Discharge Planning

After reinforcement on the inhaler technique by the pharmacist, the patient was discharged on the next day as
she was afebrile and had minimal cough.

The following meds:

Cefuroxime 500mg twice daily for the next 7 days.
Neulin SR 250mg once at night

Advice patient to
 Take your asthma medicines
 Advise the client to continue prescribed home medications to ensure optimum recovery.
 Give adequate instruction about the importance of following medication and dietary regimens.
 Instruct to give the following medications at the right time, right dose, right frequency, and right route.
 Don’t smoke. Avoid secondhand smoke. Smoke can worsen asthma symptoms.
 Eat a healthy diet that includes green leafy vegetables, fruits, milk, and egg
 Learn how to monitor your asthma.
 Educate the patient how to perform Asthma Emergency First Aid (4x4x4) explained.
 Be sure to always have a quick-relief inhaler with you. If you were given a prescription, make sure you go
to a pharmacy to get it filled out as soon as possible.
 Make sure you know what to do if exercise is a trigger for you. Many people use quick-relief inhalers before
exercise or physical activity.
 Get a flu shot every year and get pneumonia shots as advised by your healthcare provider.
 Avoid exposure to chemicals, such as the chemicals used in the manufacturing industry, and farming.
 Advise the patient's husband to monitor the patient's health and to contact the health provider immediately if
she noticed something wrong.

Call your healthcare provider if:

 Your medicines do not seem help you breathe comfortably

 Your symptoms happen more often or are worse than normal

 You have more trouble with your symptoms at night and you are not sleeping

 You are not able to do your normal daily activities because of trouble breathing

 Your peak flow number changes from day to day

 You have to use your quick-relief inhaler more than 2 days a week

 You received emergency care for an asthma attack

RRL

Asthma is a major public health challenge and is characterized by recurrent attacks of breathlessness and
wheezing that vary in severity and frequency from person to person. Asthma is defined as a chronic
inflammatory disease of the airways. The chronic inflammation is associated with airway hyperresponsiveness
(an exaggerated airway-narrowing response to specific triggers such as viruses, allergens, and exercise) that
leads to recurrent episodes of wheezing, breathlessness, chest tightness and/or coughing that can vary over time
and in intensity. Symptom episodes are generally associated with widespread, but variable, airflow obstruction
within the lungs that is usually reversible either spontaneously or with appropriate asthma treatment such as a
fast-acting bronchodilator. Asthma control is an important measure of health outcomes of the patients with
asthma and reflecting the impact of an illness and its treatment from the patient’s perspective.

Asthma is a common pathology, affecting around 15% to 20% of people in developed countries and
around 2% to 4% in less developed countries. It is significantly more common in children. Up to 40% of
children will have a wheeze at some point, which, if reversible by beta-2 agonists, is termed asthma, regardless
of lung function tests. Asthma is associated with exposure to tobacco smoke and inhaled particulates and is thus
more common in groups with these environmental exposures.

In childhood, asthma is more common in boys with a male to female ratio of 2:1 until puberty when the
ratio becomes 1:1. After puberty, the prevalence of asthma is greater in females, and adult-onset cases after the
age of 40 years are mostly females. Asthma prevalence is greater in extreme of ages due to airway
responsiveness and lower levels of lung function.

Of all the asthma cases, about 66% are diagnosed before the age of 18 years. almost 50% of children
with asthma have a decrease in severity or disappearance of symptoms during early adulthood.

Management

The primary goal of asthma management is to achieve and maintain control of the disease in order to prevent
exacerbations (abrupt and/or progressive worsening of asthma symptoms that often require immediate medical
attention and/or the use of oral steroid therapy) and reduce the risk of morbidity and mortality. Other goals of
therapy are to minimize the frequency and severity of asthma symptoms, decrease the need for reliever
medications, normalize physical activity, and improve lung function as well as overall quality of life.

Conclusion

Asthma is the most common respiratory disorder and contributes to significant morbidity and mortality. A
diagnosis of asthma should be suspected in patients with recurrent cough, wheeze, chest tightness and dyspnea,
and should be confirmed using objective measures of lung function (spirometry preferred). Allergy testing is
also recommended to identify possible triggers of asthma symptoms.
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