Advanced Pharmacology – Module
7 Asthma Diagnosis & Stepwise
Treatment Study Guide Complete
Questions Provided with A+
Graded Rationales Latest Updated
2026
How to diagnose asthma?
1. History of variable respiratory symptoms (more than 1 type)
- symptoms occur variably over time and vary in intensity.
- symptoms often occur or are worse at night or on waking.
- Exercise, laughter, allergens, or cold air often trigger symptoms.
- Symptoms often occur with or worsen with viral infections.
2. Confirmed Variable Expiratory Airflow Limitation
a) Documented Airflow limitation:
- At a time when FEV1 is reduced
- confirm that FEV1/FVC is reduced (usually > 0.75 -0.80 in adults)
- Documented Excessive Variability in Lung Function.
Bronchodilator reversibility test.
Differentiates between asthma and bronchitis
Asthma if:
There is an increase in FEV1 of > 12% and > 200 mL from baseline (greater confidence if FEV1 >
15% and > 400 mL).
How do you assess Asthma?
Mild:
,- controlled with step a 1/2 treatment
- Formoterol low-dose ICS combo used as needed
Moderate
- controlled with a step 3/4 treatment.
- A low or medium-dose ICS-LABA combo
Severe
- controlled with a step 4 or greater treatment.
- an ICS LAMA or…
- a a high-dose ICS-LABA combo.
Short-Term Goals of Asthma Treatment
Achieve good symptom control & minimize risk of asthma:
- related mortality
- exacerbations
- persistent airflow limitations
- side effects of treatment.
Asthma Treatment: Shared Decision Making
- inhaler skills
- adherence
- written asthma action plan
- self-monitorin of symptoms and peak flow
- regular medical review.
Asthma Action Plan
- The patient's usual asthma medications.
- When and how do you increase medications and start OCS?
- How to access medical care if symptoms fail to respond.
Asthma Treatment: Nonpharmacologic Interventions
- Smoking Cessation
- Physical activity.
- Investigation for occupational asthma.
- Identify aspirin-exacerbated respiratory disease.
----> DO NOT PRESCRIBE NSAIDS <-----
, Is SABA Only treament recommended for the treatment of Asthma?
NO
- Short-term use is associated with adverse eXects.
- Long-term use is associated with adverse clinical outcomes
GINA Diagnostic Flow Chart
ASTHMA TREATMENT: Stepwise approach for asthma treatment for adolescents (>12
years) and adults
Formoterol is short-acting. It can act as a maintenance or reliever treatment.
MART = Maintenance And Reliever Therapy
Track 1 = Preferred (reliever = formoterol)
Track 2 = Alternative (old program) (reliever = SABA)
Step 1:
-Track 1: as needed, Low-dose ICS-formoterol
-Track 2: low-dose ICS taken when SABA is taken.
Step 2:
-Track 1: Low-dose ICS-formoterol as needed
-Track 2: low-dose maintenance ICS.
Step 3:
-Track 1: Low-dose maintenance ICS/formoterol
-Track 2: low-dose ICS-LABA.
Step 4:
-Track 1: Medium dose maintenance ICS-formoterol
-Track 2: medium/high dose ICS-LABA.
Step 5:
-Track 1: Add on LAMA and referral to a specialist for phenotyping (i.e., anti-IgE, anti-IL5/5R, and
anti-IL4R);
-Consider high-dose ICS-formoterol (Monoclonal Ab)
7 Asthma Diagnosis & Stepwise
Treatment Study Guide Complete
Questions Provided with A+
Graded Rationales Latest Updated
2026
How to diagnose asthma?
1. History of variable respiratory symptoms (more than 1 type)
- symptoms occur variably over time and vary in intensity.
- symptoms often occur or are worse at night or on waking.
- Exercise, laughter, allergens, or cold air often trigger symptoms.
- Symptoms often occur with or worsen with viral infections.
2. Confirmed Variable Expiratory Airflow Limitation
a) Documented Airflow limitation:
- At a time when FEV1 is reduced
- confirm that FEV1/FVC is reduced (usually > 0.75 -0.80 in adults)
- Documented Excessive Variability in Lung Function.
Bronchodilator reversibility test.
Differentiates between asthma and bronchitis
Asthma if:
There is an increase in FEV1 of > 12% and > 200 mL from baseline (greater confidence if FEV1 >
15% and > 400 mL).
How do you assess Asthma?
Mild:
,- controlled with step a 1/2 treatment
- Formoterol low-dose ICS combo used as needed
Moderate
- controlled with a step 3/4 treatment.
- A low or medium-dose ICS-LABA combo
Severe
- controlled with a step 4 or greater treatment.
- an ICS LAMA or…
- a a high-dose ICS-LABA combo.
Short-Term Goals of Asthma Treatment
Achieve good symptom control & minimize risk of asthma:
- related mortality
- exacerbations
- persistent airflow limitations
- side effects of treatment.
Asthma Treatment: Shared Decision Making
- inhaler skills
- adherence
- written asthma action plan
- self-monitorin of symptoms and peak flow
- regular medical review.
Asthma Action Plan
- The patient's usual asthma medications.
- When and how do you increase medications and start OCS?
- How to access medical care if symptoms fail to respond.
Asthma Treatment: Nonpharmacologic Interventions
- Smoking Cessation
- Physical activity.
- Investigation for occupational asthma.
- Identify aspirin-exacerbated respiratory disease.
----> DO NOT PRESCRIBE NSAIDS <-----
, Is SABA Only treament recommended for the treatment of Asthma?
NO
- Short-term use is associated with adverse eXects.
- Long-term use is associated with adverse clinical outcomes
GINA Diagnostic Flow Chart
ASTHMA TREATMENT: Stepwise approach for asthma treatment for adolescents (>12
years) and adults
Formoterol is short-acting. It can act as a maintenance or reliever treatment.
MART = Maintenance And Reliever Therapy
Track 1 = Preferred (reliever = formoterol)
Track 2 = Alternative (old program) (reliever = SABA)
Step 1:
-Track 1: as needed, Low-dose ICS-formoterol
-Track 2: low-dose ICS taken when SABA is taken.
Step 2:
-Track 1: Low-dose ICS-formoterol as needed
-Track 2: low-dose maintenance ICS.
Step 3:
-Track 1: Low-dose maintenance ICS/formoterol
-Track 2: low-dose ICS-LABA.
Step 4:
-Track 1: Medium dose maintenance ICS-formoterol
-Track 2: medium/high dose ICS-LABA.
Step 5:
-Track 1: Add on LAMA and referral to a specialist for phenotyping (i.e., anti-IgE, anti-IL5/5R, and
anti-IL4R);
-Consider high-dose ICS-formoterol (Monoclonal Ab)
