COVID-19 & Respiratory Tools: How to Acess, Use and Clean Inhalers, Nebulizers & More

7/9/20

Allergy'&'Asthma'Network'News COVID919%Coping%Strategies • Videos%with%Dr.%Gia%Rosenblum • Allergyasthmanetwork.org 9 News

Need%asthma%coaching%during%COVID919? • Network%has%telehealth%asthma%coaching%available • More%info%at%https://allergyasthmanetwork.org/telehealth9for9 asthma9allergies/

July%Webinar%– 7/23%– 4:00%PM • Coordinating%Allergy%Care%Through%the%Life%Span • Dr.%Kelly%Maples

More%information%at%allergyasthmanetwork.org

COVID&19)&)Respiratory)Tools: How)to)Access,)Use) and)Clean)Inhalers,)Nebulizers)&)More

Dr.$Purvi Parikh Tonya$Winders

1 7/9/20

Our$Speakers

Dr.$Purvi Parikh Tonya$Winders Clinical$Assistant$Professor$of$ President$&$CEO,$Allergy$&$Asthma$ Medicine$NYU$Langone$School$of$ Network Medicine &$Director,$Allergy$and$ Asthma$Association,$Murray$Hill President,$Global$Allergy$&$ Airways$Patient$Platform National$Spokesperson,$$$$$$$$$$ Allergy$&$Asthma$Network$

Outline

• COVID&19)Update • Respiratory)Treatments)at)Home • School)Issues)with)Respiratory)Tools • Respiratory)Care)in)the)Office)&) Hospital)Settings • Resources)to)Help)Patients)Afford) their)Medications

2 7/9/20

Current'State'of'COVID019

Tonya&Winders

3 7/9/20

Total&Confirmed& Total&New& Total&New&Cases Total&Deaths Cases Deaths US#Data#Report# 2,982,900 50,304 131,065 932

Data$as$of$7/9/20

In#the#News

• Some#states#mandating#face#masks • Lack#of#social#distancing#at#protests#likely#added# to#new#cases#of#coronavirus • Dr.#Fauci says#a#more#infectious#strain#of#the# coronavirus#may#be#emerging • New#strain#may#make#the#virus#more#transmissible#– not#all#scientists#are#in#agreement#– more#research#is# needed • "We#are#still#kneeBdeep#in#the#first#wave#of#this.#And# I#would#say,#this#would#not#be#considered#a#wave.#It# was#a#surge,#or#a#resurgence#of#infections# superimposed#upon#a#baseline” • “A#false#narrative#to#take#comfort#in#a#lower#rate#of# death#– don’t#get#yourself#into#false#complacency”

4 7/9/20

In#the#News

• FDA#is#warning#consumers#and#health#care# professionals#that#the#agency#has#seen#a# sharp#increase#in hand#sanitizer#products that# are#labeled#to#contain#ethanol#(also#known#as# ethyl#alcohol)#but#that#have#tested#positive#for# methanol#contamination. • Methanol#is#not#an#acceptable#active# ingredient#for#hand#sanitizers#and#must# not#be#used#due#to#its#toxic#effects • Trump#administration#has#begun#formal# process#to#withdraw#from#the#World#Health# Organization • COVIDI19#antibody#drug#moves#into#phase#3# trials

COVID&19)Cases)in)US)by)Date)Reported

New)Cases)by)Day 50000 45000 40000 35000 30000 25000 20000 15000 10000 5000 0

Ap ril) 3 May)1 May)8 June)1 June)8 July)6 Ap ril) 10 Ap ril) 17 Ap ril) 24 May)15 May)22 May)29 June)15 June)22 June)29 March)6 March)13 March)20 March)27 February)28 Cases

5 7/9/20

COVID&19)Information)Center)– Allergy)&)Asthma)Network)

• https://allergyasthmanetwork.org/h ealth&a&z/covid&19/ • Webinar)recordings • Patient)program)with)ATS)recording • Infographics • Fact)Sheets)and)Q)&)A’s • Managing)Pediatric)Asthma)during) COVID&19) • What)coronavirus)looks)like • State)by)State)guidance)on)reopening

Please¬e:

• This%is%a%constantly evolving%situation • Guidance&is&likely&to& change • And&change&back • And&change&again&.&.&.

6 7/9/20

Respiratory+Treatments+at+Home

Dr.$Purvi Parikh

Respiratory Tools AllergyAsthmaNetwork.org • 800.878.4403

Allergy & Asthma Network is a national nonproﬁt organization dedicated to ending needless death and sufering due to asthma, allergies and related conditions through outreach, education, advocacy and research.

