Pharmacology - Respiratory

Question 1

What is the first step of the BTS asthma management ladder for diagnosed asthma?

Answer 1

Low dose ICS such as beclomethasone plus a SABA as required (move up if required 3+ times a week)

Question 2

What is the second step of the BTS asthma management ladder for diagnosed asthma?

Answer 2

Add a LABA to a low dose ICS inhaler - usually given as a combined inhaler. Plus a SABA as required (move up if required 3+ times a week)

Question 3

What is the third step of the BTS asthma management ladder for diagnosed asthma?

Answer 3

If there was no response to the LABA then stop it and increase ICS dose. If benefit from LABA but still inadequate control then increase ICS to medium dose and keep LABA or consider trial of luekotrine receptor antagonist such as montelukast. Plus a SABA as required (move up if required 3+ times a week)

Question 4

What is the fourth step of the BTS asthma management ladder for diagnosed asthma?

Answer 4

Increase ICS dose to medium/high. Add another treatment such as LTRA if haven’t already, theophylline, oral beta agonist. Refer to specialist care.

Question 5

What is the firth step of the BTS asthma management ladder for diagnosed asthma?

Answer 5

lowest possible daily oral steroids. high dose ICS. refer to specialist care