Guidelines for the Diagnosis and Management of Asthma

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FIGURE 11. CLASSIFYING ASTHMA SEVERITY AND INITIATING THERAPY IN CHILDREN Key: FEV 1 , forced expiratory volume in 1 second; FVC, forced vital capacity; ICS, inhaled corticosteroids; ICU, intensive care unit; N/A, not applicable Notes: ■ Level of severity is determined by both impairment and risk. Assess impairment domain by caregiver’s recall of previous 2–4 weeks. Assign severity to the most severe category in which any feature occurs. ■ Frequency and severity of exacerbations may fluctuate over time for patients in any severity category. At present, there are inadequate data to correspond frequencies of exacerbations with different levels of asthma severity. In general, more frequent and severe exacerbations (e.g., requiring urgent, unscheduled care, hospitalization, or ICU admission) indicate greater underlying disease severity. For treatment purposes, patients with ≥2 exacerbations described above may be considered the same as patients who have persistent asthma, even in the absence of impairment levels consistent with persistent asthma. 40 Guidelines for the Diagnosis and Management of Asthma
FIGURE 12. ASSESSING ASTHMA CONTROL AND ADJUSTING THERAPY IN CHILDREN Key: EIB, exercise-induced bronchospasm, FEV 1 , forced expiratory volume in 1 second; FVC, forced vital capacity; ICU, intensive care unit; N/A, not applicable Notes: ■ The level of control is based on the most severe impairment or risk category. Assess impairment domain by patient’s or caregiver’s recall of previous 2–4 weeks. Symptom assessment for longer periods should reflect a global assessment, such as whether the patient’s asthma is better or worse since the last visit. ■ At present, there are inadequate data to correspond frequencies of exacerbations with different levels of asthma control. In general, more frequent and intense exacerbations (e.g., requiring urgent, unscheduled care, hospitalization, or ICU admission) indicate poorer disease control. Managing Asthma Long Term 41
Page 1 and 2: SUMMARY REPORT 2007 National Asthma
Page 3 and 4: Contents Acknowledgments iii Prefac
Page 5 and 6: Acknowledgements National Asthma Ed
Page 7 and 8: Development of the guidelines was f
Page 9 and 10: Robert Zeiger, M.D. Kaiser Permanen
Page 11 and 12: Preface The Expert Panel Report 3 (
Page 13 and 14: Introduction More than 22 million A
Page 15 and 16: New emphasis on multifaceted approa
Page 17 and 18: Figure 1. SUMMARY OF RECOMMENDED KE
Page 19 and 20: Figure 1. SUMMARY OF RECOMMENDED KE
Page 21 and 22: Asthma Definition and Implications
Page 23 and 24: Diagnosis of Asthma To establish a
Page 25 and 26: FIGURE 3. SUGGESTED ITEMS FOR MEDIC
Page 27 and 28: Managing Asthma Long Term GOAL OF T
Page 29 and 30: FIGURE 4. SAMPLE PATIENT SELF-ASSES
Page 31 and 32: Develop an active partnership with
Page 33 and 34: FIGURE 6. SAMPLE ASTHMA ACTION PLAN
Page 35 and 36: FIGURE 7. DELIVERY OF ASTHMA EDUCAT
Page 37 and 38: these particles do not remain airbo
Page 39 and 40: Animal Dander Some people are aller
Page 41 and 42: Quick-relief medications are used t
Page 43 and 44: FIGURE 10. AEROSOL DELIVERY DEVICES
Page 45 and 46: The stepwise approach and recommend
Page 47 and 48: individual drug efficacy studies in
Page 49 and 50: of particular relevance (impairment
Page 51: ■ Albuterol is the preferred SABA
Page 55 and 56: FIGURE 14. CLASSIFYING ASTHMA SEVER
Page 57 and 58: FIGURE 16. STEPWISE APPROACH FOR MA
Page 59 and 60: FIGURE 17. USUAL DOSAGES FOR LONG-T
Page 61 and 62: FIGURE 18. ESTIMATED COMPARATIVE DA
Page 63 and 64: FIGURE 19. USUAL DOSAGES FOR QUICK-
Page 65 and 66: Managing Exacerbations Asthma exace
Page 67 and 68: FIGURE 21. MANAGEMENT OF ASTHMA EXA
Page 69 and 70: FIGURE 22. DOSAGES OF DRUGS FOR AST
Page 71 and 72: FIGURE 23a. EMERGENCY DEPARTMENT—
Page 73: For More Information The National H

Guidelines for the Diagnosis and Management of Asthma

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