Long-term control and treatment options for asthma patients

Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening symptoms. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To prepare:

Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients including adults and children Assignment: Asthma and Stepwise Management.

Review Chapter 25 of the Arcangelo and Peterson text. Reflect on using the stepwise approach to asthma treatment and management.

Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.


Write a 2- to 3- page paper that addresses the following:

Describe long-term control and quick relief treatment options for asthma patients, as well as the impact these drugs might have on patients.

Explain the stepwise approach to asthma treatment and management.

Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

Reminder: Please make sure the paper include a title page (including a purpose statement), introduction, summary, and references. Lastly please follow uploaded rubric.


Asthma is a chronic disease that causes inflammations in the human airways of the respiratory system (Hamine et al., 2015). Asthmatic patients require both long-term treatment and short-term treatment. In this case, the short-term treatment helps in relieving the patients from pain and other symptoms. Evidently, the types of treatments recommended for both long-term and quick relief of patients with asthma have the specific effect on them. The medications help the patients to control the disease by preventing the symptoms as well as supporting the patients to stay active while breathing with ease. In this discussion, the use of combination inhalers such as corticosteroids and long-acting beta agonistics as long-term medications and bronchodilators as well as short-acting beta-agonists for quick relief from asthma symptoms while a stepwise approach is explored on how to manage asthma insightfully Assignment: Asthma and Stepwise Management.

Long-Term Controllers

The long-term controllers are categorized into anti-inflammatory drugs and bronchodilators. The nurses recommend to the patient to take one each day. The anti-inflammatory drugs serve the purpose of making the breathing of the patient easy (Peláez et al., 2015). They are useful in reducing the swelling in the airways while increasing the amount of mucus produced by the airways. Some of these drugs include inhaled corticosteroids, cromolyn sodium and the Montelukast (Singulair). The bronchodilators are taken alongside the anti-inflammatory drugs and they assist the patients to breathe with ease by fostering the relaxation of the airways muscles (Howrylak et al., 2014). In this category, some examples of these diseases include inhaled long-acting beta2-agonists, combined inhalers, and theophylline among others.

Quick Relief Treatment

As the first name suggests, the drugs help in relieving the symptoms of the patients quickly. In this category inhaled short-acting beta2-agonists help in loosening the tight muscles that exist around the airways (Storms and Ferro, 2015). The ipratropium help improves breathing by initiating the relaxation of the airways. Corticosteroids, on the other hand, are used in cases of severe asthma whereby they help in relieving the swelling.

Despite the long-term medications having side effects, the effects are minimal. Apparently, the side effects of the use of inhaled corticosteroids include coughing as well as oral candidiasis. For Leukotriene modifiers use, there is a possibility of elevating the liver enzymes while the acting beta two agonists are likely to result in hypokalemia (Storms and Ferro, 2015). The side effects of quick relievers for asthma patients are that they display anxiety, irregular heartbeats, tremors, and headaches Assignment: Asthma and Stepwise Management.

Stepwise Approach to Managing Asthma

Using the stepwise approach, nurses can help in the management of asthma in patients of all ages with ease. As asthma management table above, six steps exist in the management hierarchy. In the first step, patients with intermittent asthma are considered and in this case, they are administered with quick relievers such as short-acting beta2-agonists (Nievas and Anand, 2013). If the severity of the asthmatic condition of the patients worsens, it is significant to use step two recommendations. For children below four years, it is vital to refer to a specialist, but for patients above four years, a low dosage of inhaled steroids works best. When the recommendations in step two do not yield positive outcomes, a medium-dosage for inhaled steroids for children less than four years and a combination of low-dose of inhaled steroids and the long-acting beta2-agonists are suitable for patients of all ages above five years.

In step 4, a combination of medium- dose of inhaled steroids and the long-acting beta2-agonists is recommended for patients less than four years of age, those between the age of 5 and 11 as well as those exceeding 12 years. When the dosage does not work well, a nurse initiates the high- dosage of inhaled steroids and the long-acting beta2-agonists for all ages. In any case of allergies, patients in step five who are over 12 years are advised to take the omaluzimab drug (Nievas and Anand, 2013). The last step the addition of oral steroids to the medications in step 5 is recommended for individuals of all ages Assignment: Asthma and Stepwise Management.


The management of asthmatic patients requires the use of the medications regarding the severity. Therefore, patients need to use the long-term controllers and quick relievers for relatively low severity. Many of these drugs have side effects which include drowsiness, anxiety, hypokalemia, and headaches. Nurses are advised to use the stepwise approach to managing asthmatic patients. The method considered patients of all ages. Overall, while using the approach, immunotherapy can be administered to help control allergies.


Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B. B., & Ginsburg, A. S. (2015). Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. Journal of medical Internet research, 17(2).

Howrylak, J. A., Fuhlbrigge, A. L., Strunk, R. C., Zeiger, R. S., Weiss, S. T., & Raby, B. A. (2014). Classification of childhood asthma phenotypes and long-term clinical responses to inhaled anti-inflammatory medications. Journal of Allergy and Clinical Immunology, 133(5), 1289-1300.

Nievas, I. F. F., & Anand, K. J. (2013). Severe acute asthma exacerbation in children: a stepwise approach for escalating therapy in a pediatric intensive care unit. The journal of pediatric pharmacology and therapeutics, 18(2), 88-104.

Peláez, S., Lamontagne, A. J., Collin, J., Gauthier, A., Grad, R. M., Blais, L., … & McKinney, M. L. (2015). Patients’ perspective of barriers and facilitators to taking long-term controller medication for asthma: a novel taxonomy. BMC pulmonary medicine, 15(1), 42.

Storms, W. W., Tringale, M., & Ferro, T. J. (2015, July). The impact of expired and empty quick-relief asthma inhalers: The Asthma and Allergy Foundation of America’s Asthma Inhaler Design Survey. In Allergy and asthma proceedings (Vol. 36, No. 4, pp. 300-305). OceanSide Publications, Inc Assignment: Asthma and Stepwise Management.

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