GROUND ROUNDS ASTHMA (NR 508 Advanced Pharmacology)

PRESENTATION  Casey, a 15 year old Caucasian, high school student comes to the clinic this morning with complain of chest tightness, frequent cough which disturbs his sleep at night, shortness of breath and wheezing. Symptoms started gradually after playing football in the cold whether 3 weeks ago, he has missed school for 2 days because of his frequent cough  He has history of asthma which has been controlled by ProAir inhaler 2 puffs every 4 hours as needed and Flovent inhaler twice daily a non smoker. However, he has not had asthma attack for more than a year and stopped using his Flovent.  weight 122 lbs, Heart rate is 105/m, respiration 24/m  BP 108/78mmgh and temperature 36.9 degree Celsius MEDICATION MANAGEMENT- SHORT ACTING BETA AGONIST  Pro Air (Albuterol): short acting bronchodilator. Usually the most commonly prescribed medication  Inhaler HFA Dose: Children >4 years 2-4 puffs every 4-6hours as needed. Can take 2 puffs 15 to 30 minutes prior to exercise to prevent bronchospasms  For Asthma exacerbation:  Albuterol nebulizer 2.5 – 5mg in 2ml normal saline every 20 x 3 doses, then every 1 to 4 hours as needed or  Inhaler every 20 minutes x 3 doses, then 1 to 4 hours as needed (Woo & Robinson, 2016) (Masselli & Peters, 2018)