Pulmonology Book

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Moderate Persistent Asthma

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  1. See Also
    1. Asthma Education
    2. Asthma Management
    3. Mild Intermittent Asthma
    4. Mild Persistent Asthma
    5. Severe Persistent Asthma
  2. Criteria
    1. Daily symptoms and Beta Agonist use
    2. Exacerbations affect activity
    3. Exacerbations exceed twice per week (may last days)
    4. Nocturnal symptoms more than once per week
    5. Pulmonary Function Tests
      1. FEV1 or PEF between 60-80% predicted
      2. PEF variability >30%
  3. Management
    1. Long-term
      1. Inhaled Corticosteroids (Low or Medium dose)
        1. May decrease dose once Asthma well controlled
        2. Avoid eliminating Corticosteroid completely
          1. Associated with poorer outcomes
          2. Lemanske (2001) JAMA 285:2594
      2. Long-Acting Bronchodilators (Salmeterol)
      3. Leukotriene Receptor Antagonist (Montelukast)
    2. Short-term rescue with beta agonist
    3. Asthma Education
  4. References
    1. (1997) Management of Asthma, NIH 97-4053
    2. (1995) Global Strategy for Asthma, NIH 95-3659
    3. Kalister (2001) West J Med 174:415
    4. Kemp (2001) Am Fam Physician 63(7):1341

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