The purpose of the ARFNZ Adult Asthma Guidelines is to provide simple, practical and evidence-based recommendations for the diagnosis, assessment and management of asthma in adults in a quick reference format. A key feature of the management of adult asthma is the recognition and treatment of overlapping disorders, comorbidities, environmental and behavioural factors, recently referred to as ‘treatable traits’. Implementation of a treatable traits approach to management has the potential to form the basis of a precision medicine strategy, in which specific investigations and treatments are tailored according to the characteristics of each individual patient.
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This session will reviews the differing presentations of wheeze in children as they vary with age. The presentations to primary care of congenital disorders, bronchiolitis and asthma will be discussed and red flags will be identified. It will review the differing treatments for wheeze and asthma by age and presentation with reference to the NZ Child and Adolescent Asthma Guidelines. A number of cases will be presented to illustrate the differing features and treatment. Indications for inhaled and systemic steroids will be discussed by age. Time will be allowed for interaction and participants will be able to ask about their own cases.
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Despite higher prevalence in Māori and Pacific people most of the cases of COPD remain unrecognised and undiagnosed. A variety of inhaled medications has been introduced in the last few years but exercise remains the mainstay in improving quality of life. It is important to identify and manage exacerbations early, which is the most important predictor of mortality. There is quite low uptake of advanced care planning, which is aimed to help individuals make informed choice regarding their end of life care.
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Dyspnoea or breathlessness is a common symptom which may present as an acute or chronic symptom. Dyspnoea is most often due to pulmonary or cardiac causes. Identifying the underlying cause of this symptom is essential if effective treatment is to be instituted. Cardiac cause of dyspnoea include myocardial disease, valve disease, coronary disease, rhythm disorders, and pericardial disease.
This talk will provide tips for diagnosing cardiac causes of dyspnoea and discuss when to refer to a cardiologist.
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Asthma and gastro-oesophageal reflux are common, and have a complex interaction. Asthma and asthma medications can worsen reflux, and reflux can also be a factor in asthma and other chronic respiratory conditions. Standard treatment for reflux using drugs to reduce acid secretion or neutralise gastric contents only addresses half the problem. Non-acid reflux whilst on treatment, can also lead to symptoms and can only be detected using oesophageal pH and impedance monitoring. An overview of reflux, how to diagnose reflux and how it can lead to respiratory symptoms and management options will be presented.
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