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A 65 year old asthama paitent comes to opd he has also diabeties mellitus type 2 and a exacreabtion of asthama attack how should i manage the paitent Genrate a ppt

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Asthma DM OPD Management

Presentation · PPTX

What's in the 8-slide deck

SlideContent
1Title slide — Patient profile (65-yr, Asthma + T2DM, acute exacerbation)
2Initial Assessment — History, PE, objective measures (PEFR, SpO₂, BG), severity classification table
3Acute Pharmacotherapy — SABA (salbutamol), ipratropium, systemic corticosteroids, oxygen targets; corticosteroid-hyperglycaemia warning banner
4Diabetes Co-management — BG monitoring targets, drug interactions (β-agonists → BG↑, steroids → insulin resistance, metformin hold criteria), ADA long-term goals
5Step-Up Controller Therapy — NHLBI 5-step visual (Step 1 SABA PRN → Step 5 high-dose ICS+LABA+OCS) with a note for this patient
6Special Considerations — Drug cautions (avoid β-blockers, NSAIDs), inhaler technique, written action plan (Green/Yellow/Red zones), preventive vaccines
7Disposition — Discharge criteria (PEFR >70%), admission criteria (40–70%), ICU/emergency triggers
8Quick Reference Summary — 6-step flowchart for rapid recall
Key clinical points covered:
  • Corticosteroids (essential for exacerbation) cause significant hyperglycaemia — monitor BG every 2–4 h and use a sliding-scale insulin if BG >200 mg/dL
  • Hold metformin if the patient is acutely unwell or receives IV contrast
  • β-agonists themselves can transiently raise BG and lower potassium
  • PEFR >70% = safe discharge; <40% = ICU escalation
Sources: Textbook of Family Medicine 9e | NHLBI Expert Panel Report 3 | ADA Standards of Care

A 65 year old asthama paitent comes to opd he has also diabeties mellitus type 2 and a exacreabtion of asthama attack how should i manage the paitent Genrate a ppt

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Asthma DM OPD Management

Presentation · PPTX

What's inside — 8 slides

#SlideKey Content
1TitlePatient profile: 65-yr, asthma + T2DM, acute exacerbation
2Initial AssessmentHistory, PE, investigations (PEFR, SpO₂, BG, ABG), severity scale (Mild/Moderate/Severe/Life-threatening)
3Acute PharmacotherapySABA (salbutamol), ipratropium, systemic corticosteroids, oxygen — with a steroid-hyperglycaemia alert banner
4Diabetes Co-managementBG monitoring frequency, antidiabetic drug adjustments (hold metformin/SGLT2, caution with SU, use SSI), long-term ADA goals
5Stepwise Controller TherapyNHLBI EPR-3 Steps 1–5 visual, with a note recommending Step 3 start for this patient
6Special ConsiderationsDrug cautions (β-blockers, NSAIDs, ACEi, theophylline), inhaler technique, written action plan (Green/Yellow/Red zones), vaccines
7DispositionDischarge criteria (PEFR >70%), admission criteria (40–70%), ICU escalation (<40%, silent chest, DKA)
8Summary Flowchart6-step rapid-reference guide for the entire management pathway

Critical clinical pearls covered

  • Corticosteroids are essential for the exacerbation but cause marked insulin resistance — monitor BG every 2–4 h; start sliding-scale insulin if BG >200 mg/dL
  • Hold metformin if the patient is acutely unwell, eGFR <30, or IV contrast is planned
  • β-agonists (salbutamol) transiently raise BG and lower potassium — check K⁺
  • Non-selective β-blockers are contraindicated in asthma — common mistake in DM patients on carvedilol
  • Inhaled corticosteroids at standard doses do not significantly worsen glycaemic control
Sources: Textbook of Family Medicine 9e | NHLBI Expert Panel Report 3 | ADA Standards of Medical Care
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