Asthma treatment strategy guidelines for medication
TREATING asthma requires a step-by-step approach in order to provide the correct medication. In general,,therapy is initiated at a higher level to establish prompt control and is then “stepped down” to reduce the risk of adverse effects of medication. This “step therapy” also ensures that medication will be given in the proper dosage and that unnecessary medication will not be given. To prescribe the correct asthma medication, a physician must grade patients according to the severity of their condition. This chapter will define asthma in terms of its severity and proposes a strategy for treatment based on degree of severity.
Adult Asthma: Mild, Moderate, and serve
with assisted respiration, and often have night attacks. Peak flow measurements are less than 60 percent of normal. Steroid-dependent asthmatics form a subgroup of these severe patients. These patients are never with-out oral corticosteroids due to almost continuous symptoms.
Use Severity Definitions Cautiously
These severity definitions are helpful but should not be employed rigidly. It should be emphasized that patients at any level may experience severe, life-threatening asthmatic attacks. These severe attacks may occur suddenly after long symptom-free periods with normal lung function. Patients with allergic or extrinsic asthma treatment may only be symptomatic during certain seasons depending on the amount of pollen to which they are exposed. Some allergic patients experience symptoms only when exposed to certain allergens such as cat dander; others may display symptoms only during an upper respiratory tract infection such as a sore throat or sinus infection. A few patients will be symptomatic only after exercise. All these patients could also be defined as mild asthmatics even though their attacks may sometimes be severe. lb be sure, asthma severity varies from patient to patient and strict definitions are not easily applied.
Strategy for asthma Treatment: Step Therapy
All patients should have a strategy for asthma treatment that they have discussed and agreed to after consulting with their physician. It is best that these instructions be in writing for easy reference and that close communication (aided by peak flow measurements) be maintained with the physician. Often the details of a “strategy” will be revised. No treatment plan should ever be regarded as final, since there are frequent variations in asthma as well as new medications that become available. Treatment is best given in a “step-by-step” fashion, avoiding simultaneous administration of several new agents, so the physician and patient can more accurately determine what treatment is most effective.