Definition(of(Respiratory(Tools NEBULIZERS VALVED HOLDING CHAMBERS AND SPACERS A device attached to metered-dose inhalers that extend the mouthpiece of the inhaler, trap and Nebulizers turn liquid asthma and COPD medicine suspend particles of medication long enough to be inhaled, and help direct the medication into the into a ﬁne aerosol that can be inhaled deep into lungs where it provides maximum beneﬁt. Available with masks. the airways. They are powered by a compressed air machine and can be battery operated or plugged into an electrical outlet. Many types of nebulizers are available – some are small enough for travel and most are quiet enough for silent nights. Available with masks.

InspiraChamber® MEDICATIONS Aerochamber Plus® Flow-Vu® and Aerochamber Plus® Z STAT® • Inhalers Available in sterile, unit dose vials – no measuring or mixing necessary.

= Asthma = COPD = Generic Available • Metered(dose(inhaler((MDI) Short-acting beta2-agonists (SABA) Relaxes tight muscles in airways and offers quick relief of asthma symptoms such as coughing, wheezing and shortness of breath for 3-6 hours • AccuNeb® (albuterol sulfate) Inhalation Solution AeroVent Plus® Vortex® MicroChamber® • Dry(powdered(inhaler((DPI) • Xopenex® (levalbuterol hydrochloride) Inhalation Solution

Long-acting beta2-agonists (LABA) SPIROMETER PEAK FLOW METER Relaxes tight muscles in airways and offers lasting relief of symptoms A device (used primarily in a doctor office) A handheld device to measure a patient’s such as coughing, wheezing and shortness of breath for at least 12 hours to measure the volume and speed that Peak Expiratory Flow Rate (PEFR), the • Spacer • Brovana® (arfomoterol tartrate) Inhalation Solution air is pushed in and out of the lungs; the maximum speed you can force air out results assist in diagnosis of your lung’s large airways; PEFR may ® • Perforomist (formoterol fumarate) Inhalation Solution and measure progress indicate how well lungs are working and in treatment. signal early signs of an asthma flare. Corticosteroids Reduces and prevents inflammation of airway tissue; does not relieve • Valved Holding(Chamber sudden symptoms of coughing, wheezing or shortness of breath • Pulmicort Respules® (budesonide inhalation suspension)

Short-acting muscarinic antagonists (anticholinergics) Relieves cough, sputum production, wheeze and chest tightness • Nebulizer associated with COPD for 4-6 hours • Ipratropium Bromide Inhalation Solution Sold only as a generic IN-CHECK DIAL INSPIRATORY Long-acting muscarinic antagonists (anticholinergics) FLOW METER • A handheld device to assess inspiratory ﬂow and help Spirometry Relieves cough, sputum production, wheeze and chest tightness associated with COPD for at least 24 hours determine whether a patient is using correct inhaler technique by comparing the result and optimum result. • Lonhala® Magnair® (glycopyrrolate) Inhalation Solution Lonhala is the medicine; Magnair is the nebulizer system • FeNO • Yupelri® (revefenacin) Inhalation Solution Combination medications ASTHMA CONTROL ASTHMA ACTION PLANS ™ A personalized document put together Contains both short-acting beta2-agonist (SABA) and short-acting TEST muscarinic antagonist by doctor and patient spelling out how to A quick test that provides a numerical manage symptoms daily and what to do • DuoNeb® (ipratropium bromide and score to assess a patient’s asthma control; when they worsen. Action plans are also albuterol sulfate) Inhalation Solution discuss results with a doctor. An Asthma available for COPD. • Peak(Flow(Meters Control Test for children is also available.

