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.