Asthma

Question 1

Goals for asthma treatment (2)

Answer 1

1. Reduce impairment
   - prevent sxs, reduce SABA use, maintain near normal pulmonary function, maintain normal activity levels
2. Reduce risk
   - prevent recurrent exacerbations and hospitalizations, prevent lung function loss/reduced lung growth in children, provide optimal pharmacotherapy

Question 2

Appropriate therapy for intermittent asthma (all ages)

Answer 2

SABA PRN (eg albuterol)

Question 3

Appropriate therapy for mild persistent asthma

Answer 3

Low dose ICS (+ SABA PRN for exacerbations)

Question 4

Appropriate therapy for moderate persistent asthma

Answer 4

Everyone gets a SABA PRN

0-4: Step 3 (medium-dose ICS) and consider oral corticosteroid burst

5-11 and 12+: Step 3, medium-dose ICS option preferred and consider oral corticosteroid burst

Question 5

Appropriate therapy for severe persistent asthma

Answer 5

Everyone gets a SABA PRN

0-4: Step 3 (medium-dose ICS) and consider oral corticosteroid burst

5-11: Step 3 (medium-dose ICS) or step 4 (medium dose ICS + LABA) and consider oral corticosteroid burst

12+: Step 4 (medium dose ICS + LABA) or step 5 (high dose ICS + LABA)

NOTE: asthma pts should be referred to pulmonology if step 3+ for 0-4; or step 4+ for 5 years and up