™ Is: Asthma Action Plan for Home & School Mast cell stabilizer Birthdate: Asthma Control Test Severe Persistent Moderate Persistent Name: Mild Persistent 1 Intermittent . Asthma Severity: A quick test that provides a numerical score to assess asthma control. He/she has had many or severe asthma attacks/exacerbations 2 Prevents coughing, wheezing and shortness of breath caused by Recognized by the National Institutes of Health (NIH) in its 2007 asthma guidelines Clinically validated against spirometry and specialist assessment. 1. Answer each question and write the answer number in the box to the right J Green Zone Have the child take these medicines every day, even when the child feels well. : of each question. exercise, cold and dry air, or inhaled substances such as pet dander, Always use a spacer with inhalers as directed. For Patients 12 Years and Older 2. Add your answers and write your total score in the TOTAL box shown below. Controller Medicine(s): 3. Discuss your results with your doctor. SCORE pollen, dust mites or chemicals puffs every four hours as needed None of 5 Controller Medicine(s) Given in School: A little of 4 the time puffs 15 minutes before activity as needed 1. In the past 4 weeks, how much of the time did your Someasthma of keep you 3from gettingthe time as much done at work, school or at home? Rescue Medicine: Albuterol/Levalbuterol Most of 2 the time All of 1 the time Exercise Medicine: Albuterol/Levalbuterol the time • Cromolyn Sodium Inhalation Solution Begin the sick treatment plan if the child has a cough, wheeze, shortness of breath, or tight chest. Have the Yellow Zone 5 child take all of these medicines when sick. Once or twice 4 Not at all 2. During the past 4 weeks, how often have you had3 shortnessto 6 times of breath?3 a week puffs every 4 hours as needed 2 a week Sold only as a generic More than 1 Once a day Rescue Medicine: Albuterol/Levalbuterol once a day Controller Medicine(s): Continue Green Zone medicines: 3. During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness5 Once 4 Not at all Add: or pain) wake you up at night or earlier than usual in the morning? 3 or twice 2 or 3 nights 2 Once a week 4 or more 1 a week nights a week Change: If the child is in the yellow zone more than 24 hours or is getting worse, follow red zone and call the doctor right away! 5 Once a week 4 Not at all 4. During the past 4 weeks, how often have you used2 oryour 3 times rescue inhaler3 or nebulizeror less medication (such as albuterol)? If breathing is hard and fast, ribs stickingGet Helpout, trouble Now walking, talking, or sleeping. 1 or 2 times 2 per week Red Zone 3 or more 1 per day times per day puffs every Completely 5 Take rescue medicine(s) now Well 4 controlled Rescue Medicine: Albuterol/Levalbuterol ©2020 Allergy & Asthma Network 5. How would you rate your asthma control during theSomewhat past 4 weeks?3 controlled Poorly 2 controlled AL Take: Not controlled 1 controlled TOT at all If the child is not better right away, call 911 Please call the doctor any time the child is in the red zone. If your score is 19 or less, your asthma may not be under control. Be sure to talk with your doctor about your results. The answers below should not be added to your total score. These answers should be discussed with your doctor. Asthma Triggers: (List)

In the past 12 months, how many emergency department visits have you had due to asthma School Staff: Follow the Yellow and Red Zone plans for rescue medicines according to asthma symptoms. (that did not result in a hospitalization)? ______Unless otherwise noted, the only controllers to be administered in school are those listed as “given in school” in the green zone. Both the asthma provider and the parent feel that the child may carry and self-administerAsthma Provider their Signature: inhalers In the past 12 months, how many inpatient hospitalizations have you had due to asthma? ______School nurse agrees with student self-administering the inhalers Asthma Provider Printed Name and Contact Information: Date: Copyright 2002, by QualityMetric Incorporated. Expert Panel Report 3: Guidelines for the Diagnosis and Asthma Control Test is a trademark of QualityMetric Incorporated. 2. Nathan RA et al. J Allergy Clin Immunol. The Asthma Control Test is for people with asthma 12 years and older. Parent/Guardian: I give written authorization for the medications listed in the action plan to be administered in school by the nurse or other school References: 1. US Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. members as appropriate. I consent to communication between the prescribing Schoolhealth careNurse provider/clinic, Reviewed: the school nurse, the school medical advisor Management of Asthma (EPR-3 2007). NIH Item 08-4051. http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed September 10, 2007. and school-based health clinic providers necessary for asthma management and administration of this medication. 2004;113:59-65. Parent/guardian signature: Date: Please send a signed copy back to the provider listed above. Date: AAAAI-0416-085 Alpha

HM2630R0 May 2010

7 7/9/20

Your&Best&Defense&:& Keep& your&Asthma&in&Control

• Based&upon&available&information&to& date,&those&at&high6risk&for&severe& illness&from&COVID619&include: • People&with&chronic&lung&disease& or&moderate&to&severe&asthma • People&who&are& immunocompromised&including& those&on&oral&corticosteroids • People&of&any&age&with certain& underlying&medical&conditions,& particularly&if¬&well&controlled

COVID&19)Issues

• COVID&19)is)spread)through)droplets) in)the)air • Inhalers)with)spacers)contain) respiratory)droplets • Nebulizers)spread)droplets)through) the)air

