There are several different drug types used in the management of hypertension. This back to basics provides a useful summary of the different antihypertensive drug classes and how they act to regulate blood pressure.
Back to Basics: Respiratory drugs
Getting it Right: Asthma Devices in Children
Asthma medications should routinely be delivered by a pressurised metered dose inhaler
(pMDI) and spacer system, with a facemask where necessary, in children under five,
according to the National Institute for Health and Clinical Excellence (NICE).1
For older children, aged 5-15 years, NICE has advised that a child’s therapeutic needs,
the ability to develop and maintain an effective technique, the suitability of a device for the
child’s and carer’s lifestyles (ie portability and convenience) and the likelihood of good
compliance are the factors that should govern the choice of device.2 Only once these factors
have been taken into account, should choice be made on the basis of cost minimisation.
Back to Basics: Is it COPD or asthma?
To be able to effectively manage patients with
airflow obstruction in general practice it is
imperative that we can differentiate between
asthma and chronic obstructive pulmonary disease
(COPD). Although COPD and asthma share many
clinical features, they are different conditions with
different airway inflammation and parenchymal
patterns.
Diagnosing allergy in asthma and allergic rhinitis
Patients with allergic asthma, intermittent (seasonal) or persistent (perennial) allergic
rhinitis, represent a significant proportion of primary care consultations. There is
growing awareness of allergy and the possibility of an allergic component as the cause
of a wide variety of symptoms. It is important to understand how to diagnose atopy to
ensure appropriate management and care of our patients. Diagnosing allergy is initially about
asking the right questions, followed by confirming or refuting the diagnosis by objective testing.
In this article, we explore history taking and objective testing that will help us to manage and
advise patients appropriately.
Back to Basics: Drugs for asthma – where and how do they work?
Bronchodilators in Children with Asthma
Asthma is a common condition in children, with approximately one in eight youngsters in
the UK receiving treatment for asthma at any given time. The British guidelines on the
management of asthma have separate pathways for children of different ages, for those
under 5 and for children aged 5-12 years. In this article, we review some of the
challenges of treating children with asthma, in particular, the best use of bronchodilators.
Why Optimise Inhaler Technique in Asthma and COPD?
Asthma UK estimates that 2.1 million patients in the UK are suffering unnecessarily because
they do not use their asthma treatment effectively. This article looks at how inhaled
therapies are deposited in the lungs, and at the basic differences between inhalers – with
a focus on optimising inhaler technique.
The problem with asthma…
The current treatment of asthma in the UK is rightfully seen as a triumph of chronic disease management within a primary care setting. Almost all routine asthma care and, increasingly, elements of acute asthma care, are now provided in general practice. Over the past twenty years, significant effort and investment have gone into the production […]
Which drugs are contraindicated for asthma patients
One person in every five households in the UK is receiving treatment for asthma,
according to latest figures. As well as treatment for asthma, many of these individuals
also self-medicate for minor illnesses or require prescribed medication for other
conditions. It is important that the drugs they take do not adversely affect their asthma
control. In this article we review which drugs might cause problems in patients also taking
treatment for asthma.
Scoring Top Marks for Asthma QOF Indicators
Asthma is a chronic disease that has, for a long time, been the domain of primary care nurses, and many have qualifications enabling them to run nurse-led asthma clinics. It is, therefore, essential to fully understand the Quality and Outcomes Framework (QOF) and to be able to maximise the points available to the practice, at the same time as providing a comprehensive service to patients. In this article, we review the QOF indicators for asthma, strategies for optimising record keeping and performing asthma reviews.
What do Patients Want from Asthma Therapy?
More than half of people with asthma in the UK have inadequate symptom control,
despite the range of effective therapies now available. Rather than blaming
patients when they fail to take their medications as prescribed, we need to
examine the way we conduct asthma consultations and ask whether we are failing
to meet the needs of individual patients. How can we gain greater understanding about what
people with asthma want from healthcare professionals and treatments, so we can achieve a
more patient-centred approach to care?
Thunderstorm Asthma
On 23 June 2005, the Met Office issued a warning that severe thunderstorms were likely
to hit the South East of England in the next 24 hours. On the evening of Friday 24 June,
primary care out-of-hours services and hospital accident and emergency departments
in Northwest London were inundated by patients attending with acute asthma. The
scale of these attendances – eight times more patients than usual in one hospital – meant that
departments had to call in additional staff and some ran out of emergency supplies of
bronchodilators, nebulisers and oral steroids for treating asthma. In this article, we will explain
the background and some of the theories related to this type of epidemic of acute asthma –
Thunderstorm Asthma.