Serangan Asma Akut

- Manajemen & Masalahnya-

Magdalena Sidhartani
 Acute Asthma
Life threatening attack

Severe attack

Moderate attack

Mild attack

Symptoms

NO symptoms
 Asthma management
1. Diagnosis

2. Avoidance of trigger(s)

a. Reliever
3. Drug(s)
b. Controller
 Tujuan Manajemen Serangan Asma

1.Mengatasi penyempitan saluran napas segera

1.Mengurangi hipoksemia

1.Mengembalikan fungsi paru ke keadaan normal segera

Manajemen jangka panjang untuk mencegah kambuh

 Asthma medication

Reliever • To relieve acute asthma

drug • As needed medication
• If the symptom-attack relieve, stop
(pereda)

• To control asthma inflammation

Controller • Long term medication, months - years
drug • Evaluated regularly,
• Dose adjusment: maintain, step-up,
(pengendali) step-down
PNAA 2015
 Mild-moderate Severe
•Short acting - •Short acting -agonist
agonist •Consider anti-
•Consider anti- cholinergic
cholinergic •Control O2
•Control O2 •Oral steroid
•Oral steroid •Consider IV MgSO4
•Consider high dose ICS
 The control-based
asthma management cycle
• Diagnosis
• Symptom control & risk factors
(including lung function)
• Inhaler technique & adherence
• Patient preference
• Symptoms
• Exacerbations
• Side-effects
• Patient satisfaction
• Lung function

• Asthma medications
• Non-pharmacological strategies
• Treat modifiable risk factors
GINA 2015, Box 3-2
 Masalah-Masalah
1.Pemilihan obat inhalasi, oral
• Zat aktif • Spacer?
• Tunggal vs kombinasi • Keterampilan penggunaan
• Inhaler vs nebulizer vs oral • Ketaatan pengobatan
1.Monitoring: klinis, fungsi paru, asthma diary card

Penyakit Penyerta
Inhaler vs Nebulizer
Spacer ?
 Obat/ Zat Aktif
Tunggal vs Kombinasi
 Monitoring
KLINIS FUNGSI PARU ASTHMA DIARY CARD
 Penyakit Penyerta

Gangguan
Dermatitis
emosi & GERD
atopik
perilaku

Rhinitis Alergi
alergik Makanan

Mirabelli MC et al. Respir Med. 2016; 116: 34–40.

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