Jana, a 36-year-old single mother of three children, has a 15-year history of asthma

Posted: January 24th, 2023

Jana, a 36-year-old single mother of three children, has a 15-year history of asthma. For the past month, she has been using albuterol every day. Previously, she had been using the inhaler every 3 to 4 months. She is in the office for a refill. What further information is needed to treat this patient and why? What clinical guidelines should you refer to for her medication management and why?
Dave is a 47-year-old male patient in for a follow-up visit to discuss his chronic allergic rhinitis and nasal congestion. He takes Claritin 10mg daily which seems to help his clear runny nose and itchy eyes. However, he complains of chronic nasal congestion and difficulty breathing through his nose. You find out he has been using over-the-counter nasal spray twice a day for several months. What do you think is contributing to his chronic nasal congestion? How would you manage this patient going forward?

SOLUTION:

1. Jana, a 36-year-old single mother of three children with a 15-year history of asthma, has been using albuterol every day for the past month. To treat this patient, further information is needed to determine the cause of her increased use of albuterol. This could include information about any changes in her environment, such as exposure to new allergens or irritants, as well as any changes in her symptoms, such as increased shortness of breath or wheezing. It would also be important to gather information about her current medications, including any other asthma medications she is taking, and her adherence to her treatment plan.

To manage Jana’s medication, it would be important to refer to clinical guidelines for asthma management, such as those provided by the National Heart, Lung, and Blood Institute (NHLBI) or the Global Initiative for Asthma (GINA). These guidelines provide recommendations for assessing asthma control, selecting and adjusting medications, and monitoring treatment response. By following these guidelines, it would be possible to ensure that Jana receives the appropriate treatment for her asthma and that her condition is well-controlled.

2. Dave is a 47-year-old male patient with chronic allergic rhinitis and nasal congestion who takes Claritin 10mg daily. However, he complains of chronic nasal congestion and difficulty breathing through his nose. He has been using over-the-counter nasal spray twice a day for several months.

It is likely that Dave’s chronic nasal congestion is……