Clinical Asthma: Expert Consult - Online and Print

Contributors......Page 1
Preface......Page 5
Dedications......Page 7
Epidemiology of Asthma......Page 9
Summary......Page 8
References......Page 17
Development of Asthma in Early Life......Page 19
Refrences......Page 18
Hygiene Hypothesis......Page 23
Pathophysiology of Asthma......Page 28
Suggested Reading......Page 27
The Natural History of Asthma into Adulthood......Page 40
References......Page 39
Predictors of Asthma Persistence from Childhood to Adult Age......Page 44
Upper Airway Disease......Page 45
Positive Family History......Page 46
What Is Asthma?......Page 51
Conclusion......Page 50
Rreferences......Page 57
How Do You Diagnose Asthma in the Child?......Page 59
References......Page 58
Diagnosis of Asthma in Adults......Page 69
References......Page 68
Vocal Cord Dysfunction......Page 72
Bibliography......Page 76
Suggested Reading......Page 81
Allergy Skin Tests: Use and Interpretation......Page 89
References......Page 88
Noninvasive Tests, Exhaled Nitric Oxide, and Exhaled Breath Condensate—Do They Help Diagnose Asthma?......Page 96
References......Page 95
Suggested Reading......Page 105
Clinical Assessment of Asthma......Page 116
References......Page 115
Approaches to Classify Asthma Severity......Page 124
References......Page 123
Asthma Control......Page 131
References......Page 130
Assessment of Airway Inflammation......Page 139
References......Page 138
Asthma Triggers: What Really Matters?......Page 144
Suggested Reading......Page 143
References......Page 151
The “Asthma Guidelines”: What Do the Experts Teach Us?......Page 157
Suggested Reading......Page 156
Management of Persistent Asthma in Children......Page 169
References......Page 168
Management of Persistent Asthma in Adults......Page 180
References......Page 179
Acute Asthma Management......Page 189
Suggested Reading......Page 188
References......Page 194
Oxygen......Page 197
Environmental Modification: Allergen Avoidance......Page 203
Referemces......Page 202
Teaching Patients to Manage Their Asthma......Page 210
References......Page 209
Personalized Medicine......Page 218
References......Page 217
Pharmacogenetic Consequences......Page 219
Pharmacogenetics of Asthma Drugs......Page 220
Future......Page 225
Pharmacology of Beta2-Agonists......Page 227
Efficacy......Page 228
Novel Long-Acting Anticholinergic Agents (LAMAs)......Page 226
Beta2 -Agonists in the Rescue Management of Asthma......Page 231
Safety of Beta2 -Agonists in Asthma......Page 232
Anticholinergic (Antimuscarinic) Agents......Page 233
Anticholinergics in the Maintenance Management of Asthma......Page 234
Indacaterol (QAB-149)......Page 235
Inhaled Corticosteroids......Page 236
Corticosteroids......Page 237
Acute Asthma......Page 243
Chronic Asthma......Page 244
Systemic Corticosteroids......Page 246
Suggested Reading......Page 248
Leukotriene Modifiers......Page 249
The Leukotriene Modifiers......Page 251
Allergen-Induced Asthma......Page 252
Viral-Induced Wheeze in Infants and Toddlers......Page 254
Controversies/Conclusion......Page 256
Mechanism of Action of Theophylline and Phosphodiesterase Inhibitors......Page 258
References......Page 257
Dosing of Theophylline......Page 261
Clinical Trials of Theophylline—Chronic Asthma......Page 262
Clinical Trials of PDE4 Inhibitors in Asthma......Page 263
The Role of IgE in Asthma Pathogenesis......Page 265
Published Efficacy Data......Page 266
Safety Data......Page 269
Suggested Reading......Page 270
Immunosuppression and Immunomodulation......Page 271
Allergy Immunotherapy......Page 280
Summary......Page 279
Contraindications......Page 281
Dosing......Page 282
Treatment of Anaphylaxis......Page 283
References......Page 285
Aerosol Generation......Page 286
Ultrasonic Nebulization......Page 287
New Nebulizer Technologies......Page 289
Dry Powder Inhalers......Page 290
Masks......Page 291
Activation Enablers......Page 292
Administration during Mechanical Ventilation......Page 293
Emergency Department Aerosol Delivery for Acute Asthma......Page 294
Suggested Reading......Page 295
Monitoring for Side Effects from Treatment......Page 296
Growth......Page 297
Eye Effects......Page 298
Dysphonia/Hoarseness/Cough......Page 299
Short-acting Bronchodilators......Page 300
Conclusion......Page 301
