Bij deze toets staat klinisch redeneren over, in dit geval, astma centraal. Daarom begint dit document bij het begin, de anatomie en fysiologie van astma. Hierna volgt uitleg over diagnostiek, behandeling, voorlichting en astma volgens de NHG-standaard. Dit document bevat ook de uitwerking van alle...
,Inhoud
H1. Anatomie & Fysiologie........................................................................................................4
Pathologie (M.Zelman et al,2017) & Anatomie en Fysiologie (Frederic et al, 2017)............4
JufDanielle “Astma en COPD”..............................................................................................5
H2. Samenvatting les powerpoint...............................................................................................6
Astma in het kort......................................................................................................................6
Astma aandachtspunten uit de anamnese................................................................................6
Diagnostiek..............................................................................................................................6
Behandeling.............................................................................................................................7
H3. Astma inhalatie.....................................................................................................................9
Inhalatie instructie geven.........................................................................................................9
Inhalatietechniek poederinhalatoren........................................................................................9
H4. Inhalatie medicatie...............................................................................................................9
4.1. β-Sympathicomimeticum.................................................................................................9
Salbutamol (SALB).............................................................................................................9
Terbutaline LABA(TERB)................................................................................................10
Formoterol (FORM)..........................................................................................................11
Salmeterol (SALM)...........................................................................................................12
Beclometason (BECL).......................................................................................................12
4.2. Inhalatie Corticosteroïden..............................................................................................12
Beclametason / extrafijn (BECL EF).................................................................................12
Budesonide (BUDE)..........................................................................................................13
Ciclesonide (CICL)............................................................................................................13
Fluticason ICS/LABA (FLUT)..........................................................................................13
4.3. Kortwerkende Parasympathicolyticum..........................................................................14
Ipratropium........................................................................................................................14
4.4. Langwerkende Parasympathicolyticum..........................................................................14
Tiotropium.........................................................................................................................14
Aclidinium.........................................................................................................................15
Glycopyrronium.................................................................................................................15
Umeclidinium....................................................................................................................15
Aclidinium.........................................................................................................................16
H5. Extra uitleg medicatie.........................................................................................................16
Luchtwegverwijders..............................................................................................................16
Sympathicomimetica (beta-2-antagonist)..........................................................................16
Anticholinergica................................................................................................................17
, Combinatie sympathicomimetica en anticholergica..............................................................18
Inhalatiecorticosteroïden (ICS).............................................................................................18
H5. Spirometrie.........................................................................................................................19
Tips & adviezen.....................................................................................................................19
Spirometrie algemeen............................................................................................................19
Indicaties voor spirometrie....................................................................................................19
Een astma-aanval tijdens spirometrie....................................................................................19
Uitkomstwaarden...................................................................................................................19
Spirometrie met afbeeldingen................................................................................................21
Opnieuw een samenvatting van spirometrie na filmpje........................................................22
H6. Leefstijladviezen Astma.....................................................................................................23
H7. NHG-standaard Astma bij volwassenen............................................................................26
7.1. Begrippenlijst.................................................................................................................26
7.2. Epidemiologie................................................................................................................27
7.3. Etiologie en pathofysiologie...........................................................................................27
7.4. Vormen van astma..........................................................................................................27
7.5 Richtlijn diagnostiek – Anamnese...................................................................................28
7.6 Richtlijn diagnostiek – Lichamelijk onderzoek...............................................................29
7.7 Richtlijn diagnostiek – Aanvullend onderzoek...............................................................29
7.8. Evaluatie.........................................................................................................................30
7.9. Beleid – Behandeldoel....................................................................................................31
7.9. Beleid – Voorlichting en niet-medicamenteuze adviezen..............................................32
7.10. Beleid – Zelfmanagement.............................................................................................33
7.11. Stappenplan medicamenteuze behandeling astma........................................................34
7.12. Monitoring....................................................................................................................35
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