Fostair Maintenance & Reliever Therapy (MART) for asthma

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1 Fostair Maintenance & Reliever Therapy (MART) for asthma Turnberg Building Respiratory Medicine All Rights Reserved Document for issue as handout.

2 Name: Date: Best peak flow recording in the past 2 years: Predicted peak flow: (only use predicted peak flow if best is not known) For further information please contact your specialist, general practitioner, practice nurse or pharmacist. If you wish to speak to the healthcare professional that provided this action plan the number and name are provided below. Name: Telephone number: Asthma is a common condition that causes variable symptoms. The reason for the symptoms is not always obvious but is usually triggered by an irritant to the air passages in the lungs. What symptoms or signs should I look out for? Daytime wheeze, cough, chest tightness, breathlessness or phlegm l Night-time wakening due to cough, wheeze or breathlessness l Cough or wheeze on physical exertion l Fall in the peak flow reading When will I need my Fostair metered dose inhaler? Always carry your Fostair inhaler with you. You will not know when it is needed and should always have it close to hand. What treatment should I use for prevention of these symptoms? Fostair 100/6. How may puffs should I use and how often? One puff in the morning and one puff in the evening. Don t forget to take this treatment even when you are feeling well and have no asthma symptoms. This treatment is only effective if taken regularly to prevent the symptoms of asthma. When should I use extra doses of my Fostair? When you have sudden symptoms caused by exposure to something that irritates your airways, which is likely to be slightly different for each asthmatic. When your asthma symptoms are getting much worse or you have increased symptoms for 2 days. 1 2

3 What treatment should I use for relief of these symptoms? Fostair 100/6. How may puffs should I use to relieve the symptoms? 1 extra puff, then wait 5 minutes. If the symptoms have not gone then take one more puff and repeat up to a maximum of 6 puffs. If symptoms are not relieved after six puffs then SEEK MEDICAL HELP. You can contact your GP, take yourself to the local urgent care centre or if symptoms are severe attend the local hospital Emergency Department. What is the maximum that I should take in a day? The total number of puffs in a whole day should not be more than 8. Remember to count your regular twice daily preventative doses in the total number. If you do need 8 puffs in the same day, see your GP or practice nurse for an urgent assessment of your condition. What should I use to prevent symptoms that I have during exercise? Fostair is not intended for unplanned preventative use, such as before exercise. If you do have symptoms during exercise let your doctor or nurse know and they will provide a blue reliever inhaler to use. How do I know when my asthma is stable? I can do my normal daily activity without asthma symptoms. I do not wake up at night because of my asthma symptoms. What peak flow level shows me that extra treatment is needed? If your peak flow is below... (70% of your best recording in the past 2 years or predicted value if best value is not known) you should start your rescue prednisolone tablets. Record your peak flow regularly and contact your G.P. to arrange a review and replacement of your rescue treatment. When would I consider the situation an emergency? You must consider it is an emergency situation if your chest is tight and you find it hard to breath or cannot walk or talk properly; if you have little or no improvement from 6 reliever puffs of Fostair or your peak flow is..... or below (40% of best recorded in the past 2 years or predicted value). What should I do in an emergency situation? Try not to panic. It is essential that you call an ambulance. If possible, let someone know you are unwell. Try to stay as calm as possible. Be clear in your message to the emergency services that you have asthma and need urgent medical assessment. 3 4

4 How do I control my breathing when my asthma is a problem? l Sit in a comfortable position l Let your shoulders drop and try to relax your upper chest l Place your hands on your tummy l As you breathe in, let your tummy gently rise under your hands l You will have a feeling of breathing around your waist or tummy breathing l Breathe out gently, letting the air come out naturally. Do not force it l Try making your breath out longer that your breath in l Concentrate on the action of breathing l Focus your attention on an object in the room l Breathe at your own rate and depth, slowing it down a bit at a time l Allow the muscles to relax more and more with each breath l Do not worry about breathing through your mouth or nose, do whatever feels best l Repeat this technique several times each day until you are comfortable to remember the steps when needed to help control your asthma How do I try to prevent worsening of my condition? Have a FLU jab at the beginning of the winter months every year. Your practice nurse will organise this for you upon request. Having asthma can make you prone to chest infections, which will make your asthma symptoms much worse. You should ask anyone suffering with a cold virus to use a handkerchief and wash your hands regularly. If you smoke tobacco make a determined effort to stop, as it will irritate your air passages, which could cause asthma symptoms. Help is available with stopping smoking, ask your G.P., practice nurse or call directly to the helpline outlined below. Keep as active as possible, regular exercise is essential to keep your lungs healthy. Eat a well-balanced diet with plenty of fruit and vegetables. Keep your weight within the recommended range for your height and gender. Carrying extra weight creates extra work for your lungs and may also restrict your breathing, especially in situations such as bending forwards. What should I do if I become pregnant or am breast feeding? Do not under any circumstances stop your inhaler therapy during pregnancy or breastfeeding. It is essential that you continue your regular prescribed inhalers and make sure that your practice nurse or specialist closely monitors your condition for any worsening of symptoms or improvement during the pregnancy. Your inhaler therapy is safe for you and your baby. Damage can be caused to your baby if your asthma treatment is not enough and as a result your oxygen levels drop. 5 6

5 Are there any treatments that may cause worsening of my asthma symptoms? Beta-blocker drugs used for heart problems or eye drops for glaucoma can cause severe narrowing of the airways in some patients with asthma and may also block the effects of your reliever inhaler. Therefore they are as a rule avoided in patients with asthma. However, when there is no alternative, a special heart sensitive beta-blocker drug can be given with caution and under specialist supervision. Approximately 5% of asthmatics have aspirin sensitivity that can potentially cause sudden asthma. This usually includes sensitivity to all other non-steroidal antiinflammatory drugs such as Ibrufen, however paracetamol is usually safe. Where can I find out more information about asthma? British Lung Foundation Monday to Friday 10am to 6pm) calls charged at your local rate. National Asthma Campaign Monday to Friday 9am to 5pm) org.uk British Thoracic Society Global Initiative for Asthma G.P or practice nurse Contact your surgery Specialist at your local hospital (chest doctor or nurse) The Salford Stop Smoking Service community team provides support across the Borough. You can call the hospital team on: You can call the community team on: or health.improvement@ salford.gov.uk or look on their website for more information: stopsmoking Stop smoking helpline NHS free smoking help line Notes 7 8

6 G Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2014 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: MED89(14) Review Date: November 2016 For further information on this leaflet, its references and sources used, please contact Copies of this information are available in other languages and formats upon request. If you need this interpreting please telephone In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities, to access this treatment / service. Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone If you would like to become a Foundation Trust Member please visit: for-members If you have any suggestions as to how this document could be improved in the future then please visit: for-patients