Transcript Learning to Monitor and Control Asthma

Learning to Monitor and Control Asthma
Learning to Monitor and Control Your Asthma
Pre-instruction Assessment
Learning to Monitor and Control Your
Asthma
Learning to Monitor and Control Your Asthma
Pre-instruction Knowledge Assessment
Hello and welcome to learning! The following learning module, “Monitoring
and Controlling Your Asthma”, has four components:
1.
2.
3.
4.
Identifying asthma triggers
Taking the right medication at the right time
Using medication delivery devices
Tracking your asthma condition.
In order to measure the instructional value of this presentation, an
assessment of what the learner (you) know before receiving instruction is
helpful. Please use the following Slides # 4-? to demonstrate what you know
before moving on to the presentation a material.
Learning to Monitor and Control Your Asthma
Pre-Instruction Assessment #1
The cause of asthma is a TRIGGER. When an asthma
patient comes in contact with an asthma trigger, the
airways become inflamed, narrow, and filled with
mucus. There are six asthma triggers. Type any triggers
that you know below.
1.
2.
3.
4.
5.
6.
Learning to Monitor and Control Your Asthma
Pre-instruction Assessment Trigger Case Study
Not everyone has the same triggers. This is Judy, she is an asthma
sufferer. Use her information to answer the question on the next slide.
Judy, 54-years old, is an avid gardener and
walks several miles a day. She was diagnosed
with asthma as a teenager. Her asthma is
well-controlled for the most part. She uses
her medications correctly and has not had
any attacks while exercising or gardening in
years.
A few weeks ago, Judy’s daughter moved
back home with two of Judy’s grandkids. To
help out her mom, Judy’s daughter cleans the
house daily. She keeps dust to a minimum
and the house always smells like the lemon
and Lysol that are in the products she uses.
Judy’s asthma has been flaring up since her
daughter arrived; she enjoys her and the
asthma is putting a damper on their fun.
Click on the next slide to answer a question
about Judy’s asthma.
Click next to continue.
Learning to Monitor and Control Your Asthma
Pre-instruction Assessment #2
Which trigger affects Judy’s asthma?
Click on the correct letter.
A. Ingested
B. Irritants
C. Outdoor Allergen
D. Physical Activity
Click next to continue.
Learning to Monitor and Control Your Asthma
Pre-Instruction Assessment #3
There are two types of asthma medications: Controllers and Relievers. Controllers control
symptoms and prevent attacks. Relievers provide immediate relief during an asthma attack.
Answer the following questions about Controller medications.
1. Controllers can stop sudden
asthma flare-ups.
True
False
2. Inhaled corticosteroids are used
as a controller medication.
True
False
3. Omalizumab is expensive and
not prescribed unless other
controllers fail to control asthma.
True
False
Learning to Monitor and Control Your Asthma
Pre-Instruction Assessment #4
Answer the following questions about Reliever medications.
1. Relievers are also called
“rescue medications”.
True
False
2. Relievers should be used before
your exposure to a trigger.
True
False
3. Short-acting B2 Agonists are
used as an asthma reliever.
.
True
False
Learning to Monitor and Control Your Asthma
Pre-instruction Assessment #5
Judy takes controller and reliever medications.
Which medication is a reliever? Click on the box next to the correct answer.
A.
Qvart®
B.
Prednisone spray
C.
Albuterol
Learning to Monitor and Control Your Asthma
Introduction
Hi! I’m Julie. I’m here to share with you some basic
information about controlling asthma.
I was diagnosed with asthma when I was three years
old. Throughout my life, I’ve learned how to control my
asthma so that I do the things that I love, like running,
without getting sick. I want you to have the same
experience.
Today , you will review four things that you can do to
control your asthma, including:
• Identify triggers
• Taking the right medication at the right time
• Use medication delivery devices correctly
• Track your asthma condition
Throughout this training, I’ll share with you how I
control my asthma. You’ll also get to see how others
control their asthma.
I hope you’re excited to learn how to control your
asthma so you can live the life you want. Let’s get
started.
Click next to continue.
