2. DEFINATION
• Asthma is a bronchonstriction present with wheeze
. It is (long-term) condition that affects the airways
in the lungs . It is reversible When using short
acting beta agonist
7. MANAGEMENT OF ASTHMA
Long term management
• Intermittent asthma is characterized by:
Infrequent symptoms
Child is normal in between attacks.
Treatment: Short acting beta agonists (as and when
needed).
8. PERSISTENT ASTHMA:
• mild persistent:
Day episode 2 a/month.
Night time awakening > 1/month.
Treat daily with low dose inhaled corticosteroids (ICS):
Budesonide, Fluticasone, Beclomethasone.
9. moderate persistent:
Daily attacks or need to use of SABA daily.
Treat with medium dose ICS or low dose ICS daily +
LABA (Long Acting Beta Agonist) like Salmeterol,
formoterol.
10. Severe persistent:
Daily attacks but continuous throughout day & night.
Significant limitation of physical activities.
Treatment: High dose ICS daily + LABA. Alternate choices (as add on
drugs for better control:
•montelukast ,Sustained release theophyline Oral short course steroid
13. MANAGEMENT OF ACUTE ATTACKS OF ASTHMA:
(MDI/nebulizer) One puff every minute (10 puffs ) Single
nebulisation
If respone PEFR Incresae 80
If no responce
Give 0 if Spo <95% Start oral prednisolone (1-2 mg/kg)
After 1 hour Assess
14. If Responce
Continue SABA every 6-8 hoursfor next 24 hours
If no responce
Nebulisation of salbutamol +Ipratropium + Inj.
Hydrocortisone
(10 mg/kg)
15. ASSESS AFTER 2 HOURS
Look for response
SABA
Oral prednisolone for 5 days
No response
Inj. Theophylline + IV magnesium sulfate infusion
No response
mechanical ventilation
