Академический Документы
Профессиональный Документы
Культура Документы
By:
Camelia Farahdila Musaad
1102013061
Supervisor:
Dr. Pulung M. Silalahi, Sp.A
Departemen of Pediatric
Raden Said Sukanto Polic Centre Hospital
Faculty of Medicine Yarsi University
19 November 2018 - 26 Januari 2019
INTRODUCTION
MANAGEMENT OF ASTHMA
DEFINITION
• Asthma :
a chronic inflammatory airway disorder that involves many cells
and elements, characterized by obstruction of air flow are
reversible with or without treatment
EPIDEMIOLOGY
• Asthma is a health problem worldwide à estimated at 7.2%
(6% in adults and 10% in children)
HOST ENVIRONMENT
• Type of allergen
• Genetics
• Sensitization of the work environment
• History of atopy • Cigarette smoke
• Air pollution
• Gender
• Respiratory infections
• Ras • Diet
ANAMNESIS
*) The use of peak flow meters is an important and necessary thing to do, because in addition to
supporting the diagnosis also to determine the success of the management of asthma
DIFFERENTIAL DIAGNOSIS:
TUBERCULOSIS
• In Indonesia, Tuberculosis (TB) is still a common disease and one of the
symptoms is recurrent chronic cough
CLASSIFICATION
Frequency of attacks Once per month More than 1 time per month Often
Between attacks No symptoms There are often symptoms Symptoms of the day and
night
Sleep and Activity Not disturbed Often disturbed Always disturbed
Lung function test (normal PEF/FEV1 > 80% PEF/FEV1 60- 80% PEF/FEV1 < 60%
condition)
Variability 20- 30%
1. Give oxygen
2. The use of single oral β-agonists with large doses often causes side effects such
as palpitations, and this can be reduced by reducing the dose and combined
with theophylline (evidence level C)
3. If the inhaler is not available or cannot be used, then β-agonist is given orally
(evidence level D)
MODERATE PERSISTENT ASTHMA
2. The use of oral corticosteroids as a controller is the last choice after the use
of steroid inhalers or the alternatives above have been carried out
(evidence level B)
SEVERE PERSISTENT ASTHMA
3. If with a 2nd line treatment for 6-8 weeks there are still asthma symptoms,
then a 3rd line can be given, which can increase the dose of corticosteroids
to high doses, or keep the medium dose added with PROFIT, or TSR, or ALTR
(evidence level D)
SEVERE PERSISTENT ASTHMA
• Children with severe persistent asthma à High dose inhaler steroid + short-
term oral steroid – then the steroid inhaler dose is reduced until the smallest
• The steroid dose of inhalers which is still considered safe is the equivalent of
5 – 8 years old MDI Nebulizer with spacer, Powder inhaler (Spin haler, Disk