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How do I assess the Therapy Step of an asthma patient referred to my office?
● Step1 consists of a short-acting beta2 agonist, typically salbutamol inhaled on demand for relief of asthma symptoms.
● Step 2 ADDITIONALLY comprises a low-dose of an inhaled glucocorticoid, typically budesonid.
● Step 3 is reached either by DOUBLING budesonid OR by ADDING a long-acting B2 agonist, typically formoterol.
● Step 4 obligatorily comprises formoterol and a medium (i.e. doubled original) or high (i.e. quadrupled original) dose of budesonid.
● Step 5 ADDITIONALLY comprises a minimal effective dose of a systemic glucocorticoid, typically prednisolone or methylprednisolone. The anti-IgE antibody omalizumab may be deployed in patients with severe allergic asthma who are sensitive to perennial allergens.
● In Steps 2-4 the leukotriene receptor antagonist montelukast is sometimes used instead of formoterol or, in the absence of long-acting B2 agonist treatment, instead of budenosid.
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● Step 2 ADDITIONALLY comprises a low-dose of an inhaled glucocorticoid, typically budesonid.
● Step 3 is reached either by DOUBLING budesonid OR by ADDING a long-acting B2 agonist, typically formoterol.
● Step 4 obligatorily comprises formoterol and a medium (i.e. doubled original) or high (i.e. quadrupled original) dose of budesonid.
● Step 5 ADDITIONALLY comprises a minimal effective dose of a systemic glucocorticoid, typically prednisolone or methylprednisolone. The anti-IgE antibody omalizumab may be deployed in patients with severe allergic asthma who are sensitive to perennial allergens.
● In Steps 2-4 the leukotriene receptor antagonist montelukast is sometimes used instead of formoterol or, in the absence of long-acting B2 agonist treatment, instead of budenosid.
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Karteninfo:
Autor: LWojnowski
Oberthema: Medicine
Thema: Pharmacology
Schule / Uni: University Clinical Center
Ort: Mainz
Veröffentlicht: 24.05.2013