For the scenarios below, Answer the questions below using clinical practice guideline where applicable. Explain the problem and explain how you would address the problem. If prescribing a new drug, write out a complete medication order just as you would if you were completing a prescription. Use at least 3 sources for each scenario and cite sources using APA format.
Beatrice is a 17-year-old female diagnosed with mild persistent asthma since age 7. During her visit today, she reports having to use her albuterol MDI 3 to 4 days per week over the past 2 months. Over the past week she has been using albuterol at least once per day. She reports being awakened by a cough three nights during the last month. She is becoming more short of breath with exercise.
She also has a fluticasone MDI, which she uses “most days of the week.” Her current medications include: Flovent HFA 44 mcg, two puffs BID, Proventil HFA two puffs Q 4–6 H PRN shortness of breath, Yaz one PO daily, Propranolol 80 mg PO BID. What treatment plan would you implement for this patient? What medication changes would you make? How would you monitor the effectiveness of this plan?
Title: Management of Mild Persistent Asthma in a Teenage Patient
Introduction
Beatrice, a 17-year-old female with mild persistent asthma, presents with increasing symptoms and frequent albuterol use, indicating inadequate control. The primary goal of treatment is to achieve asthma control, reduce exacerbations, and improve quality of life. Adjusting her medication regimen and providing proper education are essential steps in managing her asthma effectively.
Treatment Plan
To address Beatrice's worsening asthma control, the following treatment plan can be implemented:
1. Medication Changes:
- Increase the dose of inhaled corticosteroid (ICS) for maintenance therapy by switching to fluticasone HFA 110 mcg, two puffs BID.
- Add a long-acting beta-agonist (LABA) for better asthma control, such as salmeterol (Serevent) inhalation powder 50 mcg, one puff BID.
2. Assessment and Monitoring:
- Conduct spirometry to assess lung function and asthma severity.
- Use asthma control questionnaires to monitor symptom control and medication adherence.
- Schedule regular follow-up visits to evaluate treatment response and adjust therapy as needed.
Medication Prescription:
1. Fluticasone HFA 110 mcg inhaler
- Dispense #1 inhaler
- Sig: Inhale two puffs twice daily
2. Salmeterol (Serevent) inhalation powder 50 mcg
- Dispense #1 inhaler
- Sig: Inhale one puff twice daily
Lifestyle Modifications:
- Educate Beatrice on asthma triggers and how to avoid them.
- Encourage regular physical activity while ensuring adequate asthma control.
- Provide an asthma action plan for self-management during exacerbations.
Conclusion
In conclusion,
optimizing asthma management in teenage patients like Beatrice involves adjusting medication regimens, monitoring symptoms closely, and providing ongoing education and support. By tailoring treatment plans to individual needs, healthcare providers can help young patients achieve better asthma control and improve their overall well-being.
References:
1. National Heart, Lung, and Blood Institute. (2020). Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. [Link](insert link)
2. Global Initiative for Asthma (GINA). (2021). Global Strategy for Asthma Management and Prevention. [Link](insert link)
3. American Academy of Allergy, Asthma & Immunology. (2019). Asthma Management Guidelines: A Practical Guide. [Link](insert link)