Pulmonology Book

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Severe Persistent Asthma

Aka: Severe Persistent Asthma
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  1. See Also
    1. Asthma
    2. Asthma Evaluation
    3. Asthma Education
    4. Asthma Management
    5. Mild Intermittent Asthma
    6. Mild Persistent Asthma
    7. Moderate Persistent Asthma
    8. Asthma Exacerbation
  2. Criteria
    1. Continuous Symptoms
      1. Interferes with sleep and activity
    2. Frequent exacerbations and nocturnal symptoms
    3. Pulmonary Function Tests
      1. FEV1 or PEF <60% of predicted
      2. PEF variability > 30%
  3. Management
    1. Rule out Other Etiologies
      1. Non-compliance
      2. Cystic Fibrosis
    2. Long-term daily control medication
      1. Inhaled Corticosteroid (High dose) and
      2. Long acting beta agonist Bronchodilator and
      3. Leukotriene Receptor Antagonist (Montelukast)
      4. Consider Zileuton (Zyflo)
      5. Consider Systemic Corticosteroids (2 mg/kg/day to 60 mg/day)
      6. Consider Anti-IgE Therapy (Omalizumab)
        1. Indicated in severe refractory (Step 5-6) Asthma with IgE levels >75
        2. Subcutaneous Injection every 2-4 weeks
    3. Other measures
      1. Short term rescue with beta agonist
      2. 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 174:415-20
    4. Kemp (2001) Am Fam Physician 63(7):1341-54
    5. Pollart (2009) Am Fam Physician 79(9):761-7

Severe persistent asthma (C1960048)

Concepts Disease or Syndrome (T047)
ICD10 J45.50, J45.5
SnomedCT 426656000
English Severe persistent asthma (disorder), Severe persistent asthma, severe persistent asthma (diagnosis), severe persistent asthma, Severe persistent asthma NOS
Spanish asma persistente severa (trastorno), asma persistente severa
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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