Breaking the flare-up cycle

Clinical

AP Staff

June 5, 2000

References

Price DB, Trudo F, Voorham J, et al. Averse outcomes from initiation of systemic corticosteroids for asthma: long-term observational study. J Asthma Allergy 2018;11:193–204.
Hancock KL, Bosnic-Anticevich S, Blakey JD, et al. Characterisation of the Australian adult population living with asthma: severe – exacerbation frequency, long-term OCS use and adverse effects. Pragmat Obs Res 2022;13:43–58.
Usmani OS, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. BMC Open Respir Res 2018;19(10). Epub 2018 Jan 16. At: https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-017-0710-y
National Asthma Council Australia. Inhaler technique for people with asthma or COPD. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/information-paper/hp-inhaler-technique-for-people-with-asthma-or-copd
National Asthma Council Australia. Inhaler technique for people with asthma or COPD. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/information-paper/hp-inhaler-technique-for-people-with-asthma-or-copd
Lung Foundation Australia. How to use a Spiromax®: video. At: https://lungfoundation.com.au/resources/inhaler-device-technique-spiromax/
Lung Foundation Australia. How to use a Turbuhaler®: video. At: https://lungfoundation.com.au/resources/inhaler-device-technique-turbuhaler/
Lung Foundation Australia. How to use a Reuseable Respimat®: video. At: https://lungfoundation.com.au/resources/inhaler-device-technique-respimat-2/
Healthline. Steroids for COPD. 2025. At: www.healthline.com/health/copd/steroids#inhaled-steroids

8:30 am	Early start Morning huddle with the clinic team re who is in today, the services running, and important announcements. I calibrate spirometry software for the day. Check emails and intramails for referrals from doctors, nurses or Aboriginal health practitioners.
9.00 am	First patient of the day Review the past 2 weeks of continuous glucose monitoring, where we identified multiple early morning hypoglycemic events while using Ryzodeg twice daily. We discuss the impact of food on blood sugar levels and reflect on which foods impact this more than others. I attend the patient’s booked doctor’s appointment. This is to hand over recommended timing and dose changes to insulin to minimise hypoglycaemia as well as to collaborate to adjust medicines in line with the patient’s goals and lifestyle.
11.00 am	Asthma care A young patient with childhood history of asthma attends for spirometry complaining of experiencing increasing shortness of breath. Using the Asthma Control Test, the spirometry results demonstrate normal lung function with no change after administering a bronchodilator. We discuss her lifestyle and the symptoms, which I suspect are associated with anxiety. I hand over to the GP, who agrees with my investigations and provides the patient with a mental health care plan.
2.00 pm	Emergency support A man presents with a bag of medicines, yelling in pain, seeking analgesia and a wound dressing change post-hospital discharge for a four-toe amputation. Provided with non-PBS prescriptions for doxycycline and moxifloxacin from the hospital, he can’t afford to fill them so hasn’t started therapy. It is decided to return him to the hospital. I counsel on the importance of waiting for the hospital to dispense the medicines to ensure he gets them. I also call the hospital’s Aboriginal Liaison Officer to ask that they see the patient to ensure culturally sensitive care.
5.30 pm	Wind down End a hectic day with a pilates reformer class. Then a cup of tea and a Netflix catch-up.

8:30 am	Early start Morning huddle with the clinic team re who is in today, the services running, and important announcements. I calibrate spirometry software for the day. Check emails and intramails for referrals from doctors, nurses or Aboriginal health practitioners.
9.00 am	First patient of the day Review the past 2 weeks of continuous glucose monitoring, where we identified multiple early morning hypoglycemic events while using Ryzodeg twice daily. We discuss the impact of food on blood sugar levels and reflect on which foods impact this more than others. I attend the patient’s booked doctor’s appointment. This is to hand over recommended timing and dose changes to insulin to minimise hypoglycaemia as well as to collaborate to adjust medicines in line with the patient’s goals and lifestyle.
11.00 am	Asthma care A young patient with childhood history of asthma attends for spirometry complaining of experiencing increasing shortness of breath. Using the Asthma Control Test, the spirometry results demonstrate normal lung function with no change after administering a bronchodilator. We discuss her lifestyle and the symptoms, which I suspect are associated with anxiety. I hand over to the GP, who agrees with my investigations and provides the patient with a mental health care plan.
2.00 pm	Emergency support A man presents with a bag of medicines, yelling in pain, seeking analgesia and a wound dressing change post-hospital discharge for a four-toe amputation. Provided with non-PBS prescriptions for doxycycline and moxifloxacin from the hospital, he can’t afford to fill them so hasn’t started therapy. It is decided to return him to the hospital. I counsel on the importance of waiting for the hospital to dispense the medicines to ensure he gets them. I also call the hospital’s Aboriginal Liaison Officer to ask that they see the patient to ensure culturally sensitive care.
5.30 pm	Wind down End a hectic day with a pilates reformer class. Then a cup of tea and a Netflix catch-up.