Learning to Monitor and Control Your Asthma
Asthma Triggers
The cause of asthma is a trigger. When an asthma patient
comes into contact with an asthma trigger, the airways become
inflamed, narrowed, and filled with mucus. Avoiding triggers is
the easiest prevention and care tool.
There are six types of triggers:
1. Allergens: Indoor
2. Allergens: Outdoor
3. Allergens: Ingested
4. Irritants
5. Infections
6. Physical Activity
As you move onto the next slide, you will learn more about each trigger.
Click next to continue.
Learning to Monitor and Control Your Asthma
Trigger Types
Click on each trigger type to learn more about it.
Allergens: Indoor
Allergens: Outdoor
Allergens: Ingested
Irritants
Infections
Physical Activity
While
physical substances
activity can trigger
an immune
asthma attack
it is
Allergens
some
systems
Eggs,
milk,are
soy, fish, corn, that
and peanuts
are common
culprits.
important
for
asthma patients to remain active. Regular
recognize
as
foreign.
Americans
spendprocessed
up to 90%with
of their
timeorindoors.
Fumes
Foods or drinks
sulfites
that contain
activity strengthens
the heart
andpollen,
lungs, mold
it is good
for
bone
Allergens
found
outdoors
include
and
mildew.
from
common
household
products
can
irritate
the airway.
sulfites
such
as
dried
fruits,
fruit juices,
and
shell-fish
Infections
in
the
lungs
or
breathing
tubes
can
trigger
an
strength,
and
it helps
the
asthma
patient
a healthy
Allergens
found
intrigger
the
house
include
dustmaintain
mites,
pets,
Irritants
that
might
trigger
asthma
include:
smoke,
smog,
(shrimp)
may
also
asthma
symptoms.
Avoid
foodsas a
asthma
attach.
The
majority
of
infections
are
viral,
such
weight.
cockroaches,
and mold.
carpets
and Consider
fragrances,
aerosol
sprays,Vacuuming
fumes
from
household
products
containing
these
by reading
the
labels.
cold and the
flu. products
Additionally
sinus
infections,
bronchitis,
upholstery
help.
Use a vacuum
with
either a HEPA
and
stress
ofcan
strong
emotions
(divorce,
death).
seeing
an allergist
for
allergy
testing.
and
pneumonia
can
trigger
attacks.
If
exercise
is a trigger,
the asthma
or allergen filter. If at all possible, replace the carpet
asthma patient should use the
with hard flooring.
quick relief medication before
an activity. Swimming is an
excellent activity. However,
indoor pools have higher
levels of chlorine than
outdoor pools. Chlorine may
trigger an asthma attack in
some people.
Click next to continue.
Learning to Monitor and Control Your Asthma
Case Demonstration
The trigger that affects my asthma is physical activity. I know physical
activity is important for our overall health and that as an asthma
patient I need to stay active. Because I know what my asthma trigger
is, I am able to control my asthma and be prepared for an oncoming
attack.
Click the enter key to learn about my little friend Lauren.
This is Lauren. She is a three year-old active toddler.
A year ago Lauren’s parents learned that she has asthma. After
going through some tests, it was determined that Lauren has a milk
allergy and this is the cause of her asthma.
The trigger that causes Lauren’s asthma is considered an ingested
allergen.
To prevent an asthma attack, Lauren needs to avoid milk and
products with milk in them.
Click next to continue.
Learning to Monitor and Control Your Asthma
Let’s Look at Another Case Demonstration
Not everyone has the same triggers. Click the enter key to meet my
neighbor Paul, who also has asthma. He has a different trigger than both
Lauren and I.
Paul, 40-years old, works as a sales rep. for
local TV advertisement. He was diagnosed
with asthma during college. His asthma
seemed to get worse during mid-terms and
finals.
To stay on top of his asthma, Paul takes any
opportunity to relax . This keeps is anxiety
and stress in check. He also follows the
medical directions his doctor has provided
him. This has lessened his attacks over the
years.
Two weeks ago, Paul’s manager left the
company. Paul has been asked to work extra
hours to help out. Paul has had more attacks
recently.
Click on the next slide to answer a question
about Paul’s asthma.
Click next to continue.
Learning to Monitor and Control Your Asthma
Check your understanding
Which trigger affects Paul’s asthma?
