Pathophysiology of Asthma Medications for Asthma GINA’s recommendation Mechanism of action? Short and Long acting anticholinergic Comparative Study, Clinical outcomes Current Role of Long-Anticholinergic in asthma?
TYPICAL SYMPTOMS OF ASTHMA More than 1 symptom Symptoms often worse at night or in early morning. Symptoms vary over time and in intensity. Can triggered by viral infections, exercise, allergen exposure and other More than 1 symptom Symptoms often worse at night or in early morning. Symptoms vary over time and in intensity. Can triggered by viral infections, exercise, allergen exposure and other
STEP 4 * Two or more controllers plus as- needed reliever medication Preferred option (adults/adolescents): -combination low dose ICS/formoterol as maintenance and reliever treatment, -OR combination medium dose ICS/LABA plus as-needed SABA Tiotropium (long-acting muscarinic antagonist) by mist inhaler may be used as add-on therapy for adult or adolescent patients with a history of exacerbations (Evidence A);180 it is not indicated in children
* Higher level care and/or add-on treatment Preferred option: referral for specialist investigation and consideration of add-on treatment -Add-on tiotropium (long-acting muscarinic antagonist) in patients aged ≥12 years with a history of exacerbations despite Step 4 treatment. Add-on tiotropium by mist inhaler improves lung function and increases the time to severe exacerbation (Evidence B). STEP 5
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