Five-step Treatment Approach for Chronic Asthma
Treatment for chronic asthma is based on a five-step approach. The initial objective is to abolish symptoms and normalize lung function, then adjust medication appropriately in response to changes. The outline below generally describes the stepwise approach, which is often modified to suit the patient.
| Classification | Long-Term Control Medication | Quick-Relief Medication |
| Mild intermittent | None | Bronchodilator as needed, up to 3–4 times/day |
| Mild persistent | Cromolyn sodium, nedocromil, low-dose inhaled corticosteroid, possible leukotriene modifier | Bronchodilator as needed, up to 3–4 times/day |
| Moderate persistent | Medium-dose inhaled corticosteroid alone and with cromolyn sodium or nedocromil, leukotriene modifier, long-acting bronchodilator such as theophylline or long-acting beta2 agonist | Bronchodilator as needed, up to 3–4 times/day |
| Severe persistent | High-dose inhaled corticosteroids, oral corticosteroids; high-dose inhaled corticosteroids plus leukotriene modifier, plus long-acting bronchodilator, plus leukotriene modifier, plus long-acting bronchodilator | Bronchodilator as needed, up to 3–4 times/day |
| Step up or down as needed |
Physician-developed and -monitored.
Original Date of Publication: 01 Jun 2000
Reviewed by: Stanley J. Swierzewski, III, M.D.
Last Reviewed: 04 Dec 2007
Asthma, Five-Step Treatment Approach for Chronic Asthma reprinted with permission from pulmonologychannel.com
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