Click on the correct letter.
A. Ingested
No, that is not the correct trigger. Try Again.
B. Physical Activity
No, that is not the correct trigger. Try Again.
C. Outdoor Allergen
No, that is not the correct trigger. Try Again.
D. Irritants
Correct! The increased job stress and long
workdays are an irritant to Paul and
increases his asthma attacks.
Now let’s move on to learn about
medications.
Learning to Monitor and Control Your Asthma
Click next to continue.
Asthma Medication: Controllers and Relievers
Asthma medications can be quite confusing. Pharmaceutical companies are
always introducing new asthma drugs to the market. However, it’s a lot easier
to keep track of the different kinds of medication if you remember that
asthma medications fall into two categories of medications: controllers and
relievers. Then within those two categories are several subcategories.
Controllers are used daily to help prevent asthma attacks. Relievers are used
whenever your asthma symptoms are exacerbated. They provide immediate
relief. Below is a list of the subcategories of medication for both relievers and
controllers.
After you review this list, you will take a closer look at each medication
category on the next page.
Relievers
Controllers
Short-acting B2 agonists
Inhaled corticosteroids
Anticholinergic agents
Leukotriene modifiers
Systemic corticosteroids
Long-acting B2 agonists
Methylxanthines
Omalizumab
Click next to continue.
Learning to Monitor and Control Your Asthma
Asthma Medication: Controllers
Controllers control asthma symptoms and prevent exacerbations..
Click each arrow to learn more.
Controllers are also called “maintenance medications.”
Controllers can’t stop or treat sudden or severe flare-ups.
Once you start taking controllers, they should only be
stopped as direct by your physician.
Click next to continue.
Learning to Monitor and Control Your Asthma
Asthma Medication: Controllers
There are five subcategories of controllers. While it may be easier to remember the brand names instead of
the subcategory, you should remember that the different categories treat different asthma triggers.
Click each controller category to learn more.
Learning to Monitor and Control Your Asthma
Asthma Medication: Relievers
Relievers are used to treat symptoms when they appear
Click each arrow to learn more.
Relievers are also known as “quick relief medications” or “rescue medication” for stopping
asthma symptoms.
Relievers should be used when you first notice symptoms or before exposure to a trigger, for
example, before exercising.
You should keep your reliever with you in a bag, backpack, or some place that you can access
quickly.
Click next to continue.
Learning to Monitor and Control Your Asthma
Asthma Medication: Relievers
There are three subcategories of relievers.
Click each reliever category to learn more.
Learning to Monitor and Control Your Asthma
Julie’s Medications
When I was a kid, I took more medications for my asthma than I do today.
Some adults find that they are less sensitive to their asthma triggers than
when they were kids. I’m one of the lucky ones. None the less, if I don’t keep
on top of watching out for triggers and taking my medications, asthma make
me sick.
Controller – Daily Medication
For a controller, I use Flovent®, an inhaled corticosteroids,
with a spacer. I’ll talk about spacers later in this module.
Reliever – As-Needed Medication
For a reliever, I use an albuterol inhaler. Generally, I use a generic prescription.
Click next to continue.
Learning to Monitor and Control Your Asthma
Consequences for Non-Compliance
What happens if I stop taking my medications? Well if I stop taking my
controller, I’ll probably feel OK for a few days. Then I’ll start to feel
sluggish and short of breath. At the gym, I run the risk of having an
asthma attack.
It can really be tempting to not take my controller medication, because
I’m feeling so well. I have to remember that the reason I feel so well is
due to the controller.
Learning to Monitor and Control Your Asthma
Paul’s Medications
Earlier we talked about how stress is a trigger for Paul. He needs to take
a controller every day to help manage his symptoms.
Which medication is a controller?
X
A.
Qvart®
X
X
B.
Prednisone
C.
Albuterol
Goodquite.
Not
job! Qvar® is the only controller in this list.
Learning to Monitor and Control Your Asthma
Paul’s Consequence
With the extra stress, Paul hasn’t been very diligent at taking his
controller medication every day and his prescription for his rescue
medication needs to refilled.
