What is step 1 of the adult asthma management plan?
salbutamol (SABA) PRN - intermittent asthma
What is step 2 of the adult asthma management plan?
low dose ICS (e.g. beclometasone or budesonide)
What is step 3 of the adult asthma management plan?
Add on LABA (e.g. salmeterol)
What is step 4 of the adult asthma management plan?
No response to LABA: Increase ICS
If benefit from LABA but control still inadequate – continue LABA and increase ICS to medium dose
If benefit from LABA but control still inadequate - continue LABA and ICS and consider trial of other therapy - LTRA (montelukast), SR theophylline, LAMA (tiotropium bromide)
What is step 5 of the adult asthma management plan?
Increase ICS to high dose
OR Addition of a fourth drug, eg LTRA,
SR theophylline, beta agonist tablet (e.g. albutarol), LAMA
REFER TO SPECIALIST
What is step 6 of the adult asthma management plan?
Use daily steroid tablet in the lowest dose providing adequate control
maintain high dose ICS
Consider other treatments to minimize use of steroid tablets
REFER TO SPECIALIST
When should someone be moved up a step in asthma management?
If they are using their salbutamol inhaler 3 or more times a week
If an asthmatic patient has IgE (allergic type) asthma, what drug can be given?
Omalizumab
What is steps of the adult asthma management plan needs referral to a specialist?
5 + 6
What is step 1 of the child asthma management plan?
SABA
What is step 2 of the child asthma management plan?
> 5: very low dose ICS (paeds dose)
<5: LTRA
What is step 3 of the child asthma management plan?
ICS +
> 5: LABA (salmeterol)
<5: LTRA
What is step 4 of the child asthma management plan?
No response to LABA/LTRA - stop LABA/LTRA and increase dose of ICS to low dose
If benefit from LABA/LTRA but control still inadequate – continue LABA and increase ICS to low dose
If benefit from LABA but control still inadequate - continue LABA and ICS and consider trial of other therapy - LTRA
What is step 5 of the child asthma management plan?
Increase ICS to medium dose
OR Addition of a fourth drug – SR theophylline.
REFER TO SPECIALIST
What is step 6 of the child asthma management plan?
Use daily steroid tablet in the lowest dose providing adequate control
Maintain medium-dose ICS
Consider other treatments to minimize use of steroid tablets
REFER TO SPECIALIST