Home' Australian Pharmacist : Australian Pharmacist November 2014 Contents Australian Pharmacist November 2014 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
chest tightness, chest tightness which
is worse in the morning and a history
of atopic dermatitis.20 If asthma is
diagnosed, it is also likely that he will
be prescribed some medicines, with
the aim of reducing daytime symptoms
(to minimal or absent) and improving
When treating adults
with asthma, it is typical that a step-wise
approach be taken (see Table 1).
Sebastian returns to the pharmacy
six weeks later to update you on his
progress. He is progressing well with
his nicotine patches, and thanks you
for the referral to the Quitline, as this
has been very helpful. Sebastian also
visited his GP, who initially prescribed
salbutamol 200−400 mcg 3– 4 times a
day (as needed) and 10 minutes before
any exercise, such as going to the gym.
Two weeks later Sebastian was still
experiencing symptoms several times
a week, and his GP added budesonide
200 mcg daily to his therapy. Sebastian
now rarely experiences symptoms
of asthma, and will revisit his GP in
a few months for further review and
assessment of his symptoms.
Sebastian’s GP also provided him with
an asthma action plan; this enables
Sebastian to recognise when his
symptoms are getting worse, when to
start his prescribed treatment, and when
he should seek medical attention.
Sebastian thanks you for your assistance,
and is happy to inform you that he will
be participating in the charity fun run in
a few weeks.
You provide Sebastian with some
additional patient information resources:
• PSA Self Care Fact Card – Asthma
• National Asthma Council website:
• Asthma Australia website: www.
KEY LEARNING POINTS
• Patients often present to the
pharmacy with a cough, and it is
imperative that the pharmacist is
able to collect relevant information
in order to provide treatment, or refer
for further investigation.
• Symptoms of asthma include
breathlessness, chest tightness,
wheeze and cough.
• There is a link between cigarette
smoking and asthma severity and
• Treatment of asthma in patients
who are cigarette smokers should
commence with smoking cessation,
followed by a step-wise approach to
• The provision of patient information
resources, counselling and support
can assist patients with both smoking
cessation and asthma therapy.
1. Bredenoord A, Padolfino J, Smout A. Gastro-oesophageal
reflux disease. Lancet 2013;381:1933−42.
2. Kunsch S, Gross V, Neesse A, et al. Combined lung-sound
and reflux-monitoring: a pilot study of a novel approach
to detect nocturnal respiratory symptoms in gastro-
oesophageal reflux disease. Aliment Pharmacol Ther
3. Fireman P. Symposium: understanding asthma
pathophysiology. Allergy and Asthma Proc.
4. Allan G, Arroll B. Prevention and treatment of the
common cold: making sense of the evidence. CMAJ.
5. Rothberg M, He S, Rose D. Management of influenza
symptoms in healthy adults. JGIM 2003;18(10):808−15.
6. Monto A, Gravenstein S, Elliot M, et al. Clinical signs and
symptoms predicting influenza infection. Arch Intern Med
7. Rutter P, Newby D. Community pharmacy. Symptoms,
diagnosis and treatment. 2nd edn. Sydney: Churchill
8. Pharmaceutical Society of Australia. Non-prescription
medicines in the pharmacy – a guide to advice and treatment.
Canberra: Pharmaceutical Society of Australia; 2012.
9. Bird J, Biggs T, Thomas M, et al. Adult acute rhinosinusitis.
BMJ 2013;346:38−9 .
10. Lodge C, Allen K, Lowe A, et al. Overview of the
evidence in prevention and aetiology of food allergy:
a review of systematic reviews. Int J Res Pubic Health
11. Mucci T, Govindaraj S, Tversky J. Allergic rhinitis. Mt Sinai J
Med 2011;78:634−44 .
12. Uzzaman A, Story R. Allergic rhinitis. Allergy Asthma Proc
13. Camelo-Nunes I, Sole D. Allergic rhinitis: indicators of quality
of life. J Bras Pneumol 2010;36(1):124−33 .
14. Currie G, Baker J. Asthma. Oxford: Oxford University Press; 2012.
15. Jindal S, Gupta D. The relationship between tobacco smoke
and bronchial asthma. Indian J Med Res 2004;120:443−53.
16. Piipari R, Jaakola J, Jaakkola N, et al. Smoking and asthma in
adults. Eur Respir J. 2004;24:734−9 .
17. Chauduri R, McSharry C, McCoard A, et al. Role of symptoms
and lung function in determining asthma control in
smokers with asthma. Allergy 2008;63:132−5 .
18. Rigotti N. Smoking cessation in patients with respiratory
disease: existing treatments and future directions. Lancet
Respir Med 2013;1:241−50.
19. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook; 2014.
20. Respiratory Expert Group. Therapeutic guidelines: respiratory.
Version 4. Melbourne: Therapeutic Guidelines; 2009.
21. Price D, Dutchman D, Mawson A, et al. Early asthma control
and maintenance with eformoterol following reduction of
inhaled corticosteroid dose. Thorax. 2002;57:791−8 .
22. Reddell H. Rational prescribing for ongoing management of
asthma in adults. Aust Prescr 2012; 35(2):43–6 .
a) Is a chronic inflammatory condition of
b) Is not affected by cigarette smoke.
c) Is almost always associated with hay
fever and atopic dermatitis.
d) Can be treated with long-acting beta2
2. The pathophysiology of asthma
a) Bronchial muscle weakness.
b) Cell dysplasia.
c) Reduced bronchial responsiveness.
d) Airway remodelling.
3. Patients who experience wheeze
may be suffering from:
a) Food allergies.
b) Acute rhinosinusitis.
c) Common cold.
d) Hay fever.
4. Food allergies:
a) Usually develop in adulthood.
b) Are caused by an immunoglobulin-A-
c) Can cause symptoms such as colic and
d) Are not related to the development of
hay fever or asthma.
a) Is caused by a variety of factors
including rapid stomach emptying.
b) Can be associated with respiratory
symptoms such as asthma.
c) Is not likely to be associated with
symptoms of a cough.
d) Causes reduced airway responsiveness
due to acid reflux.
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