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Steven Hartland, PA-C Scottsdale Healthcare Occupational Health June 21, 2010

Sneezy and Wheezy. Steven Hartland, PA-C Scottsdale Healthcare Occupational Health June 21, 2010. RIO SALADO COLLEGE WELLNESS WORKSHOP. Asthma. Definition: A chronic inflammation of the airways. INTERMITTENT: Symptoms less than 2 days a week. MILD: Symptoms more than 2 days a week,

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Steven Hartland, PA-C Scottsdale Healthcare Occupational Health June 21, 2010

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  1. Sneezy and Wheezy Steven Hartland, PA-C Scottsdale Healthcare Occupational Health June 21, 2010 RIO SALADO COLLEGE WELLNESS WORKSHOP

  2. Asthma Definition: A chronic inflammation of the airways.

  3. INTERMITTENT: Symptoms less than 2 days a week MILD: Symptoms more than 2 days a week, but not daily, uses MDI at least 2 days a week MODERATE: Symptoms Every day, uses MDI every day SEVERE: Symptoms throughout The day, uses MDI all day

  4. Triggers can include allergies-temperature changes, especially cold; exercise; viruses; air pollution/dust; perfumes; chemicals; and some medications (ASA). CIGARETTE SMOKE!

  5. SYMPTOMS Most Common- Wheezing and shortness of breath? COUGHING

  6. Symptoms are often worse at night!

  7. TREATMENT

  8. MEDICATIONS • Breathing Machines: Nebulizers; “SVN” • Short acting beta 2 agonist: Albuterol, Xopenex MDI e.g. • Long acting beta 2 agonists: Serevent, e.g. • Inhaled steroids: Azmacort, Flovent, e.g. • Inhaled antiinflammatories: Tilade, e.g. • Anticholinergic agents: Atrovent, e.g.

  9. MEDICATIONS • Leukotriene antagonists: Singulair, e.g. • Systemic steroids: prednisone, e.g. • Combinations: -Advair: Steroid + long acting beta 2 agonist (Flovent + Serevent), e.g. -Combivent, Duoneb: Short acting beta 2 agonist + anticholinergic (Albuterol + Atrovent), e.g.

  10. MEDICATIONS • Symbicort: Inhaled steroid + long acting beta 2 agonists • Others: -Brethine, Maxair (a form of albuterol) -Spiriva (a type of anticholinergic) -Xolair (for asthmatics with severe allergies) -Xopenex (“single isomer” albuterol) -Theophylline (one of the older asthma medications; rarely used now)

  11. PREVENTION • Wash bedding often • Avoid down comforters, etc. • Try to buy washable stuffed animals • Use blinds instead of curtains • Wood/tile floors instead of carpet • Pets ???? • No smoking in the house or in the presence of an asthmatic!!!!

  12. Allergies Definition: An exaggerated immune response or reaction to substances that are not usually harmful. IgE

  13. Types of Allergies: • Respiratory • Food • Drug • Cosmetic • Animal • And plenty more…

  14. Where do allergies come from? Genes – most are inherited Acquired – from frequent exposure

  15. TRIGGERS • Pollen • Dust mites • Mold • Animal Dander: insects/cockroaches • Insect Stings • Latex • Food • Medicine

  16. Allergy Common Cold Sinus Infection WHAT IS THE DIFFERENCE?

  17. TREATMENT #1 – Avoid the allergen • Use A/C: air purifiers • Vacuum often • Check for plumbing leaks • Read food labels • Carry an Epi-pen if severely allergic

  18. MEDICATIONS -1st Generation antihistamines: Benadryl enadrylTM(diphenhydramine), TriaminicTM (chlorpheniramine); can be sedating! -2ndGeneration antihistamines: Claritin (loratidine), Allegra (fexofenadine), Zyrtec (ceterizine); non-sedating (sometimes…). -Decongestants: Sudafed (pseudoephedrine) and many other generics. -Leukotrieneagonists: Singulair, Accolate…recently approved for allergies.

  19. MEDICATIONS - Steroid nasal sprays: Rhinocort, Nasonex, Flonase, Azmacort, Flovent and MANY more! - Saline spray: Salt water solution that is often the CHEAPEST and single MOST EFFECTIVE remedy for congestion, sinus pressure, sinus headache! (Nedi-Pot) - Antibiotics? Rarely. Antibiotics do not treat allergies!!!!!!!!!!!

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