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Severe Persistent Asthma
Aka: Severe Persistent Asthma
- See Also
- Asthma
- Asthma Evaluation
- Asthma Education
- Asthma Management
- Mild Intermittent Asthma
- Mild Persistent Asthma
- Moderate Persistent Asthma
- Asthma Exacerbation
- Criteria
- Continuous Symptoms
- Interferes with sleep and activity
- Frequent exacerbations and nocturnal symptoms
- Pulmonary Function Tests
- FEV1 or PEF <60% of predicted
- PEF variability > 30%
- Management
- Rule out Other Etiologies
- Non-compliance
- Cystic Fibrosis
- Long-term daily control medication
- Inhaled Corticosteroid (High dose) and
- Long acting beta agonist Bronchodilator and
- Leukotriene Receptor Antagonist (Montelukast)
- Consider Zileuton (Zyflo)
- Consider Systemic Corticosteroids (2 mg/kg/day to 60 mg/day)
- Consider Anti-IgE Therapy (Omalizumab)
- Indicated in severe refractory (Step 5-6) Asthma with IgE levels >75
- Subcutaneous Injection every 2-4 weeks
- Other measures
- Short term rescue with beta agonist
- Asthma Education
- References
- (1997) Management of Asthma, NIH 97-4053
- (1995) Global Strategy for Asthma, NIH 95-3659
- Kalister (2001) West J Med 174:415-20
- Kemp (2001) Am Fam Physician 63(7):1341-54
- Pollart (2009) Am Fam Physician 79(9):761-7