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Asthma

Asthma

General asthma evaluation and management including severity assessment and treatment plans.

Severitycontroller vs rescuetriggersspirometryaction plan

Overview

Asthma is a chronic inflammatory disease of the airways characterized by reversible airflow obstruction, airway hyperresponsiveness, and inflammation. Proper evaluation and management are essential for optimal control.

symptoms

  • Wheezing
  • Shortness of breath
  • Chest tightness
  • Cough (especially at night or early morning)
  • Difficulty breathing during exercise

severity

mild

Symptoms <2 days/week, nighttime awakenings <2/month, normal lung function between episodes

moderate

Symptoms daily, nighttime awakenings 1-2/week, lung function 60-80% of predicted

severe

Symptoms throughout the day, frequent nighttime awakenings, lung function <60% of predicted

triggers

  • Allergens (pollen, dust mites, pet dander, mold)
  • Respiratory infections
  • Exercise
  • Cold air
  • Irritants (smoke, strong odors)
  • Medications (aspirin, beta-blockers)
  • Stress and strong emotions

evaluation

history

Detailed symptom history, triggers, frequency, and impact on daily activities

physical

Lung examination, assessment for allergic conditions

spirometry

Pulmonary function testing to assess airflow obstruction and reversibility

allergy

Allergy testing to identify triggers

fe N O

Fractional exhaled nitric oxide to assess eosinophilic inflammation

treatment

controller

  • Inhaled corticosteroids (ICS) - mainstay of controller therapy
  • Long-acting beta-agonists (LABA) combined with ICS
  • Leukotriene receptor antagonists
  • Biologics for severe asthma

rescue

  • Short-acting beta-agonists (SABA) - albuterol
  • Use as needed for symptoms
  • Should not be needed more than 2x/week if well-controlled

action Plan

Every patient should have a written asthma action plan with clear instructions for daily management, recognizing worsening symptoms, and when to seek emergency care.

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