cough-variant asthma - Kelkar - World Allergy Organization

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Stepwise Approach for Managing Asthmain Children Aged 0 to 4 YearsIntermittentPersistent Asthma: Daily MedicationStep 1Preferred:SABA prnStep 2Preferred:Low-Dose ICSAlternative:MontelukastorCromolynStep 3Preferred:Medium-Dose ICSStep 4Preferred:Medium-DoseICSand eitherMontelukastorLABAStep 5Preferred:High-DoseICSand eitherMontelukastorLABAStep 6Preferred:High-Dose ICSand eitherMontelukastorLABAandOralCorticosteroidsStep Up ifNeeded(first, checkadherence andenvironmentalcontrol)AssessControlStep Down ifPossible(and asthma iswell controlledat least 3months)Patient Education and Environmental Control at Each StepICS = inhaled corticosteroid; LABA = long-acting β 2-agonist; SABA = short-acting β 2-agonist.Adapted from http://www.nhlbi.nih.gov/guidelines/asthma/epr3/resource.pdf. Accessed February 5, 2007.
Stepwise Approach for Managing Asthmain Children Aged 5 to 11 YearsIntermittentPersistent Asthma: Daily MedicationStep 1Preferred:SABA prnStep 2Preferred:Low-Dose ICSAlternative:LTRA,Cromolyn,Nedocromil,orTheophyllineStep 3Preferred:Medium-DoseICSorLow-Dose ICSand eitherLABA, LTRA,orTheophyllineStep 4Preferred:Medium-DoseICS + LABAAlternative:Medium-DoseICSand eitherLTRAorTheophyllineStep 5Preferred:High-DoseICS + LABAAlternative:High-DoseICSand eitherLTRA orTheophyllineandOmalizumabMay BeConsideredFor PatientsWho HaveAllergiesStep 6Preferred:High-Dose ICS+ LABA + OralCorticosteroidAlternative:High-Dose ICSand eitherLTRA orTheophylline +OralCorticosteroidandOmalizumabMay BeConsidered ForPatients WhoHave AllergiesStep Up ifNeeded(first, checkadherence andenvironmentalcontrol)AssessControlStep Down ifPossible(and asthma iswell controlledat least 3months)Patient Education and Environmental Control at Each StepLTRA = leukotriene receptor antagonist.Adapted from http://www.nhlbi.nih.gov/guidelines/asthma/epr3/resource.pdf. Accessed February 5, 2007.
Page 1 and 2: Cough-variant AsthmaPramod Kelkar,
Page 4 and 5: Eosinophilic bronchitis• NAEB- No
Page 6 and 7: Exhaled Nitric Oxide/eNO• Levels
Page 8 and 9: Natural history of NAEB• In one s
Page 10 and 11: Recurrent Cough• What is the like
Page 12 and 13: Cough in an asthmatic child• Coug
Page 14 and 15: PatientDeaths(%)Pediatric Asthma De
Page 16 and 17: Key New Concepts of AsthmaManagemen
Page 18 and 19: Asthma Severity and Control: Risk D
Page 20 and 21: Asthma Severity: 5 to 11 Years*Comp
Page 22 and 23: Assessing Asthma Control inChildren
Page 24 and 25: Key Changes in AssessingAsthma Cont
Page 26 and 27: Wheezing Children: Asthma or Not?
Page 28 and 29: Early Aeroallergen Sensitization in
Page 30 and 31: Effect of Inhaled Budesonideon Infl
Page 32 and 33: Many Patients Incorrectly Perceive
Page 35 and 36: Exploring Reasons for Failureof Ast
Page 37 and 38: Asthma Action Plan until __________
Page 39 and 40: Key Questions• Are Peak Flow Mete
Page 41 and 42: Can you outgrow asthma?• 10-39% r
Page 43: Don’t forget to address• Enviro
Page 47 and 48: Inhaled Steroids Target MultipleInf
Page 49 and 50: The Risk of Asthma in Wheezing Chil
Page 51 and 52: Follow-Up• Visits every 2-6 weeks
Page 53 and 54: What can lead to “difficult-to-co
Page 55 and 56: Can diet affect respiratory system?
Page 57 and 58: Bibliography(1) Ramanuja S, Kelkar
Page 59: Thank you!Pramod Kelkar, MDFounder,

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