Asthma Treatment Algorithm:
To successfully treat asthma, you must first classify it and then be familiar with step therapy. For this assignment and in
... [Show More] this course, we will focus on patients 12 years and older. Complete the blanks in the following table to create an algorithm for asthma care using your textbook as well as GINA guidelines.
Step
Asthma Classification
Asthma symptoms and frequency as noted in textbook Controller and Preferred Reliever:
(Drug Class and frequency if provided from GINA guidelines) Controller and Alternative Reliever:
(Drug Class and frequency if provided from GINA guidelines)
Step 1
Intermittent Daytime symptoms 2 days/week or less
Drug class: ICS-formoterol
Frequency: As needed
Drug class: ICS
Frequency: As needed
Nighttime awakenings 2 times/month or less
Step 2
Mild Persistent Daytime symptoms More than 2 days/week but less than daily
Drug class: SABA as needed
Nighttime awakenings 3-4 times/month
Step 3
Moderate Persistent Daytime symptoms Daily
Drug class: ICS-formoterol
Drug class: ICS-LABA, and a SABA as needed
Nighttime awakenings More than once/week but less than nightly
Step 4-5
Severe Persistent Daytime symptoms Several times a day Step 4:
Drug class: ICS-formoterol Drug class: ICS-LABA, and a SABA as needed
Nighttime awakenings
Often nightly Step 5:
Drug class: ICS-formoterol
No change.
Refer for: Phenotypic assessment
± anti-IgE, anti-IL5/5R, anti-IL4R
Starting treatment: Complete this section using the GINA guidelines provided.
First Assess:
1. Confirm diagnosis
2. Symptom control and modifiable risk factors, including lung function
3. Comorbidities
4. Inhaler technique and adherence
5. Patient preferences and goals
6. (There is not a 6th “first assess”)
Fill in the blank:
1. Using low-dose ICS-formoterol as a reliever reduces the risk of severe exacerbations compared with using a SABA as a reliever.
2. Before considering a regimen with a SABA reliever, check if the patient is likely to be adherent with their ICS-containing
controller therapy.
Dosing: Low, Medium, High
Low dose ICS provides most of the clinical benefit for most patients. However, ICS responsiveness varies between patients, so some patients may need medium dose ICS if asthma is uncontrolled despite good adherence and correct inhaler technique with low dose ICS. High dose ICS is needed by very few patients, and its long-term use is associated with an increased risk of local and systemic side-effects.
Adults and adolescents Inhaled corticosteroid Total daily (24 hour) ICS dose (mcg)
Low Medium High
BDP (pMDI, HFA) 200-500 >500-1000 >1000
BDP (DPI or pMDI, extrafine particle, HFA) 100-200 >200-400 >400 [Show Less]