History of Present Illness:

Haley, a 14-year-old girl with asthma, presents to the clinic with complaints of a persistent cough. She reports getting up 3-4 nights a week to use her albuterol inhaler, including the morning of the visit. She also reports coughing and experiencing shortness of breath daily when she runs in gym class or pet’s the neighbor’s cat. Haley is currently taking a SABA (short-acting beta-agonist) for relief of her asthma symptoms. Except for a cough, Haley has no other complaints. She is accompanied by her parents.

1. Based on the table you created from your book above, how would you classify Haley’s asthma?
2. Based on the table you created using the GINA guidelines provided, what is the controller and preferred reliever Haley should be prescribed at today’s visit? (Provide general statement and not specific drug- the same as you listed in the table for this severity of asthma)
3. Now, looking in your textbook, what are some examples of inhaled corticosteroids or inhaled glucocorticoids? Your book lists six for you to provide here:
4. What is the drug classification of formoterol?
5. What is a specific drug you could prescribe today that would meet the drug classification from question 2? Your book provides two options in table 62.1.
6. Go to Prescriber’s Digital Reference and identify the dose you would prescribe of the two drugs from Question 5 to fall into the “low dose” range as indicated by the low, medium, high dose table you completed above from the GINA guidelines.
7. Why is it important for Haley to have a LABA in addition to her SABA?
8. What education does Haley, and her parents need regarding when to take the medicine you will prescribe today versus the SABA she is already taking?
9. What are two environmental factors may be contributing to Haley’s asthma symptoms that were noted in the case study information?
10. What do the GINA guidelines say about “action plans”?
11. Do a web search for “asthma action plan”. Provide a link to an example of an asthma action plan you could either use or adapt in your own clinical practice.

Preparing the Assignment

You will be presented with a patient case and then answer a series of questions in the document provided.Links to an external site.

• Resources to support completion of this assignment:
  • Course Textbook:
    • Rosenthal, L. & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.
  • Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2021
    • Direct link to pocket guide: GINA guidelinesLinks to an external site.
      Links to an external site.
  • Prescriber’s Digital ReferenceLinks to an external site.

Asthma Treatment Algorithm:

To successfully treat asthma, you must first classify it and then be familiar with step therapy. For this assignment and in this course, we will focus on patients 12 years and older. Complete the blanks in the following table to create an algorithm for asthma care using your textbook as well as GINA guidelines

SOLUTION

1. Based on the table you created from your book above, how would you classify Haley’s asthma?

According to my assessment, Haley’s asthma is a mild case of chronic bronchitis. The reason for this is that she is waking up three or four times throughout the night during the week. She falls into that group as well since she is experiencing symptoms of shortness of breath.

2. Based on the table you created using the GINA guidelines provided, what is the controller and preferred reliever Haley should be prescribed at today’s visit? (Provide general statement and not specific drug- the same as you listed in the table for this severity of asthma)

On the basis of the GINA guidelines’ table, I would recommend a low-dose maintenance ICS-formoterol to her on a daily basis as a regulated and preferred relief during her appointment. Next, a SABA if necessary……………………………………………$30