ASTHMA-MANAGEMENT SUMMARY
SUMMARY
The most effective treatment is stopping exposure to any environmental triggers; manage GORD, ABPA, OSA, stress, rhinits with intranasal steroids.
1. INTERMITTENT: Symptoms < 2 days/week => inhaled short-acting beta-2-agonist (SABA), albuterol, is the 1st choice for "rescue" treatment of an acute exacerbation.
2. MILD PERSISTENT: Symptoms 3-6 days/week => SABA + inhaled corticosteroid (ICS).
3. MODERATE PERSISTENT: Symptoms daily => low-dose ICS + LABA (salmeterol, formoterol) OR medium dose ICS.
4. SEVERE PERSISTENT: Symptoms throughout the day => medium-dose ICS + LABA (salmeterol, formoterol).
5. SEVERE PERSISTENT: Symptoms throughout the day => high-dose ICS + LABA and consider omalizumab for patients with allergies.
6. SYMPTOMS ALL NIGHT: consider short course of oral corticosteroids, step up 1-2 steps and re-evaluate in 2 weeks.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