References......Page 302
Not All Patients with Difficult-to-Treat Asthma Have Severe Asthma!......Page 303
Compliance with Prescribed Therapy and Correct Inhalation Technique......Page 304
Physiologic Factors......Page 305
Genetic and Environmental Factors......Page 306
Pathophysiologic Conditions......Page 307
History......Page 308
How About Noninvasive Measurements of Airway Inflammation?......Page 309
Pharmacotherapy......Page 310
References......Page 311
Chronic Sinusitis......Page 312
Natural History/Epidemiology of Asthma in Chronic Sinusitis......Page 317
Humoral Recirculation......Page 318
Aspirin Desensitization......Page 321
Vocal Cord Dysfunction......Page 323
References......Page 322
Treatment of Vocal Cord Disorder......Page 326
Gastroesophageal Reflux......Page 329
Nonacid GER......Page 328
GER Symptoms......Page 330
Conclusions......Page 331
Airway Inflammation......Page 332
Lifestyle Modification......Page 333
Medical Therapy......Page 334
Surgical Therapy......Page 335
References......Page 336
Exercise-Induced Asthma......Page 338
Suggested Reading......Page 337
Treatment......Page 342
LONG-Acting Beta-AGONISTS......Page 343
Epidemiology......Page 344
Gastroesophageal Reflux......Page 346
Impaired Arousal Responses......Page 347
Treatment of Obstructive Sleep Apnea......Page 349
Suggested Reading......Page 350
Occupational Asthma......Page 351
Epidemiology......Page 352
Wood Dust......Page 353
Laboratory Animals......Page 354
Workers Compensation Issues......Page 356
Allergic Bronchopulmonary Aspergillosis......Page 358
References......Page 357
Imaging Studies......Page 359
Diagnosis......Page 361
Pathogenesis......Page 362
Summary and Conclusions......Page 363
Definitions......Page 364
Presentation......Page 365
CSS Therapy and Prognosis......Page 367
Controversies......Page 368
References......Page 369
Psychological Sequelae in Pediatric Asthma: Identification and Intervention......Page 370
Identification of Psychosocial Risk Factors......Page 374
Identification of Psychosocial Risk Factors......Page 375
Summary......Page 376
Conclusion......Page 377
Managing the Pregnant Asthma Patient......Page 378
Updated Guidelines for the Use of Specific Asthma Medications During Pregnancy......Page 382
Systemic Corticosteroids......Page 383
Theophylline......Page 384
Management of Acute Exacerbations of Asthma During Pregnancy......Page 385
References......Page 388
Assessing Educational Needs......Page 389
Goals......Page 391
Cognitive Skills......Page 392
Finances......Page 393
references......Page 394
Educational and Communication Strategies and Resources......Page 395
Learning Styles......Page 397
Teachable Moments......Page 399
Conclusion......Page 401
Education and Support for Larger Groups......Page 402
Asthma Education/Self-Management Classes......Page 403
Challenges and Solutions......Page 405
Location and Scheduling......Page 406
Coordination with the Patient’s Medical Care......Page 407
Age-, Gender-, or Disability-Specific Asthma Education......Page 408
Assessment......Page 409
Literacy and Low Educational Attainment......Page 410
Gender......Page 412
Asthma Education in Populations with Low Literacy or Low Educational Attainment......Page 413
Education in Distrustful Populations......Page 415
References......Page 416
Improving Adherence......Page 418
References......Page 417
Cultural Barriers to Adherence......Page 419
Objective Assessment Tools......Page 420
Skills Training......Page 421
Social Support, Problem Solving, and Communication Training......Page 422
Promoting Adherence in a Clinicial Practice Setting: The Prevention Model......Page 424
Summary......Page 425
Development, Implementation, and Evaluation of an Asthma Management Plan......Page 427
References......Page 426
Medication Schedules and Delivery Devices......Page 433
Asthma Self-Management......Page 440
Outcomes......Page 439
Patient Collaboration—The Role of Attitudes, Beliefs, and Values......Page 442
Teenagers......Page 446
Socioeconomic Status......Page 447
Summary......Page 449
Evaluating Individual and Program Outcomes......Page 450
Clinical Measures of Patients and Asthma......Page 453
Asthma Exacerbations......Page 456
Gathering Evaluation Data......Page 457
Electronic Monitoring Systems......Page 460
References......Page 461
Index......Page 462