• Be)sure)to)access)asthma)care • Telehealth)is)a)great)tool)during) COVID&19

8 7/9/20

Asthma'Care

• Check'in'that'you'are'on'the'right'dose • Using'the'right'technique'of'inhaled'medications • Know'when'to'call'if'you'are'having'trouble'breathing • Review'the'importance'of'taking'maintenance' medications'to'control'your'asthma • Use'your'inhaler'as'directed • Quick'relief'inhaler • Controller'medication

Nebulizers*at*Home

For*people*with*known*or*suspected*COVID=19* who*are*administering*nebulizers*at*home: • Nebulizers*should*be*used*in*a*location*that*limits* exposure*to*other*household*members • Locations*where*the*air*is*not*circulated*into*the*home* are*preferable*such*as*a*porch,*patio,*or*garage*

9 7/9/20

Cleaning%a%Nebulizer%at% Home

• Follow%the%manufacturer’s%instructions%for% cleaning%the%nebulizer%equipment • Some%suggested%guidelines%include%the%following:% • 1.%Take%apart%the%nebulizer.%Wash%all%parts% (except%tubing%and%finger%valve)%in%liquid%dish% soap%and%water.%Rinse%with%water.% • 2.%After%washing%the%nebulizer%shake%off%any% excess%water.% • 3.%Reattach%the%nebulizer%pieces%and%tubing% to%the%air%compressor%and%turn%on%the% compressor%to%dry%the%nebulizer%quickly.%

• Make%sure%the%nebulizer%is%completely%dry% before%storing%the%nebulizer.%

School&Issues&with&Respiratory&Tools

Tonya&Winders

10 7/9/20

Asthma,(COVID(&(Schools

CDC:( 1(out(of(12(children(has(asthma(— and(it’s(a(leading(cause(of(school( absenteeism,(causing(more(than(10( million(missed(days(of(school(every( year

As(symptoms(of(COVIDE19(may( overlap(with(asthma,(students( experiencing(a(cough(and(shortness( of(breath(should(not(attend(school( unless(approved(by(a(health(care( provider

Inhalers)at)School

• When)permitted)by)school)policies)or)state)laws)students) Policies should)be)allowed)to)use)their)personal)inhaler)

• All)surfaces)of)the)inhaler)should)be)cleaned)using)a)wipe)with) Cleaning 70%)alcohol)or)greater)after)each)use)and)then)allowing)to) airdry)

• Staff)administering)inhalers)should)practice)good)hand)hygiene)– either) washing)hands)for)20)seconds)with)soap)and)water)before)and)after) Administering administration.))If)soap)and)water)is)unavailable,)then)staff)should)use)a) alcoholEbased)hand)sanitizer)with)at)least)60%)alcohol)

11 7/9/20

How$to$Clean$a$Spacer/Valved Holding$Chamber

Washing$instructions$will$vary$from$one$brand$to$another,$but$these$are$the$most$common$steps:

Disassemble: Follow$instructions$for$taking$the$holding$chamber$ apart.$This$may$include$removing$the$soft$plastic$port$where$the$ inhaler$is$inserted,$the$mouthpiece$cap$and$sometimes$the$mask.$Do$ not$take$the$valve$section$apart,$unless$instructed. • TIP: Always remove$your$MDI$from$the$holding$chamber$before$washing.$MDIs$ require$a$totally$different$cleaning$procedure,$usually$without$water. Soak: Prepare$a$large$bowl$with$a$solution$of$lukewarm$water$and$ liquid$dishwashing$detergent.$(Washing$with$water$alone$causes$an$ electrostatic$charge$to$develop.2)$Soak$the$device$and$all$its$pieces$for$ 15$minutes. • TIP:$Choose$a$bowl$large$enough$for$the$chamber$to$rest$fully$in$the$water.

How$to$Clean$a$Spacer/Valved Holding$Chamber

Washing$instructions$will$vary$from$one$brand$to$another,$but$these$are$the$most$common$steps:

Rinse: Rinse$all$the$pieces$in$clean$water.

• TIP:$You$can$reduce$the$static$charge$of$non@antistatic$holding$chambers$and$spacers$ by$washing$the$device$in$a$dishwashing$liquid$solution$and$letting$it$air$ dry without rinsing,$but$this$is$not$as$effective$as$using$antistatic$materials. Air,Dry: Shake$off$excess$water,$then$place$pieces$on$a$clean,$lint@free$cloth$or$drying$ rack$to$air$dry.$Rest$the$chamber$section$on$end$(vertically),$rather$than$on$its$side. • TIP:$Do$not$towel@dry,$as$that$can$build$up$static$charge. Reassemble: When$all$the$pieces$are completely dry,$carefully$put$them$back$together$ according$to$instructions.