8:30 am	Early start Morning huddle with the clinic team re who is in today, the services running, and important announcements. I calibrate spirometry software for the day. Check emails and intramails for referrals from doctors, nurses or Aboriginal health practitioners.
9.00 am	First patient of the day Review the past 2 weeks of continuous glucose monitoring, where we identified multiple early morning hypoglycemic events while using Ryzodeg twice daily. We discuss the impact of food on blood sugar levels and reflect on which foods impact this more than others. I attend the patient’s booked doctor’s appointment. This is to hand over recommended timing and dose changes to insulin to minimise hypoglycaemia as well as to collaborate to adjust medicines in line with the patient’s goals and lifestyle.
11.00 am	Asthma care A young patient with childhood history of asthma attends for spirometry complaining of experiencing increasing shortness of breath. Using the Asthma Control Test, the spirometry results demonstrate normal lung function with no change after administering a bronchodilator. We discuss her lifestyle and the symptoms, which I suspect are associated with anxiety. I hand over to the GP, who agrees with my investigations and provides the patient with a mental health care plan.
2.00 pm	Emergency support A man presents with a bag of medicines, yelling in pain, seeking analgesia and a wound dressing change post-hospital discharge for a four-toe amputation. Provided with non-PBS prescriptions for doxycycline and moxifloxacin from the hospital, he can’t afford to fill them so hasn’t started therapy. It is decided to return him to the hospital. I counsel on the importance of waiting for the hospital to dispense the medicines to ensure he gets them. I also call the hospital’s Aboriginal Liaison Officer to ask that they see the patient to ensure culturally sensitive care.
5.30 pm	Wind down End a hectic day with a pilates reformer class. Then a cup of tea and a Netflix catch-up.

8:30 am	Early start Morning huddle with the clinic team re who is in today, the services running, and important announcements. I calibrate spirometry software for the day. Check emails and intramails for referrals from doctors, nurses or Aboriginal health practitioners.
9.00 am	First patient of the day Review the past 2 weeks of continuous glucose monitoring, where we identified multiple early morning hypoglycemic events while using Ryzodeg twice daily. We discuss the impact of food on blood sugar levels and reflect on which foods impact this more than others. I attend the patient’s booked doctor’s appointment. This is to hand over recommended timing and dose changes to insulin to minimise hypoglycaemia as well as to collaborate to adjust medicines in line with the patient’s goals and lifestyle.
11.00 am	Asthma care A young patient with childhood history of asthma attends for spirometry complaining of experiencing increasing shortness of breath. Using the Asthma Control Test, the spirometry results demonstrate normal lung function with no change after administering a bronchodilator. We discuss her lifestyle and the symptoms, which I suspect are associated with anxiety. I hand over to the GP, who agrees with my investigations and provides the patient with a mental health care plan.
2.00 pm	Emergency support A man presents with a bag of medicines, yelling in pain, seeking analgesia and a wound dressing change post-hospital discharge for a four-toe amputation. Provided with non-PBS prescriptions for doxycycline and moxifloxacin from the hospital, he can’t afford to fill them so hasn’t started therapy. It is decided to return him to the hospital. I counsel on the importance of waiting for the hospital to dispense the medicines to ensure he gets them. I also call the hospital’s Aboriginal Liaison Officer to ask that they see the patient to ensure culturally sensitive care.
5.30 pm	Wind down End a hectic day with a pilates reformer class. Then a cup of tea and a Netflix catch-up.

