A primary care NP sees a child with asthma to evaluate the ...

[KimWrice]

A primary care NP sees a child with asthma to evaluate the child's response to the prescribed therapy. The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed. The child's symptoms are well controlled.
 
  The NP notes slowing of the child's linear growth on a standardized growth chart. The NP should change this child's medication regimen to a: a. combination ICS/LABA inhaler twice daily.
  b. short-acting 2-agonist (SABA) with oral corticosteroids when symptomatic.
  c. combination ipratropium/albuterol inhaler twice daily.
  d. SABA as needed plus a leukotriene modifier once daily.

Question 2

A patient asks a primary care NP whether over-the-counter drugs are safer than prescription drugs. The NP should explain that over-the-counter drugs are:
 
  a. generally safe when label information is understood and followed.
  b. safer because over-the-counter doses are lower than prescription doses of the same drug.
  c. less safe because they are not well regulated by the Food and Drug Administration (FDA).
  d. not extensively tested, so claims made by manufacturers cannot be substantiated.

[milbourne11]

Answer to Question 1

D
A leukotriene modifier may be used as an alternative to ICS for children who experience systemic side effects of the ICS. This child's symptoms are well controlled, so there is no need to step up therapy to include a LABA. Oral corticosteroids should be used only for severe exacerbations. Ipratropium and albuterol are used for severe exacerbations.

Answer to Question 2

A
Over-the-counter products have a wider margin of safety because most of these drugs have undergone rigorous testing before marketing and further refinement through years of over-the-counter use by consumers. When labels are understood and followed, over-the-counter medications are safe. Over-the-counter medications are regulated by the FDA.

[KimWrice]

Excellent

[ricroger]

TYSM