12 7/9/20

Stock&Albuterol&Inhalers

If&stock& Must&be&cleaned&according&to&the&manufacturer’s& inhaler& instructions& is&used: Disposable&mouthpieces&or&spacers&should&be&used&

Employ&additional&strategies&to&reduce&risk&include&using& spacers&with&one?way&valves,&and¬&allowing&the& student&to&touch&the&inhaler&(can&touch&the&spacer)&

Nebulizers*&*Peak*Flow*Meters

• During*the*COVID<19*pandemic,*asthma* treatments*using*inhalers*with*spacers*are* preferred*over*nebulizers.**Nebulizers*should*be* reserved*for*students*who*cannot*use*an*inhaler* or*do*not*have*access*to*one* • Peak*flow*meters*involve*forceful*exhalation,* which*is*not*considered*an*aerosol*generating* procedure,*though*data*is*limited,*and*it*can* produce*a*cough*in*students*with*asthma* • Both*pose*some*risk*in*the*school*setting

13 7/9/20

Cleaning(Nebulizers(at(School

• After(every(use:(rinse(the(nebulizer(cup,(mask,(or(mouthpiece(thoroughly(with( warm(water,(shake(off(excess(water(and(let(air(dry. • At(the(end(of(each(day:(the(nebulizer(cup,(mask,(or(mouthpiece(should(be( washed(with(warm(soapy(water(and(rinsed(with(clean(water,(then(laid(out(on(a( paper(towel(over(night(to(dry. • Once(a(week:(wash(with(warm(soapy(water(and(after(rinsing(thoroughly,(disinfect( with(white(vinegar.(To(use(the(vinegar(solution,(mix(1/2(cup(white(vinegar(with(1( 1/2(cups(of(water.(Soak(the(equipment(for(20(minutes(and(rinse(well(under(a( steady(stream(of(water.(Shake(off(the(excess(water(and(allow(to(air(dry(on(a( paper(towel.(Always(allow(the(equipment(to(completely(dry(before(storing(in(a( plastic,(zippered(bag. • The(nebulizer(kit,(cup,(mask,(or(mouthpiece(should(not(be(used(for(multiple( children.

Nebulizer)Administration

For)staff)administering)nebulizers)to)students)5 • Should)be)wearing)PPE)(gloves,)medical)or)surgical)facemask,)and)gloves) • Should)receive)training)on)how)to)safely)administer)treatments)and) appropriate)use)and)disposal)of)PPE) During)administration)of)nebulizers)5 • Only)the)student)and)staff)responsible)for)administering)should)be)in)the) room)and,)if)appropriate,)the)staff)member)may)leave)the)room • After)administration,)the)room)should)undergo)routine)cleaning)and) disinfecting)

14 7/9/20

Respiratory+Care+in+the+Office+&+Hospital+Settings

Dr.$Purvi Parikh

Metered&dose)Inhalers)(MDIs)

Hospitals)may)reuse)MDIs,)but)an)MDI)should)be)dedicated)to)a) single)patient)during)their)hospitalization)(or)until)medication) discontinued)

Hospitals)should)implement)a)workflow)regarding)MDI)use

If)MDIs)must)be)reused)due)to)shortage,)a)strict)sterilization)protocol) should)be)followed)

15 7/9/20

Aerosol'Generating'Procedures'(AGP)

• Per'the'CDC: • The'concern'is'for'procedures'that'may'generate'higher' concentrations'of'infectious'respiratory'aerosols.' • These'are'AGPs'known'to'create'uncontrolled'respiratory'secretions

• Open'suctioning'of'airways • NonFinvasive'ventilation'(e.g.,'BiPAP,'CPAP) • Sputum'induction • Bronchoscopy • Cardiopulmonary'resuscitation • Manual'ventilation • Endotracheal'intubation'and'extubation

AGPs

If' HCP'in'the'room'should'wear'an'N95'or'equivalent'or'higherA performed,' level'respirator,'eye'protection,'gloves,'and'a'gown. the' following' The'number'of'HCP'present'during'the'procedure'should'be' should' limited'to'only'those'essential'for'patient'care'and'procedure' occur: support.'Visitors'should'not'be'present'for'the'procedure.

AGPs'should'ideally'take'place'in'an'AIIR'(Airborne'Infection' Isolation'Room).

