Pharmacology Paper on Asthma Example

Introduction

According to the presenting symptoms, the patient has severe asthma. This is a chronic disease that affects the lungs' airwave due to inflammation. Asthma manifests in a variety of clinical presentations but has some hallmark symptoms. These symptoms include dyspnoea, wheezing, chest tightness, cough, and chronic symptoms such as sputum production. Asthma symptoms are often episodic and may be worse in the early morning or late at night. Additionally, asthmatic attack a may occur in reaction to a one or more of triggers such as cold air, exercise, viral upper respiratory infections, inhalant allergies, irritants, weather changes, and emotional stress (Lockey & Ledford, 2014).

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Treatment Plan

The main aim of pharmacological interventions is to control asthma. Asthma control is achieved by reducing impairment regarding the intensity and frequency of symptoms as well as the functional limitations experienced by the patient (Olivieri, Barnes, Hurd, & Folco, 2013). Asthma control is also achieved by minimizing the risk of future attacks and progressive lung function decline alongside medication side effects. To this effect, some drugs will be prescribed for Adam:

Rapid-acting bronchodilator: the patient will be prescribed Albuterol at a dosage of 2 puffs every 4 to 6 hours. Albuterol is a beta2-adrenergic agonist that works by activating the beta2-adrenergic receptors on smooth muscle of the airway, which in turn triggers adenyl cyclase activation and results in an upsurge of the intracellular levels of cyclic-3', 5'-adenosine monophosphate (cyclic AMP). In essence, the Albuterol causes the relaxation of the smooth muscle of the airways to preclude bronchoconstrictor problems (Edmunds & Mayhew, 2013).

Cromolyn: the patient will be instructed to take two puffs before exercise. Cromolyn achieves its effect by reducing the activity of allergy cells. Specifically, it inhibits the issue of mediators from mast cells.

Montelukast at a dosage of 10 mg PO daily. It is a Leukotriene modifier that exerts its effects by reducing airway inflammation, narrowing, and mucus production

Fluticasone with Salmeterol at a dosage of I inhalation twice daily. This is a combination of an inhaled corticosteroid with long-acting v2 agonist bronchodilator

Resources for the Patient

The patient's mother has expressed concerns about the family's socioeconomic challenges which have impacted her ability to secure and adhere to treatment. Notably, researchers have identified socio-economic problems as a risk factor for asthma morbidity given the numerous direct and indirect costs that are involved in the treatment of the disease (Braido, 2013; Nunes, Pereira, & Morais-Almeida, 2017). In Ohio, there is a range of services where the family can obtain therapeutic and non-therapeutic support for asthma. The mother and child can access free consultation and medication at these clinics. These include:

Ohio Association of Free Clinic in partnership with Charitable Healthcare Network: The organizations offer free clinic services ranging from primary care, prescription assistance, dental, vision, to behavioral health and other specialties

Breathing Association: Offers chronic obstructive pulmonary disease (COPD), asthma and Ohio Benefit Bank (OBB) services; a free Lung Health Clinic and Mobile Medical Unit that offer medical and nursing care for asthma patients using qualified respiratory health professionals. The organization also assists during winter and summer by providing heating and cooling plans for households that are medically needy through HEAP, window air conditioners to those without central air and electric bill assistance.

Nationwide Children's Hospital (NCH) Allergy & Immunology Clinic: this organization provides diagnostic and treatment services for allergic diseases for patients from birth through age 21.

Flying Horse Farms: This organization offers a free camp for children with severe medical disorders, including asthma. It provides free twenty four hour healthcare for patients through specialized doctors and nurses

Columbus Public Health (CPH) Healthy Homes Program: this program offers community support for households by advising on the creation of a safe home environment.

Forum Health Pediatric/Adolescent Asthma Center: The center features an interdisciplinary team of specialists, ranging from respiratory therapists, nurses, and child life and education specialists. The Asthma Centre provides an all-inclusive inpatient and outpatient initiative for pediatric asthma patients and their families. Services include individualized and group education sessions, school liaison programs, and a one-day asthma camp for kids.

Communication plan

According to Kopel, Phipatanakul, and Gaffin (2014), the educational status of the caregiver may exacerbate asthma morbidity in children. Consequently, the primary focus of the communication plan is to educate the child's mother about management of the disease as well as increasing compliance with medication. Concerning patient education, the professional should instruct patients on how to use inhalers with this medication. This is because the efficacy of inhaled medications is determined by a range of factors such as the size of the particles, compliance and correct inhalation techniques. Patient education will also include warnings about the potential adverse effects of the drug (Frandsen & Pennington, 2017). Some of the possible adverse effects of albuterol generally relate to overdosage. These effects may include nervousness, dry mouth, headache, chest pain, tremor, erratic or irregular or rapid heart rate, dizziness, pain extending to the shoulder or arm, sweating, nausea, convulsions or seizures, light-headedness or fainting (Edmunds & Mayhew, 2013). Other adverse effects include allergic reactions, wheezing, choking, painful urination, elevated blood sugar and low potassium. Back pain, body aches stomach-aches, sore throat, sinus pain, and stuffy, runny nose are also common side effects of the drug (Edmunds & Mayhew, 2013). For example, patients will be advised to notify their care provider if shortness of breath is not relieved immediately or is attendant with chest pain, palpitations, dizziness or diaphoresis.

Specifically, the practitioner will warn the patient regarding the possibility of paradoxical bronchospasm and that the medication should be discontinued if this occurs. It is essential to monitor for possible albuterol interactions with other asthma medications which are indicated by elevations in heart rate, blood pressure and the occurrence of irregular heart rhythm. Additionally, it is crucial to monitor clinical responses to the albuterol therapy indicated by a regression of symptoms or the alleviation of the risk for potential asthma episodes (Frandsen & Pennington, 2017). The patient will also be instructed on how to use the medication alongside a steroid inhaler, whereby it advised that the bronchodilator is used 5 minutes before the steroid. The practitioner should also educate the patient about the proper cleaning, storage and hygiene protocols for the inhaler canister. It is recommended that all albuterol preparations are stored at room temperature in lightly-closed, light-resistant containers, away from moisture.

Finally, the professional will also issue caregiver hand-out that will empower the mother on how to take care of her child. The handout will also include additional information on various resources that the family can use to obtain assistance for medications and non-therapeutic help. The professionals will also outline a follow-up plan including a schedule for follow-up phone calls, in-hospital check-ups, and visits by a community health nurse.

References

Braido, F. (2013). Failure in asthma control: Reasons and consequences. Scientifica, 2013, 1-15. doi: 10.1155/2013/549252

Edmunds, M. W. & Mayhew, M. S. (2013). Pharmacology for the Primary care provider (4th ed.). St. Louis, MO: Elsevier.

Frandsen, G, & Pennington, S. S. (2017). Abrams' clinical drug therapy: rationales for nursing practice (11th ed.). Bethesda, Maryland: Lippincott Williams & Wilkins.

Kopel, L. S., Phipatanakul, W., & Gaffin, J. M. (2014). Social disadvantage and asthma control in children. Pediatric Respiratory Reviews, 15(3), 256-263. http://doi.org/10.1016/j.prrv.2014.04.017

Lockey, R. & Ledford, D. (2014). Asthma. New York: Oxford University Press, Incorporated.

Nunes, C., Pereira, A., & Morais-Almeida, M. (2017). Asthma costs and social impact. Asthma Research and Practice, 3(1). doi: 10.1186/s40733-016-0029-3

Olivieri, D., Barnes, P., Hurd, S., & Folco, G. (2013). Asthma treatment. New York: Springer Science & Business Media.