Tezepelumab in Adults with Uncontrolled Asthma - Annualized Rate of Asthma Exacerbations

Rate of Survival and the Risk of Death at 90 Days, According to Subgroup #EBM #PCC #ADRENAL #glucocorticoid #SepticShock #NEJM

Consensus diagnostic criteria for asthma-COPD overlap syndrome (ACOS) in patients with airflow limitation. COPD=chronic obstructive pulmonary disease; CT=computed tomography; FeNO=fractional exhaled nitric oxide; FEV1=forced expiratory volume in 1 s; FVC=forced vital capacity; LLN=lower limit of normal #Diagnosis #PCC #IM #ACOS #AsthmaCOPD #OverlapSyndrome #Asthma #COPD #Criteria #BMJ

Assessment and Treatment of Severe Asthma, According to Inflammatory Phenotypes, in Patients without a Response to Core Multidisciplinary Management. Eligibility for omalizumab includes an IgE level of at least 30 IU per milliliter and evidence of reactivity to at least one perennial aeroallergen. #Management #PCC #Asthma #Severe #Algorithm #Phenotypes #NEJM

Features Associated with Pathobiologic Characteristics of Severe Asthma, According to Phenotype. #Diagnosis #PCC #Asthma #Severe #Phenotypes #Feature #Eosinophilic #Neutrophilic #Paucigranulocytic #Hyperresponsive #Fixed #NEJM

An Integrated Multidisciplinary Approach to Assessment and Initial Management of Difficult-to-Treat and Severe Asthma in Adults. MART (maintenance and quick-relief therapy) involves a low-dose inhaled glucocorticoid and formoterol as the patient’s regular therapy and as quick-relief therapy. This regimen reduces exacerbations and allows the use of lower doses of inhaled glucocorticoids #Management #PCC #Asthma #Severe #Algorithm #Multidisciplinary #DifficultToTreat #Assessment #NEJM

Neurally adjusted ventilatory assist as an alternative to pressure support ventilation in adults - This randomised controlled multi-centre trial failed to demonstrate that NAVA can increase the probability of remaining in a partial ventilator mode in intubated patients recovering from acute respiratory failure #EBM #PCC #NAVA #Neurally #Adjusted #Ventilation

Fremanezumab for the Preventive Treatment of Chronic Migraine - Adverse Events in the Safety Population, According to Trial Group #EBM #Neuro #IM #Fremanezumab #Migraine #CGRP #CalcitoninGeneRelatedPeptideAntibody #AdverseEvents #NEJM #NEJM

Asthma Assessment Tools - Is your patients asthma controlled? - Asthma Control Test (ACT) - GINA Symptom Control Assessment As with many conditions, a primary starting point is to assess the level of control. For asthma we have a variety of tools/methods of determining if a patients asthma is controlled. The first is the ACT, which is a 5 question survey. If the patients answers results in a score of 19 or less, this indicates its uncontrolled. The GINA 2019 guidelines recommend asking these 4 listed questions, and how many the patient answers "yes" to will determine if their asthma is uncontrolled. The last method is more of a rule-of-thumb but is a great screening tool from the pharmacy perspective. If a patient receives more than 2 rescue inhalers per year, their asthma is uncontrolled. This is because a normal albuterol inhaler carries 200 puffs, so if patients are using 2 full inhalers per year, the frequency in which they are using it indicates uncontrolled asthma. Jarred Prudencio, PharmD - https://www.instagram.com/ambcarerx #Asthma #Assessment #Tools #Diagnosis #ACT #GINA

Stepwise approach for managing asthma in youths greater than 12 years of age and adults as recommended by the Expert Panel 3 of the National Asthma Education and Prevention Program(4) Therapy should be increased to the next step if symptoms are not well controlled or poorly controlled, as indicated by the use of short-acting β2-agonists or the presence of asthma symptoms more than 2 days per week, nighttime awakenings due to asthma symptoms at least once per week, some interference with normal activities, or a reduction in FEV1 or peak flow below 80% of predicted or personal best. Allergen immunotherapy may be considered for patients at steps 2 – 4, especially those with single allergies to house-dust mites, animal danders or pollens. Health care providers should be prepared to identify and treat anaphylaxis that can be associated with immunotherapy and omalizumab. All patients should receive education, environmental control and management of co-morbidities. If asthma is well controlled for at least 3 months, then therapy should be decreased downward to the next step. Abbreviations are as follows: ICS (inhaled corticosteroids), LABA (long-acting β2-agonists), LTRA (leukotriene receptor antagonists), and SABA (short-acting β2-agonists). Ann Intern Med. 2010 Feb 16;152(4):232-7 #Management #Asthma #Stepup #Therapy #LABA #ICS #Corticosteroid

Intravascular Complications of Central Venous Catheterization by Insertion Site Complications in the Three-Choice Comparison, According to Insertion-Site Group. #EBM #RCT #Central #Venous #Catheters #CVC #Lines #Rates #Complications #Locations #Sites #Infections #Selection #NEJM