Keenan uses several inhaled medications to manage asthma. What side effects might he experience?Diarrhea and gasRapid pulse and nervousnessWeakness and fatigueFrequent urination and urgency

Patient Profile:David, a 50-year-old man, has been diagnosed with asthma. His physician has prescribed an inhaler containing albuterol, a bronchodilator, for acute symptom relief.Case Scenario:David uses his albuterol inhaler as needed to alleviate symptoms such as shortness of breath and wheezing. He follows the recommended dosage instructions provided by his healthcare provider.Questions:Explain how albuterol is absorbed and distributed in David's respiratory system after inhalation.What factors could affect the absorption and distribution of albuterol from the inhaler?Compare and contrast the advantages and limitations of inhalation therapy with oral administration for managing asthma symptoms.What are the potential adverse effects associated with albuterol inhaler use?How can David optimize the effectiveness of his albuterol inhaler therapy while minimizing risks?

Symptoms and signs of a severe asthma attack are:Select 2 correct answers.  Moderate to loud wheeze Gasping for breath (may have little or no wheeze due to little movement of air) Little or no improvement after using “reliever” medication A dry, irritating, persistent cough, particularly at night, early morning, with exercise or activity

What are possible signs and symptoms of a severe allergic reaction (anaphylaxis)?Answer Chest pains and diarrhoea Rapidly developing airway and breathing problems due to swelling of the throat and tongue, difficulty in talking, possible dizziness and collapse Slightly increased blood pressure with normal breathing A small cough that won’t settle and headache

> Jack is 62 years old; he works in sales for a multinational company and leads a busy and stressful life. Jack has had asthma since childhood. He has been prescribed Flixotide (fluticasone) metered dose inhaler (MDI) 125mcg/actuation 2 inhalations twice daily and salbutamol MDI 100mcg 2 puffs prn. > > > Jack has been extremely busy lately with some overseas trips and has missed the evening dose of his medications on some days. He was taken to the emergency department today by his partner with a chief complaint of shortness of breath. He claims that he has been struggling to breathe and tried his salbutamol inhaler three times at the prescribed dose before going into the emergency department. Jack claims he suffers from breathlessness and has episodes of wheezing at least 3-4 times a week during the day and uses his salbutamol inhaler when needed. > > The diagnosis has been acute exacerbation of asthma and was promptly managed in the emergency department with additional doses of salbutamol via spacer. > 1. *Which of the following might have worsened Jack’s asthma control?* **I. Advancing age** II. Male gender **III. Stress at work** **IV. Medication nonadherence** 1. I, III 2. **I, III, IV** 3. II, IV 4. III,IV *2. What recommendations would you make in terms of managing Jack’s asthma upon discharge from the emergency department?* I. Substitute Flixotide (fluticasone 125mcg/actuation) MDI with Seretide MDI (fluticasone 125 microgram /actuation + salmeterol 25 microgram /actuation) 2 puffs twice daily **II. Reinforce the importance of good adherence and spacer use** **III. Increase the dose of fluticasone MDI to 250 mcg/actuation, 2 inhalations twice daily** **IV. Address and/or remove trigger factors** 1. II,IV 2. I,II,IV 3. II,III,IV 4. I

> Sam visits a friend and inhales **second-hand cigarette smoke**. Within minutes Sam experiences wheezing, chest tightness, dyspnoea and a cough. Sam’s symptoms are likely to reflect: > 1. A delayed asthmatic response 2. **An immediate asthmatic response** 3. A profile of responses indicating acute rhinosinusitis 4. Early symptoms of allergic rhinitis