What could happen if Paul doesn’t take his medication?
X
A.
He’ll be extra sleepy over the weekend.
X
B.
He’ll be OK since he has built up a tolerance to his triggers.
X
C.
He’ll have an asthma attack.
Not quite.
Good
job! Not only is Paul setting himself up for an asthma attack, without his reliever he may need
emergency medical attention to treat the attack.
Learning to Monitor and Control Your Asthma
What Would You Do?
This is Shelby, age 15. Shelby was diagnosed with exercise-induced
asthma. She has been directed by her doctor to take two puffs of her
reliever before exercise or other exerting activities.
Which medication is a reliever?
X
A.
Foradil®
X
B.
Singulair®
X
C.
Proventil®
Goodquite.
Not
job! Proventil® is the only drug in this list that is a reliever. It’s a brand-name drug of albuterol.
Learning to Monitor and Control Your Asthma
Shelby’s Consequence
Despite her doctor’s direction, Shelby has not followed instructions to take her
rescue medication on her runs in case of emergency. Last week Shelby ran in
very cold weather at night without her rescue inhaler.
What could happen if Shelby doesn’t take her medication?
X
A.
She’ll be fine. The cold weather will make it easier to rrun
X
X
B.
She could have an asthma attack.
C.
She could catch a cold from the cold air.
Not quite.
Good
job! Shelby could have an asthma attack. The
Shelby
safest
needs
thing
to Shelby
take hercould
rescue
do inhaler
for herself
withisher.
to take
While
her
rescue
she
could
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call for
with
help,
her.there’s
While no
sheguarantee
could call that
for help,
helpthere’s
would arrive
no guarantee
in time. that help would arrive in time.
Shelby was lucky on this day. She called her parents when the attack started. They were able to get to her
in time.
Learning to Monitor and Control Your Asthma
Hi there, remember me? I’m Julie, your asthma trainer.
Do you remember earlier in our conversation I
mentioned I use a couple of devices to deliver my
medications? I told you I’d talk about these later in this
training, and here we are!
My asthma medications need to have the best chance
of getting into my lungs. For a controller medication, I
inhale corticosteroids with a spacer. For a reliever
during an attack, I use an albuterol inhaler.
Unless you’re an asthmatic, these probably mean
nothing to you, so let me introduce you to these
devices and a couple of other common ones. Then
you’ll get to see how different people use different
devices for their asthma. Click on the arrow to your
right and here we go!
Learning to Monitor and Control Your Asthma
Click on each picture below to learn more about each device
This device is called a Meter Dose Inhaler
(MDI). They deliver medications as sprays,
and are sometimes called “puffers”.
This is called a spacer and it attaches to an
MDI to maximize medication to the lungs.
It also helps reduce side effects.
This spacer with a mask is best for small
children or people who can’t use the regular
spacer with mouthpiece.
Learning to Monitor and Control Your Asthma
This device is called a Dry Powder Inhaler (DPI)
and delivers a powered medication. The
powder must be inhaled quickly and deeply,
something a child over the age of 7 usually
should be able to do correctly.
A nebulizer, depicted here, delivers
rescue medications in a fine mist. It is
usually only used in acute situations or
urgent care facilities.
This is a picture of the medical device that I use to
inhale my controller medications. I put the spacer
mouthpiece in my mouth, pump the MDI which
releases a meter-dose amount into the chamber. I
then breath in and hold it for 10+ seconds. The
chamber helps me maximize the amount of
medication I get into my lungs.
Meter Dose Inhaler (MDI) with
medication canister inside
Spacer mouthpiece
Chamber
Learning to Monitor and Control Your Asthma
Now remember that I said I use something
different for my reliever meds when I have an
attack? What I use to relieve an asthma attack is
just an inhaler (MDI) without the spacer. It looks
like this picture below. It’s more convenient to
carry in a purse or pocket than the an MDI with the
spacer. This feature makes it great for active young
people, like my friend Shelby, pictured below.
