GINA Charts Flashcards
Preferred, 12+ yrs, step 1
PRN low dose ICS-formoterol
Preferred, 12+ yrs, step 2
PRN dose ICS-formoterol
Preferred, 12+ yrs, step 3
Low dose ICS-formoterol
Preferred, 12+ yrs, step 4
Medium dose ICS-formoterol
Preferred, 12+ yrs, step 5
Add on LAMA, Refer to phenotype
High dose ICS-formoterol, ± anti-IgE, ± anti-IL5/5R, ± anti-IL4R, anti-TSLP
Alternative, 12+ yrs, step 1
Take ICS whenever SABA taken
Alternative, 12+ yrs, step 2
Low dose ICS
Alternative, 12+ yrs, step 3
Low dose ICS-LABA
(Advair 100/50)
Alternative, 12+ yrs, step 4
Med/high dose ICS-LABA
(Advair 250/50 or 500/50)
Alternative, 12+ yrs, step 5
Add on LAMA, Refer to phenotype
High dose ICS-formoterol, ± anti-IgE, ± anti-IL5/5R, ± anti-IL4R, anti-TSLP
Preferred reliever for 12+
PRN low dose ICS-formoterol
Alternative reliever for 12+
PRN SABA or ICS-SABA
Other controllers options for 12+, step 2
Low dose ICS, whenever SABA taken, or QD LTRA or add HDM SLIT
Other controllers options for 12+, step 3
Medium dose ICS, or add HDM SLIT, or add LTRA
Other controllers options for 12+, step 4
Add LAMA or LTRA or HDM SLIT, or switch to high dose ICS
Other controllers options for 12+, step 5
Add azithromycin or LTRA.
Last resort OCS
Preferred, 6-11 yrs, step 1
Low ICS whenever with SABA
Preferred, 6-11 yrs, step 2
QD low ICS
Preferred, 6-11 yrs, step 3
Low dose ICS-LABA,
or Medium dose ICS,
or Very low dose ICS-formoterol MART
Preferred, 6-11 yrs, step 4
Medium dose ICS-LABA,
or Low dose ICS-formoretol MART
Refer to expert for advice
Preferred, 6-11 yrs, step 5
Refer to phenotypic assessment.
±higher dose ICS-LABA, or add-on anti-IgE, ± anti-IL5/5R, ± anti-IL4R
Alternative, 6-11 yrs, step 1
Consider QD low ICS
Alternative, 6-11 yrs, step 2
QD LRTA or low dose ICS whenever with SABA
Alternative, 6-11 yrs, step 3
Low dose ICS+LTRA
Alternative, 6-11 yrs, step 4
Low dose ICS+LTRA
Add tiotropium or add LTRA
Alternative, 6-11 yrs, step 5
low dose OCS
Reliever for 6-11 years
PRN SABA or ICS-formoterol in MART in steps 3-4
Preferred, 5> yrs, stage 1
N/A
Preferred, 5> yrs, stage 2
QD low dose ICS
Preferred, 5> yrs, stage 3
Double low dose ICS
Preferred, 5> yrs, stage 4
COntinue controller and refer to specialist
Other options, 5> yrs, stage 1
Short course ICS at onset of viral illness
Other options, 5> yrs, stage 2
QD LTRA or intermittent short course of ICS at onset of respiratory illness
Other options, 5> yrs, stage 3
Low dose ICS+LTRA
Consider specialist referral
Other options, 5> yrs, stage 4
Low dose ICS+LTRA
Add LTRA, or increase ICS frequency, or add intermittent ICS
Consideration for step 1 5> children
Infrequent viral wheezing and no/few interval symptoms
Consideration for step 2 5> children
Symptoms not consistent with asthma but wheezing requiring SABA
Consideration for step 3 5> children
Asthma diagnosis and asthma not well controlled on low dose ICS
Consideration for step 4 5> children
Asthma not well controlled on double ICS
Consideration for step 3 and 4 5> children
Before stepping up, check for alternative diagnosis check inhaler skills, and review adherence and exposures
