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Monday, February 4, 2013
  Clinical Accuracy Spoken Here  

Asthma: Possible Contributing Factors

The NAEPP Expert Panel Report 2 recommends that patients with persistent asthma who require daily therapy be evaluated for possible contributing factors such as:

  • rhinitis and sinusitis
  • gastroesophageal reflux
  • aspirin sensitivity
  • nonsteroidal anti-inflammatory drugs and sulfite use
  • topical and systemic beta-adrenergic blocking agents (beta-blockers)
  • upper respiratory infections.

[Reference: Asthma, Module B, Complications]
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  Excellence in Case Mgmt  

Asthma: CM Coaches Asthma Patient

The Case Manager Coach can emphasize that:

  • Patients seek medical help early if: 1) an asthma exacerbation is severe, 2) therapy does not give rapid, sustained improvement, or 3) there is further deterioration.
  • Patients with moderate-to-severe persistent asthma or a history of severe exacerbations must have the medication and equipment for treating exacerbations at home.
  • Patients with severe asthma should wear a medical alert bracelet so that EMT responders will be aware of the potential life-threatening situation and seek emergency services immediately.

[Reference: Asthma, Module D, CM Role]
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  Improving Patient Care...  

Asthma: CFCs Use Banned Internationally

Historically, MDI technology has utilized chlorofluorocarbons (CFCs) as propellants. CFCs usually constitute 95% or more of the formulation emitted from an MDI; CFCs are metabolically stable and even the portion of an actuation that is systemically absorbed is quickly excreted unchanged via exhalation.

However, CFCs have been found to deplete stratospheric ozone and have been banned internationally.

MDIs with other propellants (such as hydrofluoroalkane [HFA] 134a) do not have ozone-depleting properties. An MDI for albuterol with HFA 134a has been approved for use; additional non-CFC products are expected in the future.

[Reference: Asthma, Module C, Pharmacologics]
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