II. Management: Explain Pathophysiology

  1. Contrast between Asthmatic and normal lungs
  2. Describe what happens to airways in Asthma attack
  3. Explain Asthma as a chronic disease
    1. No Cure (although may resolve on its own)
    2. Management directed at achieving Asthma control

III. Management: Describe Medication Roles

  1. Emphasize Long-term medications as key to control
  2. How Medications work
    1. Long-term medications reduce inflammation (e.g. Inhaled Corticosteroid)
    2. Short-term medications rescue from bronchospasm (e.g. Short acting beta Agonist)

IV. Management: Skill Training

  1. See Inhaler Education
  2. See Metered Dose Inhaler
  3. See Inhalers above
  4. Inhaler technique teaching is billable (CPT 94664)
  5. Spacer and holding chamber use
    1. See Spacer Devices for Asthma Inhalers
  6. Monitoring methods
    1. Symptom monitoring
    2. Peak Flow meter
    3. Early recognition of exacerbation
  7. Written action plan
    1. Stepwise plan for exacerbations
    2. When and how to take Rescue medications
  8. Discuss Exercise
    1. See Breathing Exercises in Asthma
    2. Encourage regular physical Exercise as tolerated
      1. Carson (2013) Cochrane Database Syst Rev (9): CD001116 +PMID: 24085631 [PubMed]

V. Management: Control Measures for Environmental Allergens

  1. See Environmental Allergen
  2. Tobacco Cessation and eliminate Secondhand Smoke exposure
  3. Animal Dander
    1. Remove animal from house
    2. Keep animal out of patient's bedroom
    3. Install Filter on bedroom air duct
  4. House-Dust mites
    1. Encase mattress and pillow in impermeable cover
    2. Wash bedding weekly in hot water
    3. Reduce indoor humidity <50%
    4. Remove dust "collectors" from room
  5. Cockroaches
    1. Set traps
    2. Preventative measures
  6. Pollens
    1. Keep windows closed during the season
  7. Indoor Mold
    1. Fix leaks and other water sources of mold growth
    2. Reduce indoor humidity to <50%
    3. Clean

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