Learning to Monitor and Control Your Asthma
Hi, I’m Shelby and I’m 15 years old. I was diagnosed with
exercise-induced asthma two years ago. I was directed by
my doctor to take 2 puffs of my controller medication
through an inhaler (MDI) with a spacer before exercise or
other exerting activities. I also am supposed to carry my
reliever medication with me on my runs. Based on what
you’ve learned about each of the medical devices for
delivery of asthma medications so far, click on which two do
you think I use?
Correct!
Meter-Dose
Inhaler (MDI)
Correct!
She uses the MDI w/ spacer for
MDI
withand
spacer
controller
meds
the MDI
She uses the MDI w/ spacer for
alone to take on runs for rescue
controllerIncorrect.
meds and the MDI
meds.
MDI
with
mask rescue
alone
to
take
on
runs
MDI w/Incorrect.
mask
is forfor
small
meds.
children.
DPI’s are powders
usually used
Incorrect.
Dry-Powder
Inhaler (DPI)
for children.
Nebulizers
are used in urgent
care facilities.
Nebulizer
Learning to Monitor and Control Your Asthma
I’m an avid runner and follow doctor's instructions about 2 puffs
before running. However, last week I chose to carry my phone
instead of my rescue inhaler medications with me on my run. I
ran in very cold weather that night and had a severe attack two
miles from home. I couldn’t breath. I was able to text my parents
to come get me. They took me to an Emergency Room and I was
given a breathing treatment there.
Choose which device below Shelby would use in the specific circumstance listed.
A.
B.
No. This
doesn’t have a
spacer.
Correct.
This inhaler is small
and convenient to
carry on runs in
case of attack..
1. Before a run
2. During attack
No. This is an MDI
(meter-dose inhaler). It
doesn’t deliver as much
medicine as a nebulizer.
3. At Emergency Room
C.
Correct.
This inhaler with
spacer is what I’m
directed to use
before runs.
No. This MDI
with spacer is
too big to pack
on a run.
A
No. This is a
nebulizer
C.
A
No. This is a
nebulizer
C.
A
Learning to Monitor and Control Your Asthma
B
B
Correct.
A nebulizer is used
in E.R.’s for acute
attack treatment
B
C.
No. This is an MDI
with spacer and
can’t deliver as
much medicine as a
nebulizer
So now that you’ve seen a few of
the medical devices and which
circumstances they are used, I’d like
you to meet Brandon. You’ll learn
more about Brandon in later
segments—mostly about his triggers
and how to figure his Asthma
Tracker and Asthma Control Plan.
For right now, just click next to learn
more about the specific medical
device he uses and why.
Learning to Monitor and Control Your Asthma
Hi there, I’m Brandon! I’m 8 years old and love soccer. I’m
super active and don’t like to be bogged down with a bunch of
stuff in my pockets that gets in the way of my play time. I’m
going to let you practice what you know about medical devices
here. You’ve already learned about 3 devices and 2 spacers. If
you’re feeling a little fuzzy on those, you can refer to the
previous slides for a refresher. But, back to me. You already
know enough about me and asthma devices by now to have a
pretty good idea of which of the following devices I carry with
me. Go ahead, give it a try and click on one, I’ll be sure to let
you know if you’re right or not!
No, this is a mask for
babies and kids 7 and
under .
Try again.
Learning to Monitor and
No, this is a nebulizer
and used in urgent care
facilities. Not for little
boy’s’ pockets. Try
Controlagain.
Your Asthma
No, this is a spacer with
mouthpiece and inhaler.
It’s too big to carry this
device around. Try
again.
Correct! great job! This
Dry-Powder Inhaler (DPI) is
perfect in size I’m old
enough to use correctly
Controlling Your Asthma
We’ve covered a lot of information, including
triggers, medication, and medication devices. Now
it’s time to pull all that information together and talk
about how you can monitor your own asthma
symptoms and identify when you need to step up
your care.
Let’s start by looking at an asthma control test.
Learning to Monitor and Control Your Asthma
Controlling and Monitoring Asthma Symptoms
I’d like to introduce you to Brandon. Brandon is eight
years old. Let me tell you a few things about
Brandon. His favorite sport is soccer, his best friend is
Joshua, he loves pizza, and he has asthma. His main
triggers are seasonal allergies. Brandon tries not to
let asthma get in the way of playing soccer. Instead
he has learned how to control his symptoms.
