Table 2: Treatment Guidelines for Asthma
Classification
Short-Term Treatment
Long-Term Treatment
Additional Treatment
Step 1:
Mild-Intermittent
  • Short-acting inhaled ß2-agonist
  • Use of rescue inhaler > 2 times per week consider long-term treatment
  • None needed
  • None needed
Step 2:
Mild-Persistent
  • Short-acting inhaled ß2-agonist
  • Use of rescue inhaler daily or increased frequency need additional long-term treatment
  • Inhaled low doses of corticosteroids, cromolyn sodium (Intal®), or nedocromil (Tilade®)
  • Sustained-release theophylline, zafirlukast (Accolate®) or zileuton (Zyflo®)

 
  • None needed
Step 3:
Moderate-Persistent
  • Short-acting inhaled ß2-agonist
  • Use of rescue inhaler daily or increased frequency need additional long-term treatment
  • Inhaled medium dose corticosteroids OR
  • Inhaled low-medium dose corticosteroids plus long-acting inhaled ß2-agonist
  • Medium-high dose inhaled corticosteroids AND
  • Long-acting inhaled ß2-agonist, sustained-release theophylline, or long-acting ß2-agonist tablets
Step 4:
Severe-Persistent
  • Short-acting inhaled ß2-agonist
  • Use of rescue inhaler daily or increased frequency need additional long-term treatment
  • High dose inhaled corticosteroid AND
  • Long-acting inhaled ß2-agonist, sustained-release theophylline, or long-acting ß2-agonist tablets
  • Long-term oral corticosteroids
Adapted from: National Asthma Education and Prevention Program. Expert Panel Report 2: Guidelines for the diagnosis and management of asthma. NIH 1997;97-405:iii-86.
Kelly HW, Sorkness CA. Asthma In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, et al. editors. Pharmacology: A Pathophysiologic Approach 5th ed. New York: McGraw-Hill; 2002. p. 475-510.

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