Asthma longterm treatment | Respiratory system diseases | NCLEX-RN | Khan Academy
26
August

By Adem Lewis / in , , , /


– So, I’ve got a nice little chart here that tells us how to categorize how severe somebody’s asthma is. Basically, these three are persistent, as you can see, more than twice a week. Moderate is daily. Severe is bad symptoms every day, sometimes twice a day. So, here we’ve got severity scale, and this scale I found is actually, we can adapt it very
little to make this scale for evaluating how well
somebody is treated. So TX is treatment. The goal in treating asthma,
since we can’t cure it, is to control the symptoms and
reduce the number of times. Basically, we’re trying to get them towards the intermittent stage. So, basically for someone
to be well controlled, the definition is very similar to the definition for intermittent. So, well controlled would
be less than two a week and never more than once a day. So, less than or equal to one a day, when they do have their attack. So, here you say it
happened once on Wednesday, just once, then this person is okay. Their medication is working. So, next level is, we say this
patient is not well controlled. Don’t let the colors confuse you. I’m using green here just
to match with this row here, but not well controlled is
not green, it’s not good. So, I’m going to write
WC for well controlled, and this one is defined as
more than twice per week, or even if they only have it twice a week, more than once per day
when they do have it. So, if they have it on Monday, Tuesday, Thursday, Friday, Sunday,
that’s not well controlled. That’s five times a week. Or even if they only have
Wednesday and Saturday, say it only happened on these two days, if they have it let’s say
two times on Wednesday or three times on Saturday,
that already pushes them, that puts them in the not
well controlled as well. And then, of course, the last two here, that’s poorly controlled. We’re not even going to
distinguish between them. We’re just going to write poor. And if you’re the physician, the person who is poorly controlled needs to go way up on their meds. The person who is not well controlled also needs to go up on their meds. So, in terms of treatment,
first we’ve got two modes of delivering the drugs. Let’s not worry about the drugs for now. Let’s talk about how it’s delivered. First we have a nebulizer. Let’s spell it out, nebulizer. Now, this needs this big machine here, and it has a hose connected to a mask. So, my very crude drawing
of a medical mask. The person basically puts this mask on, and the medication gets evaporated into mist in this machine, and it’s delivered with
oxygen to the person. It takes about 10 minutes. They just sit there with
their mask and breathe it in. Now, this machine can be more expensive, and you need electrical wiring for it, and you need to stay in one place, and it takes about 10 minutes. So, those are the drawbacks,
but it works very well. Alternatively, I’m sure
you’ve seen people use this. We have the inhaler, which
is this L-shaped tube here with an opening and a button on top. This person can push this button, and the medicine squirts out here. Now, the best way to use
this is with a spacer, because the medicine
needs to travel with air, and then a person puts their head here and inhales this medication. It takes about 30 seconds, at most. So, this is an inhaler. It is relatively cheap. It’s small. It can fit in your pocket. So, it can go with the patient anywhere. So, remember for each of these you can use multiple medications with it. It just depends on what’s more
convenient for the patient. So, in terms of the drugs
that we actually put in here, there are a couple of categories. So first, I want to talk
about the drugs that decrease the inflammation. Inflammation is your
body’s natural reaction to something that’s bothering it. Unfortunately, with asthma, inflammation gives us all these symptoms. So, we temper down the
inflammation with drugs. So, first we’ve got steroids. Now, steroids in the body,
that’s naturally produced there, can also fight inflammation, but, obviously, it’s not enough, so we give artificial steroids to temper down the inflammation. We’ve also got leukotriene inhibitors. This is a weird word. It’s just a molecule,
leukotriene inhibitors. So, basically it stops the leukotriene from having an effect on the body. Now, the reason these two
are related has to do with the way the inflammation
starts in the body. We have something, a trigger. An A leading to B, leading
to C, leading to D, all the way to the end,
we make leukotriene. That’s the goal of this whole cascade. So, of course, to stop the inflammation we can either get rid of this,
or steroids comes in earlier and gets rid of an earlier
stage in the cascade. So, both of these drugs
have the same goal, which is to decrease the leukotriene, decrease the whole cascade
from causing the symptoms. So, that’s one big class of drugs. The other one is bronchodilators. Now, broncho is airway, and dilator means increase the diameter or just open it up, because asthma involves the clamping down or closing of the bronchial pathway. Now, within here we
have the beta agonists. Beta is a type of receptors in the body, and in the lungs, their
job is to open it up. So, literally we relax the smooth muscle, or if this is asthma right now, with all this smooth muscle clamping down, the beta agonist is able to turn that into a nice open airway,
with the smooth muscle much more relaxed around here. So, we throw this drug
at the beta-2 receptors on the airway through all of our lungs, and they do different things
in different parts of the body, but here, we care about bronchodilation. There are other drugs that also do this. For example, we have theophylline, which is a drug that can
be toxic to some people, and we have to monitor
the levels very carefully, but it basically does the same thing, of relaxing the smooth muscle and giving us a bigger airway. So, treatment can be
kind of trial and error, because our goal is just
to go in this direction. So, whatever gets us there, whatever combination of drugs, the amount, we just keep going up
and keep adding drugs until we get to well
controlled, and that is the goal of our long-term treatments for asthma.


6 thoughts on “Asthma longterm treatment | Respiratory system diseases | NCLEX-RN | Khan Academy

  1. Thanx for this nice videos..

    In addition to the bronchodilators there is another medication which was not mentioned in this video. It is parasympatholytic like ATROVINE..

  2. this is very interestng video about the asthma management
    . A product I also found helpfull for bronchial asthma
      is Knewreck Asthma Eradicator Guide – it should be on google if you need it.."asthma management"

  3. Wow, I have never seen such a detailed explanation for such a severe problem. An A+ Job!. I use grathaw asthma treatment expert as long term treatment for asthma. It's doing a very nice job and helps a lot. Use google to find info about it and let it guide you to a new life full of air!

  4. OMG!! This video really helped me a lot. I was having trouble trying to understand this. Rn all my doubts have been cleared. Thank you!!!!

  5. I've been investigating reducing asthma naturally and found a fantastic resource at Laken Chest Remedy (google it if you're interested)

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