Let’s explore the steps that you and Brandon need to
take to monitor your asthma symptoms.
Click next to continue.
Learning to Monitor and Control Your Asthma
Step 1: Asthma Control Test
Each week you need to evaluate your asthma status. This is the first step in deciding if you need to change anything
in your asthma protocol to keep asthma symptoms under control. Click each number to learn more.
1
3
2
4
3
3
4
3
5
3
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Learning to Monitor and Control Your Asthma
6
16
Step 2: Brandon’s Score on the Asthma Tracker
Brandon’s score from his Asthma Control Test was 16 (slide 2). See below
how that has been marked with an “X”. Click on the X below to see what
Brandon should do next.
X
Note how the “X” is in the yellow range of
this graph. Yellow means that Brandon is in
the CAUTION stage of the Asthma Action
Plan. The next slide will show you what
actions Brandon must take to control his
asthma when in the CAUTION stage.
Learning to Monitor and Control Your Asthma
Step 3: Asthma Action Plan
Brandon’s ACT score of 16 puts him in the CAUTION stage of the Asthma Action Plan. Click on the
Caution icon to learn more about what it means to be in this stage.
If asthma symptoms are starting
to appear, asthma patients modify
their care to the Step Up Therapy
zone.
Learning to Monitor and Control Your Asthma
Patients continue to take their
controller medicine. Quick relief
medicine is either additional
dosages or a stronger medicine.
Controlling and Monitoring Asthma Symptoms
Now let’s see how much you know. You will evaluate
my symptoms and help monitor my condition.
Here’s some additional information about me. I’m
25 years old and work as a human resource
specialist. Over the past week, I haven’t been feeling
well. For the past five nights, I’ve come home and sat
on the couch, skipping my trip to the gym. When I
pick up lunch, I feel short of breath. I’ve used my
quick-relief inhaler everyday to help recover from
shortness of breath. I’ve woken up in the middle of
the night. I feel like my asthma is poorly controlled.
Click next to continue.
Learning to Monitor and Control Your Asthma
Check Your Knowledge: Asthma Control Test
i
Julie
is total
25 years
andClick
works
as the
a human
Using your best judgment, enter a score for each question
and
her old
score.
each
info button
resource
specialist.
Over
the
past
week,
to review Julie’s condition.
Julie hasn’t been feeling well. For the past
five nights, she has come home and sat on
the couch, skipping her trip to the gym.
When she picks up her lunch, she feels
short of breath. She has used her quickrelief inhaler everyday to help recover from
shortness of breath. On three separate
nights, Julie has woken up in the middle of
the night. She feels like her asthma is poorly
controlled.
X
Learning to Monitor and Control Your Asthma
Step 2: Julie’s Score on the Asthma Tracker
My score from the Asthma Control Test was 10. Click the circle correlates
with my score.
Incorrect. The green range is for scores 19-25. My score is
10. Try again.
Incorrect. The orange range is for scores 15-19. My score
is 10. Try again.
Correct! Good job! The red range is for scores 5-15 . Click
the next button to see what I should do to control my
asthma at this stage.
Learning to Monitor and Control Your Asthma
Select which stage of the Asthma Action plan
Click the icon you believe is the correct action plan for my situation.
That is correct. My score is a 10 which puts
me in the STOP stage. I should follow the
steps below to manage my asthma.
If medicine is not working,
breathing is very difficult,
and the patient cannot
walk, play or talk easily.
Then it is time to increase
quick relief medicine and
seek medical care.
Learning to Monitor and Control Your Asthma
Summary
You did a great job at evaluating my condition.
Now that you’ve completed this training, I hope you
were able to learn the four things that you can do to
control your asthma:
 Identify triggers
• What is the cause
 Taking the right medication at the right time
• What your doctor has prescribed
 Use medication delivery devices correctly
• Using equipment correctly
 Track your asthma condition
• Monitoring your symptoms
I know from personal experience as an asthma
patient, that you can live the life that you want. I
promise that if you follow the steps outlined in this
training, you will feel better. Asthma does not have
to hold you back!
Good luck!
Learning to Monitor and Control Your Asthma