ASHTMA

Types and treatment:

- There are four types of asthma based on severity
Mild intermittent
- Symptoms </= 2 days/week, nighttime awakenings </= 2x/month, use of beta agonist </=2
times/week,
FEV1 and FEV1/FVC normal, no limitations on daily activities
- Rx: short acting beta agonist (eg albuterol) as needed (PRN), no need of daily controller meds
Mild persistent
- Symptoms >2 days/week but less than daily, nighttime awakenings 3-4x/month, FEV1 and FEV1/FVC
normal, mild limitations of daily activities
- Rx: short acting beta agonist (eg albuterol) as needed (PRN), low dose inhaled corticosteroids as
controller med
Moderate persistent
- Symptoms daily, nighttime awakenings weekly, FEV1 60-80% predicted
- Rx: short acting beta agonist (eg albuterol) as needed (PRN) + low dose inhaled corticosteroids+ long
acting beta 2 agonists inhaler
Severe persistent
- Symptoms throughout day, frequent nighttime awakenings, FEV1 <60% predicted, extremely limited
activities
- Rx: short acting beta agonist (eg albuterol) as needed (PRN) + long acting beta 2 inhaler+ high dose
inhaled corticosteroids. Oral prednisone can also be used in cases of severe persistent asthma
Diagnosis of asthma
- PFTs/spirometry to assess bronchodilator responseno responsemethacoline challenge test
- Nocturnal or early morning peak expiratory flow rates measurement—for those with nocturnal
symptoms only
- Alternative approach: 2-4 wks treatment with inhaled glucocorticoidsimproved
conditionasthma
diagnosed