Respiratory Quiz - Module 7

Intermittent asthma requires only reliever therapy and environmental control, whereas persistent asthma requires regular controller therapy.

More severe asthma should commence therapy on more treatment than less severe asthma            

Treatment of mild persistent asthma (step 2 therapy) is a choice between a low dose inhaled steroid and a leukotriene receptor antagonist

Moderate persistent asthma should be started on step 3 therapy, comprising either medium dose inhaled steroids, medium dose inhaled steroids PLUS a long acting beta 2 agonist, or medium dose inhaled steroids PLUS a leukotriene receptor antagonist

Long acting beta 2 agonists can be used on their own

A child under the age of 5 who is already on medium dose inhaled steroids (with good adherence and technique) and who is still not controlled, should have a long acting beta 2 agonist added to their therapy

People with asthma should be reviewed every year to assess their control

Children with asthma will always have some symptoms, so they must limit their activity and not exercise.

Assessment of control relies on asking 5 questions regarding daytime symptoms, nighttime symptoms, symptoms limiting activity, use of reliever medication and missed days of work/school; all in the last week.  

A child who uses his reliever medication during the day three times in the last month may still be well controlled

A child who uses his reliever medication during the night three times in the last month may still be well controlled

A child who uses his reliever medication during the day three times in the last week may still be well controlled

Patients with uncontrolled asthma need more medication  

Where asthma is uncontrolled despite good adherence and technique, treatment may be stepped up by one step.

If asthma is controlled for at least 1 month consider stepping down therapy.