prevent exacerbations and frequent emergency visits to hospital.National Asthma Education and Prevention Program (NAEPP).

The most likely adverse drug events that could arise after the initiation of therapy is oral candidiasis. Oral candidiasis occurs from the use of Inhaled corticosteroids. During follow-up visits, oral candidiasis can best be detected through a candida throat culture or examining the tongue for oral thrush (White et al., 2018). This effect increases with dosage increase and vice versa.

Pregnancy tends to worsen asthma and can result to complications such as pre-eclampsia, premature births and intrauterine growth retardation if not adequately managed. If Julia were to e pregnant again, I would recommend that the therapy changes to an inhaled corticosteroid combined with a beta-adrenergic agonist.National Asthma Education and Prevention Program (NAEPP).