Check adherence inhaler technique and possible interfering comorbidities Target dyspnea sx w additional tx consider switching inhaler device or molecules Implement or escalate non pharm tx Investigate and treat other causes of dyspnea Mitigate risks

By rray, 22 February, 2024
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<sup>1</sup> <b>Brief cessation counseling:</b><br>
• <b>Ask</b> tobacco users about tobacco use at every visit; use office-wide identification system.<br>
• <b>Advise</b> quitting, in a clear, strong, personalized manner.<br>
• <b>Assess</b> willingness to quit, determine when (e.g., w/in next 30 days).<br>
• <b>Assist</b> w/ quit plan, including practical counseling, exploring social support, prescribing pharm tx, educational resources.<br>
• <b>Arrange</b> f/u in person or via phone, etc.
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If on single LABA or LAMA Use LAMA LABA combo SABA SAMA combos more effective than mono tx A LABAs and LAMAs improve dyspnea reduce exac rate A LAMAs reduce exac A and hospitalizations B more than LABAs combos more effective than mono tx B nbsp nbsp LAMA
Continue short acting BD for sx rescue SAMA ipratropium MDI NEB SABA albuterol levalbuterol MDI NEB for all pts
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<b>Check adherence, inhaler technique, and possible interfering comorbidities. Target dyspnea sx w/ additional tx; consider switching inhaler device or molecules. Implement or escalate non-pharm tx. Investigate and treat other causes of dyspnea. Mitigate risks.</b>