You may have thought you were safe from dire warnings about global warming in the pages of BJPCN. But hayfever is one of the themes of this issue and the mild winter has meant that some people suffered symptoms much earlier than usual as pollens which can trigger allergic reactions were found in the air as early as January.
Anticholinergic drugs are bronchodilators that act by blocking acetylcholine, the
neurotransmitter for the parasympathetic nervous system. By blocking parasympathetic
stimulation, anticholinergics reduce cholinergic tone, therefore producing
bronchodilation. In this article we review when and how these drugs should be used.
What are their potential benefits and what should we tell patients who need them?
The Department of Health’s Expert Patient Programme recognises the role of selfmanagement
in many different disease areas and its report Self Care recommends the
concept of encouraging people with long-term conditions to self-manage where
possible. Diabetes management would never succeed without the active participation of
the person with the condition and asthma management plans have been advocated for some
time for people with asthma. What can self-management plans achieve in chronic obstructive
pulmonary disease (COPD)?
Primary healthcare staff are in an influential position when it comes to helping people to
stop smoking. They clearly understand the dangers of smoking and have access to
excellent smoking cessation services. In addition, the recent public smoking legislation
has given many smokers added motivation to stop (See Prevention in Practice, BJPCN
December 2008). However, there is much still to be done. This article recommends an easy and
effective brief intervention for primary healthcare professionals to help patients towards the
most effective way to stop – support and pharmacotherapy.
Abnormal breathlessness is a common symptom with a wide variety of causes and it can
be quite a challenge to diagnose the cause and plan appropriate treatment. Practice
nurses are often the first point of contact for patients with these conditions and play an
important role as part of the multidisciplinary healthcare team. This article completes a
series of three on causes of breathlessness (‘The breathless patient: is it asthma or COPD?’ Vol 2,
Issue 1, December 2007 and ‘Respiratory causes of breathlessness.’ Vol 2, Issue 2, March 2008).
Was it me? Did I blink and miss the spring? There I was, trying to plan my
early initiation of inhaled steroids and nasal sprays to ward off seasonal
exacerbations of allergic rhinitis and asthma but spring just doesn’t seem
to have sprung this year! It made me wonder whether the wet weather
had an influence on hay fever levels.
Interstitial lung disease (ILD) is a general term for a number of diseases characterised by
progressive pulmonary fibrosis or ‘scarring’ of the lungs. The term fibrosis implies formation
of abnormal connective tissue within the lung parenchyma. These diseases are less
commonly seen in primary care than airways diseases such as asthma and COPD. However,
like COPD, they produce progressive debilitating breathlessness for the patient. It is important
that practice nurses, particularly those with an interest in respiratory diseases, are aware of this
group of diseases and their management as early referral to specialist care is important.
Practice nurses often get to know their patients with chronic obstructive pulmonary
disease (COPD) very well. Over the years, they have attended for reviews, flu injections
and when they have exacerbations. Nurses get to know their families as well as the
patient, and it can be hard to observe the inevitable deterioration as the condition
progresses. This article will outline some of the key issues for practice nurses when their patients
start to have frequent hospital admissions or cannot attend the surgery for reviews. Has their
condition become palliative, and what can practice nurses contribute to their care?
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.
The BJPCN interviewed Dr Steve Holmes (Chairman of the GPIAG) and
Stephanie Wolf (GPIAG General Committee member) on the 20th anniversary
of the organisation.
This year there is more reason than ever for people to stop smoking, with the ban on
smoking in public places coming into force in July. How can we support smokers
who want to quit? In this article, we provide a comprehensive guide to resources
that can help.