Clinical calm under kitchen pressure

From drug compounds to unexpected ingredients

Counselling skills at the judging table

Balancing pharmacy passion with culinary ambitions

New pharmacy horizons

Expanding 24/7 access in metropolitan Adelaide

Sydney’s only hub for after-hours pharmacy support

Self-funded after-hours service in regional Victoria

PSA Victorian Pharmacist of the Year – Sara Murdock MPS

PSA Victorian Early Career Pharmacist of the Year – Dr Wejdan Shahin MPS

PSA Victorian Intern Pharmacist of the Year – Katelyn Beattie

PSA Victorian Lifetime Achievement Award – Joe Demarte FPS

PSA Victorian Pharmacist Medal – Linda Ha

Why choose pharmacy?

What’s the benefit of running GP pharmacist-led spirometry in an Aboriginal Health Service (AHS)?

What initiative are you proud of introducing?

How do you establish a culturally safe environment at the AHS?

What are the opportunities for pharmacists working in an AHS?

Clinical calm under kitchen pressure

From drug compounds to unexpected ingredients

Counselling skills at the judging table

Balancing pharmacy passion with culinary ambitions

New pharmacy horizons

Expanding 24/7 access in metropolitan Adelaide

Sydney’s only hub for after-hours pharmacy support

Self-funded after-hours service in regional Victoria

PSA Victorian Pharmacist of the Year – Sara Murdock MPS

PSA Victorian Early Career Pharmacist of the Year – Dr Wejdan Shahin MPS

PSA Victorian Intern Pharmacist of the Year – Katelyn Beattie

PSA Victorian Lifetime Achievement Award – Joe Demarte FPS

PSA Victorian Pharmacist Medal – Linda Ha

Why choose pharmacy?

What’s the benefit of running GP pharmacist-led spirometry in an Aboriginal Health Service (AHS)?

What initiative are you proud of introducing?

How do you establish a culturally safe environment at the AHS?

What are the opportunities for pharmacists working in an AHS?

Clinical calm under kitchen pressure

From drug compounds to unexpected ingredients

Counselling skills at the judging table

Balancing pharmacy passion with culinary ambitions

New pharmacy horizons

Expanding 24/7 access in metropolitan Adelaide

Sydney’s only hub for after-hours pharmacy support

Self-funded after-hours service in regional Victoria

PSA Victorian Pharmacist of the Year – Sara Murdock MPS

PSA Victorian Early Career Pharmacist of the Year – Dr Wejdan Shahin MPS

PSA Victorian Intern Pharmacist of the Year – Katelyn Beattie

PSA Victorian Lifetime Achievement Award – Joe Demarte FPS

PSA Victorian Pharmacist Medal – Linda Ha

Why choose pharmacy?

What’s the benefit of running GP pharmacist-led spirometry in an Aboriginal Health Service (AHS)?

What initiative are you proud of introducing?

How do you establish a culturally safe environment at the AHS?

What are the opportunities for pharmacists working in an AHS?

Clinical calm under kitchen pressure

From drug compounds to unexpected ingredients

Counselling skills at the judging table

Balancing pharmacy passion with culinary ambitions

New pharmacy horizons

Expanding 24/7 access in metropolitan Adelaide

Sydney’s only hub for after-hours pharmacy support

Self-funded after-hours service in regional Victoria

PSA Victorian Pharmacist of the Year – Sara Murdock MPS

PSA Victorian Early Career Pharmacist of the Year – Dr Wejdan Shahin MPS

PSA Victorian Intern Pharmacist of the Year – Katelyn Beattie

PSA Victorian Lifetime Achievement Award – Joe Demarte FPS

PSA Victorian Pharmacist Medal – Linda Ha

Why choose pharmacy?

What’s the benefit of running GP pharmacist-led spirometry in an Aboriginal Health Service (AHS)?

What initiative are you proud of introducing?

How do you establish a culturally safe environment at the AHS?

What are the opportunities for pharmacists working in an AHS?

References

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