Chronic asthma treatment

Question 1

What is step 1 of asthma treatment in patients under 5 ?

Answer 1

Start a short-acting beta-2 antagonist inhaler - salbutamol

Question 2

What is step 2 of asthma treatment in patients under 5 ?

Answer 2

Add a lose dose corticosteroid inhaler OR a leukotriene antagonist (montelukast) to the SAB2A

Question 3

What is step 3 of asthma treatment in patients under 5 ?

Answer 3

Add whichever is not already given between the low dose corticosteroid inhaler or leukotriene antagonist to the previous step + SAB2A

Question 4

What should be done if all 3 steps are failing to treat asthma in a patient under 5 ?

Answer 4

Referral to a specialist

Question 5

What is step 1 in chronic asthma treatment for children aged 5-12 ?

Answer 5

Start a short-acting beta-2 agonist inhaler

Question 6

What is step 2 in chronic asthma treatment for children aged 5-12 ?

Answer 6

Add a regular low dose corticosteroid inhaler to the SAB2A

Question 7

What is step 3 in chronic asthma treatment for children aged 5-12 ?

Answer 7

Add a long-acting beta-2 agonist inhaler (salmeterol) to the SAB2A

Question 8

What is step 4 in chronic asthma treatment for children aged 5-12 ?

Answer 8

Titrate up the corticosteroid inhaler to a medium dose and consider adding a leukotriene receptor antagonist (montelukast) or oral theophylline

Question 9

What is step 5 in chronic asthma treatment for children aged 5-12 ?

Answer 9

Increase the dose of the inhaled corticosteroid to a high dose

Question 10

What should be done if all 5 steps are failing to treat asthma in a patients aged 5-12 ?

Answer 10

Referral to a specialist - they may require daily oral steroids

Question 11

What is step 1 of asthma treatment in adults ?

Answer 11

Start a short-acting beta-2 agonist inhaler (salbutamol) as required

Question 12

What is step 2 of asthma treatment in adults ?

Answer 12

Add a regular low dose corticosteroid inhaler to the SAB2A

Question 13

What is step 3 of asthma treatment in adults ?

Answer 13

Add a long-acting beta-2 agonist inhaler (salmeterol) to the SAB2A and corticosteroid

Question 14

What is step 4 of asthma treatment in adults ?

Answer 14

Titrate up the corticosteroid inhaler to a medium dose and consider a trial of:
- leukotriene receptor antagonist
- oral theophylline
- inhaled LAMA

Question 15

What is step 5 of asthma treatment in adults ?

Answer 15

Titrate the inhaled corticosteroid up to a high dose and combine additional treatments from step 4 - can include the option of an oral B2A

Question 16

What is step 6 of asthma treatment in adults ?

Answer 16

Add oral steroids at the lowest possible dose to achieve good control under specialist guidance

Question 17

Summarise the 4 steps of asthma management in patients under 5 ?

Answer 17

1. SAB2A (salbutamol)
2. • low dose corticosteroid or leukotriene antagonist (montelukast)
3. add the other option from above
4. Refer to a specialist

Question 18

Summarise the 6 steps in asthma management in patients aged 5-12 ?

Answer 18

1. SAB2A (salbutamol)
2. • regular low dose corticosteroid inhaler
3. • LAB2A inhaler
4. Titrate up the corticosteroid inhaler to a medium dose
5. Increase the dose of inhaled corticosteroid to a high dose
6. Refer to a specialist

Question 19

Summarise the 6 steps of asthma management in adults ?

Answer 19

1. SAB2A (salbutamol)
2. • regular low dose corticosteroid inhaler
3. • LAB2A inhaler (salmeterol)
4. Titrate up corticosteroid inhaler to medium dose
5. Titrate inhaled corticosteroid up to high dose, consider combining additional treatments (leukotriene receptor antagonist, oral theophylline, inhaled LAMA)
6. Add oral steroids at lowest dose possible