16 7/9/20

Environmental,Infection,Control

Dedicated(medical(equipment( • All,non3dedicated,,non3disposable,medical,equipment, should(be(used(when(caring( used,for,patient,care,should,be,cleaned,and, for(patients(with(suspected(or( disinfected,according,to,manufacturer’s,instructions, confirmed(SARS:CoV:2( and,facility,policies. infection.(

Routine(cleaning(and( disinfection(procedures(are( • Using,cleaners,and,water,to,pre3clean,surfaces,first appropriate(for(SARS:CoV:2(in( healthcare(settings,(including( • Apply,an,EPA3registered,,hospital3grade,disinfectant,to, those(patient:care(areas(in( frequently,touched,surfaces,or,objects,for,appropriate, which(aerosol(generating( contact,times,as,indicated,on,the,product’s,label) procedures(are(performed

Nebulizers?+– Guidance+seems+ unsure+.+.+.+

• We+just+talked+about+nebulizer+guidance+at+school+.+.+.+ • It+is+uncertain+whether+the+aerosols+from+some+ procedures,+including+nebulizer+administration+and+high+ flow+O2+delivery,+will+result+in+generating+infectious+ respiratory+aerosols • During+the+SARS+outbreak,+nebulizers+were+not+ associated+with+significantly+increased+transmission+risk++ of+the+virus • A+2004+study+of+SARS+was+unable+to+detect+the+presence+ of+airborne+SARS+when+a+patient+used+a+nebulizer+or+ humidifier • In+the+United+Kingdom,+guidance+on+COVIDN19+infection+ transmission+does+not+list+nebulizers+as+a+potential+ infection+risk+as+the+aerosols+come+from+the+medication,+ not+the+patient+

17 7/9/20

Spirometry*/*FeNO

Identified*as*aerosol*generating*procedures • Use*only*when*essential*for*immediate*treatment*decisions • Recommended*that*care*providers*use*appropriate*PPE*(limits*droplet* acquisition*for*staff*and*individuals) • Enhanced*cleaning*of*testing*space • Wipe*down*surfaces*with*appropriate*cleaners • Transmission*may*occur*from*asymptomatic*individuals • Increasing*levels*of*Fractional*exhaled*Nitrous*Oxide*(FeNO)*may*be* an*early*indicator*of*the*presence*of*the*coronavirus

AAAAI#&#ATS#Recommendations

Public'Health'Guidance'

If'the'patient'can'tolerate'a'meteredDdoseDinhaler,'then'they'should'be'switched'to'one' with'a'dedicated'spacer

If'nebulizer'needed,'all'health'care'workers'should'wear'appropriate'PPE,'including'face' mask'(if'respirator'not'available),'eye'protection,'gloves,'and'a'gown

Keep'door'closed'during'nebulizer'treatment

Once'nebulizer'is'set'up,'health'care'workers'should'remain'6'feet'away'or'more,'or'even' outside'the'door'

18 7/9/20

Resources(to(Help(Patients(Afford(their(Medications

Tonya&Winders

Asthma'Medications

19 7/9/20

Patient'Medication'Assistance

What'if'I'Can’t'Afford'my' Allergyasthmanetwork.org Asthma Asthma'Medication?

Allergyasthmanetwork.org'– Asthma'– What'if'I'Can’t'Afford'my'Asthma'Medication?'''OR' https://allergyasthmanetwork.org/whatCisCasthma/whatCifCiCcantCaffordCmyCasthmaCmedication/

Examples:

For$demonstration$purposes:$$We$are$not$endorsing$a$ specific$brand

Includes: • Short9acting$beta29agonist$bronchodilators • Long9acting$beta29agonist$bronchodilators • Inhaled$corticosteroids • Combination$medications • Muscarinic$antagonist$bronchodialtors • Severe$asthma$treatments

• PDE4 Inhibitors

20 7/9/20

Questions?

Please&record&your&questions&in&the&Question&box&on&your& webinar&control&panel We&will&address&as&many&questions&as&we&can

Join%us%on%July%29th at%4:00%PM%for%the%9th webinar%in% our%COVID=19%Webinar%Series%=

Back%to%School:%Considerations%for%Students% with%Asthma%in%the%Era%of%COVID=19

Dr.$Mary$Cataletto Tonya$Winders Dr.$Purvi Parikh

21 7/9/20

COVID&19)&)Respiratory)Tools: How)to)Access,) Use)and)Clean)Inhalers,)Nebulizers)&)More

Thank&you&for&listening! Get&guidelines5based&information&at& allergyasthmanetwork.org