Albuterol via nebulizer or handheld administration are rescue medications. “Rescue medications” are utilized to wheezing, dyspnea, and bronchospasm (drugs.com). Bronchodilators have faster onset, enhancing breathing and reducing mucus buildup, examples of this group of medications are Metaproterenol, Pirbuterol, Bitolterol, Terbutaline, Levalbuterol, and Albuterol (drugs, com). The side effects of the medications could include, but not limited to, tremors, anxiety, nervousness, palpations or tachycardia. (Arcangelo and Peterson, 2017). Stepwise Approach to Treatment and Management Once asthma has been diagnosed, the seriousness of the disease is evaluated. Advanced Practice Nurse (APRN) utilizes Stepwise, as a treatment option, based on the level of asthma presentation. The National Asthma Education and Prevention Program (NAEPP, 2007) prescribes a Stepwise approach for the use and conformity of pharmacotherapy in asthma management. The stepwise tool, initiates a concentrated treatment to maximize rapid control, afterward maintenance treatment. There are six phases, in the stepwise approach. Phase one includes utilizing a short-acting beta-agonist to treat intermittent asthma. Phase two through six incorporates treating people with chronic asthma with medications for daily use. Per the National Asthma Education and Prevention Program (NAEPP,2007), the dosages and medicines are suggested as the disease progresses. Phase two prescribes corticosteroids (ICS); three a medium measurement ICS or low dose LABA, combined with ICS; stage four LABA and medium dosage of ICS; five includes a LABA and high-dosage ICS, and six an oral corticosteroid in combination with LABA and high dosages of ICS. Before adjusting medications, it is imperative, identifying adherence, inhaler technique, and environmental triggers.
Asthma and Stepwise Management The Stepwise technique, provides a framework, for a medication plan for patients with uncontrolled asthma. The treatment guidelines assist providers, to manage asthma by the most
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- Fall '13